Improving the Presumptive Disability Decision-Making Process for Veterans

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Table of Contents
Front Matter R1-R32
General Summary 1-6
Summary 7-26
1 Introduction 27-35
2 A Brief History of Presumptive Disability Decisions for Veterans 36-51
3 The Presumptive Disability Decision-Making Process 52-69
4 Legislative Background on Presumptions 70-82
5 Case Studies Summary Chapter 83-135
6 Establishing an Evidence-Based Framework 136-149
7 Scientific Evidence for Causation in the Population 150-174
8 Synthesizing the Evidence for Causation 175-197
9 Applying Population-Based Results to Individuals: From Observational Studies to Personal Compensation 198-236
10 Health and Exposure Data Infrastructure to Improve the Scientific Basis of Presumptions 237-297
11 Governmental Classification and Secrecy 298-308
12 The Way Forward 309-328
13 Recommendations 329-338
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 339-343
Appendix B: Committee on Evaluation of the Presumptive Disability Decision-Making Process for Veterans Open Session Meeting Agendas 344-348
Appendix C: Glossary 349-408
Title Page 409-409
Appendix D: Historical Background 410-423
Appendix E: Arguments Favoring and Opposing Presumptions 424-433
Appendix F: Tables: Summary of Presumptive Disability Decision-Making Legislative History 434-565
Appendix G: VA's White Paper on the Presumptive Disability Decision-Making Process 566-569
Appendix H: IOM's Statements of Task and Conclusions for Agent Orange and Gulf War Reports 570-591
Appendix I: Case Studies 592-709
Appendix J: Causation and Statistical Causal Methods 710-719
Appendix K: Sources of Health and Exposure Data for Veterans 720-763
Appendix L: Additional Classification and Secrecy Information 764-773
Appendix M: Biographical Sketches of Committee Members, Consultants, and Staff 774-781

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12:15 p.m.	Lunch
1:15 p.m.	The Role of Science in Establishing VA Disability Compensation Policies Mark Brown, Ph.D. (Director, VA’s Environmental Agents Service, Office of Public Health and Environmental Hazards, Department of Veterans Affairs)
1:45 p.m.	Presumptions in VA’s Disability Program—The Effect Thomas Pamperin, M.B.A. (Assistant Director for Policy, Compensation and Pension Service, Department of Veterans Affairs)
2:05 p.m.	PANEL Q&A—VA Presenters and Committee Members
2:45 p.m.	Break
3:00 p.m.	An Examiner’s Use of the Clinician’s Guide and How Examiners Are Selected and Trained by VHA Patrick Joyce, M.D., J.D., M.P.H. (Chief Physician, Compensation and Pension Program, VA Medical Center, Washington, D.C.)
3:45 p.m.	Making Decisions Based on Medical Evidence Bradley Flohr (Chief of Advisory Review Staff, Compensation and Pension Service)
4:15 p.m.	Public Comments (Attendees will be given the opportunity to make brief remarks to the Committee Members)
5:15 p.m.	Open Session Ends
5:15 p.m.	Closed Session (Committee Members and IOM Staff Only)
6:15 p.m.	Adjourn

Committee Meeting #2

July 27, 2006

Keck Center of the National Academies

Washington, D.C.

AGENDA

Thursday, July 27

Room 101

8:30 a.m.

Closed Session (Committee Members and IOM Staff Only)

9:00 a.m.

Open Session Begins

9:00 a.m.

Welcome and Introductory Remarks, Introduction of Committee Members and Attendees

Jonathan Samet, M.D., M.S., Committee Chair

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