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Improving the Presumptive Disability Decision-Making Process for Veterans (Paperback, New)
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Improving the Presumptive Disability Decision-Making Process for Veterans (Paperback, New)
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The United States has long recognized and honored the service and
sacrifices of its military and veterans. Veterans who have been
injured by their service (whether their injury appears during
service or afterwards) are owed appropriate health care and
disability compensation. For some medical conditions that develop
after military service, the scientific information needed to
connect the health conditions to the circumstances of service may
be incomplete. When information is incomplete, Congress or the
Department of Veterans Affairs (VA) may need to make a
"presumption" of service connection so that a group of veterans can
be appropriately compensated. The missing information may be about
the specific exposures of the veterans, or there may be incomplete
scientific evidence as to whether an exposure during service causes
the health condition of concern. For example, when the exposures of
military personnel in Vietnam to Agent Orange could not be clearly
documented, a presumption was established that all those who set
foot on Vietnam soil were exposed to Agent Orange. The Institute of
Medicine (IOM) Committee was charged with reviewing and describing
how presumptions have been made in the past and, if needed, to make
recommendations for an improved scientific framework that could be
used in the future for determining if a presumption should be made.
The Committee was asked to consider and describe the processes of
all participants in the current presumptive disability
decision-making process for veterans. The Committee was not asked
to offer an opinion about past presumptive decisions or to suggest
specific future presumptions. The Committee heard from a range of
groups that figure into this decision-making process, including
past and present staffers from Congress, the VA, the IOM, veterans
service organizations, and individual veterans. The Department of
Defense (DoD) briefed the Committee about its current activities
and plans to better track the exposures and health conditions of
military personnel. The Committee further documented the current
process by developing case studies around exposures and health
conditions for which presumptions had been made. Improving the
Presumptive Disability Decision-Making Process for Veterans
explains recommendations made by the committee general methods by
which scientists, as well as government and other organizations,
evaluate scientific evidence in order to determine if a specific
exposure causes a health condition. Table of Contents Front Matter
General Summary Summary 1 Introduction 2 A Brief History of
Presumptive Disability Decisions for Veterans 3 The Presumptive
Disability Decision-Making Process 4 Legislative Background on
Presumptions 5 Case Studies Summary Chapter 6 Establishing an
Evidence-Based Framework 7 Scientific Evidence for Causation in the
Population 8 Synthesizing the Evidence for Causation 9 Applying
Population-Based Results to Individuals: From Observational Studies
to Personal Compensation 10 Health and Exposure Data Infrastructure
to Improve the Scientific Basis of Presumptions 11 Governmental
Classification and Secrecy 12 The Way Forward 13 Recommendations
Appendix A: Statement of the Veterans' Disability Benefits
Commission to the Institute of Medicine's Committee on the
Presumptive Disability Decision-Making Process, May 31, 2006
Appendix B: Committee on Evaluation of the Presumptive Disability
Decision-Making Process for Veterans Open Session Meeting Agendas
Appendix C: Glossary Title Page Appendix D: Historical Background
Appendix E: Arguments Favoring and Opposing Presumptions Appendix
F: Tables: Summary of Presumptive Disability Decision-Making
Legislative History Appendix G: VA's White Paper on the Presumptive
Disability Decision-Making Process Appendix H: IOM's Statements of
Task and Conclusions for Agent Orange and Gulf War Reports Appendix
I: Case Studies Appendix J: Causation and Statistical Causal
Methods Appendix K: Sources of Health and Exposure Data for
Veterans Appendix L: Additional Classification and Secrecy
Information Appendix M: Biographical Sketches of Committee Members,
Consultants, and Staff
General
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