Retired Lt. Col. Susan Lukas looked no further than her own personal experience in the Air Force Reserve when weighing the benefits of a new bill that could be approved by lawmakers later this year.
Now a legislative director for the Reserve Organization of America, she was on active duty at the Pentagon on Sept. 11. At the time, Lukas never considered the toxins that she was breathing in during the terrorist attack.
“As time went on, I started having a problem with my throat and started getting tests. What happened is I ultimately had lung damage from 9/11,” she said.
In the months following the attack, Lukas said she had problems with breathing and coughing, but wrote it off as part of flu season. It took several years and a worsening of her symptoms to put the two together. Had documentation of the exposure been in her medical records, Lukas believes diagnosis and proper treatment could have come more quickly.
A bill now attached to the National Defense Authorization Act for fiscal year 2020 requires the medical records of servicemembers to include whether they were exposed to toxic materials in an effort to ease access to disability compensation and treatment at the Department of Veterans Affairs. Lawmakers are reconciling the two versions of the annual legislation into a final version and it is expected to move forward following their August recess.
Known as the Occupational and Environmental Transparency Health Act, or OATH Act, the bill stands to impact all servicemembers as toxic exposure can happen at home or while serving on deployment. Even troops living in barracks or military family housing that was found to be unsafe because of mold or lead paint would have the exposure documented, said Rep. John Garamendi, D-Calif., who introduced the bill alongside Rep. Austin Scott, R-Ga.
“[A servicemember’s] health is jeopardized and when they get ill and it is difficult to understand the relationship between a previous chemical exposure and the illness because that information is not available,” Garamendi said July 25 during a phone interview.
Toxic materials often associated with servicemembers’ illnesses include the herbicide Agent Orange, fumes from burn pits, chemical foam used in firefighting and mold in living quarters.
“We find it very hard to qualify for treatment for toxic exposure because it often doesn’t manifest itself until later,” Lukas said, noting it can be especially challenging for Reserve and National Guard members who transition in and out of active duty.
The OATH Act calls for three major changes. It requires the Defense Department to include in a servicemember’s health records any toxic exposures, either at home or while deployed, conduct a post-deployment health assessment, and update veterans’ health records based on information submitted to the VA’s Airborne Hazards and Open Burn Pit Registry.
In 2014, Congress created the burn pit registry, but of the estimated 3 million veterans eligible to sign up, only about 178,000 have voluntarily taken the time to do so.
Travis Horr, director of government affairs for Iraq and Afghanistan Veterans of America, sees the OATH Act as complimentary to the Burn Pits Accountability Act, which is also an amendment on both versions of the NDAA. That bill calls for servicemembers to be asked about burn pit exposure during a post-deployment medical exam and added to the registry, if required.
“As many touch points as we can get with servicemembers to say that they’ve been exposed, or catching when they have been exposed, the better,” Horr said.
This new law would automatically document those exposures when they occur, taking the responsibility from the veteran.
The Congressional Budget Office has not estimated any costs associated with the law but linking the burn pit registry and electronic records for servicemembers can be done without an impact to the workforce, Garamendi’s office said they were told by Defense Department officials. Exposure information would be added to medical records from the Periodic Occupational and Environmental Monitoring System, which already tracks exposures that a general population of an area might encounter.
Meanwhile, VA officials are already working to ensure the electronic health records system is prepared to take on the new information, Garamendi said.
Not tracking hazardous exposures leaves doctors in the dark on vital health information, said retired Rear Adm. Christopher W. Cole, CEO of the Association of the U.S. Navy, which supports the OATH Act.
Cole said the Blue Water Navy veterans are a key example of why documentation of exposure is important. They are Navy personnel who served aboard aircraft carriers, destroyers and other ships in the territorial seas of Vietnam and fought for years to prove they were exposed to the chemical herbicide Agent Orange. In June, a new law made them eligible for VA disability compensation.
Their continuing fight for coverage shows “accurate record-keeping when it comes to toxic exposure is of the utmost importance, particularly several decades after a veteran was first exposed and health issues from the exposure start to emerge," Cole said.
Lukas and Horr also believe better documentation could lead to faster diagnosis or treatment of a veteran’s illness. If a veteran is too young for a specific test for cancer, a doctor who knows the veteran has a history of exposure to a specific chemical can administer the needed test on that veteran, Horr said.
Garamendi, too, sees this benefit.
“I think we could save the lives of individuals exposed and also save the quality of their life,” he said.
Thayer.rose@stipes.com Twitter: @Rose_Lori