2021 Veterans Day Q&A with U.S. Secretary of Veterans Affairs, Denis McDonough

VA is aware of the interest in the potential of hyperbaric oxygen therapy for treating PTSD and TBI. Despite the interest, though, the evidence is far from definitive. VA and the Department of Defense collaborate to review evidence and produce practice guidelines to promote care for Veterans and Service members. According to the PTSD guideline, the evidence is insufficient for determining effectiveness for PTSD. According to the TBI guideline, there is a strong recommendation to not use hyperbaric oxygen therapy for mild TBI. VA will continue to monitor the evidence as it emerges and revise its guidance according to what the evidence tells us. Analysis of all available research on hyperbaric oxygen therapy (HBOT) has shown this intervention to only be as effective as placebo for the treatment of TBI, PTSD, and depression.  VA continually reviews emerging research findings to update it's clinical practice guidelines and promote utilization of treatments with the strongest scientific evidence base. 

The contract vendors release all compensation and pension (C&P) exam results directly to the Veterans Benefits Administration. At this time, there is no centralized portal for Veterans to obtain copies of their C&P exam. Veterans or Service members can obtain C&P exam results by submitting a Privacy Act request to VA. An electronic request may be emailed to [login to see] , utilizing VA Form 20-10206.

VA would like all Veterans to have access to good oral health care; however, VA is limited to providing dental benefits to those Veterans who meet specific eligibility criteria as defined by statute. In order to provide dental care to a larger group of Veterans, statutes defining eligibility would need to change. VA does not have the authority to write policy that is not in accordance with statute. VA continues to explore options presented by members of the house, senate, Veteran Service Organizations, and stakeholders in the community, to expand eligibility and access to dental care for Veterans.  Veterans who are enrolled in the VA health care system and who are not eligible for VA Dental Care can enroll in the Veterans Affairs Dental Insurance Program to purchase discounted dental insurance.

VA is closely following rates of breast cancer in women Veterans.
To date, current evidence does not support a link between Gulf War I service and breast cancer based on DoD, VA, or other data. Research on women Veterans from other eras is ongoing.
Regarding active duty service women, one 2009 study (Zhu et al, Cancer Epidemiol Biomarkers Prev.2009) found a slightly higher rate of breast cancer among military personnel. It was noted this may possibly be explained by differences in the populations such as delays in age at first birth or increased use of contraceptives (which are known risk factors for breast cancer) among military personnel. Another factor may be that military personnel had more access to routine screening, resulting in more identification of early-stage breast cancers, resulting in higher measured rates.

VA offers screening mammograms, either on site at 69 VA facilities, or at convenient community locations, and exceeds the private sector in breast cancer screening rates. For women diagnosed with Breast Cancer, VA offers full-service Oncology treatment that includes imaging, surgery, chemotherapy, radiation and other advanced state of the art treatments as needed, either on site, or referred into the Community. VA patients are eligible for enrollment into clinical trials.

VA is excited to be standing up a Breast Cancer System of Excellence that will ensure availability of nationally recognized expert consultative services enterprise-wide through electronic-consultation, telehealth and a virtual tumor board, including partnership with VA and non-VA research entities.

For women receiving VA care, VA does have a Breast Care Registry that enables tracking and follow-up of breast cancer screening, diagnosis and treatment.

Fort McClellan was an Army installation in Alabama that opened in 1917.
Some members of the U.S. Army Chemical Corp School, Army Combat Development Command Chemical/Biological/Radiological Agency, Army Military Police School and Women's Army Corps, among others, may have been exposed to hazardous materials, at low levels, during service at Fort McClellan. Potential exposures could have included the following:
- Radioactive compounds (cesium-137 and cobalt-60) used in decontamination training activities in isolated locations on base.
- Chemical warfare agents (mustard gas and nerve agents) used in decontamination testing activities in isolated locations on base.
- Agent Orange was not used, stored or buried at Fort McClellan.
- Airborne polychlorinated biphenyls (PCBs) from the Monsanto plant in the neighboring town.
Although exposures to high levels of the compounds named above have been shown to cause a variety of adverse health effects in humans and laboratory animals, there is no evidence of exposures of this magnitude having occurred at Fort McClellan.
From 1929 to 1971, an off-post Monsanto chemical plant operated south of Fort McClellan in Anniston. PCBs from the plant entered into the environment, and the surrounding community was exposed.
Since the 1990s, several investigations have been conducted to characterize the exposure of Anniston residents to PCBs from the Monsanto plant. In 2015, the Agency for Toxic Substances and Disease Registry (ATSDR) published an assessment of the potential health risks caused by airborne PCBs in Anniston and concluded that the concentrations found were 'not expected to result in an increased cancer risk or other harmful health effects in people living in the neighborhoods outside the perimeter of the former PCB manufacturing facility.'
The bottom line: There are currently no adverse health conditions associated with service at Fort McClellan.

VA added asthma, rhinitis and sinusitis (to include rhinosinusitis) on a presumptive basis based on particulate matter exposures during military service in Southwest Asia and certain other areas. If you feel you have a chronic condition attributed to an in-service exposure, we highly encourage you to file a claim.

In developing claims for disability compensation that may involve special operations, VA procedures provide that a Military Records Specialist coordinates with the Department of Defense to determine whether the alleged event involving special operations occurred. The Department of the Navy has access to classified sources that it can review, other than deck logs, to assist VA in determining whether a submarine was in the offshore waters of Vietnam. These sources include, but are not limited to, commander’s operation reports, communication traffic and patrol reports.

Unfortunately, we are unable to answer questions specific to your individual claim in this forum due to privacy issues. Please contact our national call center for claim specific assistance at [login to see] for the status of your claim and so we may provide individual assistance.

VA provides wheeled mobility devices that are Food and Drug Adminsitration cleared and determined medically necessary by your clinical provider. These clinical decisions are best made in collaboration between the medical provider and the Veteran. We recommend you meet with your local provider to discuss the best option for your individualized care. If you disagree with a clinical decision, you may file a clinical appeal through your facility to have your medical case reviewed

Hypertension reached the level of "sufficient evidence of and association" based on a study of a specific cohort, the Army Chemical Corps, done by VA's Post Deployment Health Services (now Health Outcomes Military Exposures). However, hypertension is also a disease with many causes that increases with age, independent of environmental exposures. Because this is a common condition of ageing and conflicting evidence, hypertension is not currently a presumption for Agent Orange exposure. VA is currently awaiting two other studies that may shed light on possible associations between Agent Orange and hypertension. VA considers all relevant information about a condition before a recommendation is made.