Veterans' Benefits:

Independent Review Could Improve Credibility of Radiation Exposure Estimates

HEHS-00-32: Published: Jan 28, 2000. Publicly Released: Jan 28, 2000.

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Pursuant to a congressional request, GAO reviewed the Department of Defense's (DOD) use of "radiation dose reconstruction" as a tool for determining veterans' eligibility for benefits, focusing on: (1) studies that assessed the validity of dose reconstruction for estimating veterans' radiation exposure and discussing the issue with experts in the field and other knowledgeable individuals; (2) what activities are in place to oversee the dose reconstruction process; and (3) alternatives for deciding veterans' claims for compensation related to radiation exposure.

GAO noted that: (1) some veterans, veterans' organizations, and experts GAO talked with do not have confidence in the Department of Defense's (DOD) dose reconstruction program; (2) they question the completeness of DOD's data and methodology and believe the DOD's involvement in estimating radiation doses from exposure to tests for which it was responsible presents a conflict of interest; (3) however, independent studies by the National Research Council and the Institute of Medicine have validated the dose reconstruction process that DOD uses for deciding radiation claims; (4) these studies point out that DOD's reconstruction process tends to overestimate both external and internal does--an outcome that would increase the likelihood that a claim would be decided in a veteran's favor; (5) DOD conducted separate studies to determine the accuracy of dose reconstruction and found that the external radiation dose estimates obtained through reconstruction methods were about the same as the readings directly measured by film badges worn by other participants at the same tests; (6) some experts interviewed, including Health Physics Society representatives, also support the use of dose reconstruction for claims decisions; (7) although studies appear to validate DOD's dose reconstruction program for deciding claims, the agency is not providing for independent oversight of the program; (8) the Institute of Medicine has been critical of the program's lack of quality control, including the lack of a peer review process; (9) the National Research Council has also suggested that dose reconstruction be reviewed, or subjected to peer review, by outside independent scientists; (10) a VA official told GAO it was not VA's responsibility to establish a process to oversee a DOD program; (11) a DOD official explained that there had been no direct recommendation to DOD for a peer review process and the program did not include one when it was designed; (12) GAO did not identify any better alternatives available for deciding claims than dose reconstruction; (13) some suggest expanding the list of presumptive diseases as an alternative to dose reconstruction; and (14) others favor adding all human cancers to the list, but some experts, including officials at the National Cancer Institute, find little or no evidence that would link many cancers to relatively low levels of radiation, such as those levels to which most veterans were exposed.

Recommendation for Executive Action

  1. Status: Closed - Implemented

    Comments: Public Law 106-419, passed November 1, 2000, requires the Department of Defense to contract with the National Academy of Sciences to carry out periodic reviews of the dose reconstruction program.

    Recommendation: The Secretary of Defense should establish an independent review process for the dose reconstruction program under which independent verifications of a sample of individual dose reconstructions are made.

    Agency Affected: Department of Defense

 

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