OPENING STATEMENT OF
HONORABLE BOB FILNER
RANKING DEMOCRATIC MEMBER
SUBCOMMITTEE ON BENEFITS - HEARING
ON
HEPATITIS C, H.R. 1020, H.R. 3816,
H.R. 3998 AND H.R. 4131
April 13, 2000
Thank you, Mr. Chairman. I am an original co-sponsor and
strong supporter of all the bills we are considering today. I thank the gentleman from
Michigan, Mr. Stupak for bringing to our attention the serious impact on veterans and
their families of failing to provide service-connection to Members of the Guard and
Reserve when they suffer a heart attack or stroke while on inactive duty training. This is
a wrong which must be righted.
I thank Dr. Snyder for keeping our focus on the emerging
issue of Hepatitis C. H.R. 1020 provides a presumption of service-connection recognizing
the impossibility of proving the etiology of infection with the Hepatitis C virus.
Veterans would, of course, still be required to establish that they were exposed to one of
the listed risks during military service. This is, in itself a formidable task, since
military records are often silent as to risk factors, even when hepatitis has been
diagnosed in service.
The bill also recognizes the impossibility of determining
the source of an infection once an individual has developed Hepatitis C and can identify
at least one recognized risk factor. The impossibility of determining which of multiple
risk factors is responsible for an infection in an individual veteran was clearly stated
by Dr. Thomas Holohan, VAs Chief Patient Care Officer during a June, 1999
subcommittee hearing of the Committee on Government Reform and Oversight.
A patient may have one, two or many risk factors and to
determine which was in fact the proximate cause of the disease is in my opinion
impossible.
Despite VHAs recognition of the impossibility of
making a medical determination in an individual case, veterans are currently required to
obtain just such a medical opinion. When it is not possible for medical science to provide
an answer concerning whether a service-connected event is the cause of a veterans
disability, the evidence should be considered equal and the benefit of the doubt should be
given to the veteran. HR 1020, by presuming service-connection when certain risk factors
recognized by the Veterans Health Administration are incurred in-service, would provide
that veterans are to be given the benefit of the doubt.
I am troubled by VBAs testimony which suggests that
the criteria used by VBA should not be Veterans Health Administration (VHA)
criteria, but epidemiological data from the Centers for Disease Control. Since VHA
criteria focuses on the specific characterizations of Hepatitis C in veterans rather than
the population in general, I believe that it is more appropriate for
"OneVA" to use one set of criteria, based upon the unique factors
applicable to veterans.
I am also concerned that VBA now seems to be rejecting
evidence of abnormal liver tests during military service (particularly for veterans whose
military service predates the discovery of the Hepatitis C virus) as evidence of infection
in service. Since the onset of this disease is so insidious, abnormal liver tests may be
the only evidence available to a veteran in trying to establish a claim for
service-connection. The Committee continues to hear from veterans who appear to warrant
service-connection for Hepatitis C, but are facing serious bureaucratic barriers in
receiving it.
I welcome testimony recognizing the importance of special
monthly compensation for veterans who have undergone a radical or modified radical
mastectomy. As more and more women enter military service, they should understand that a
disease which impacts them disproportionately will be compensated commensurate with those
paid for conditions which impact male veterans.
I firmly believe that we cannot allow the costs of
inflation to eat away at the benefits earned by our disabled veterans and their survivors.
HR 4131 will at least assure that compensation and dependency and indemnity compensation
benefits will keep pace with the cost of living.
I welcome the witnesses who will be testifying today and
look forward to your testimony.
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