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Improving the Presumptive Disability Decision-Making Process for Veterans (2008)

Chapter: Appendix M: Biographical Sketches of Committee Members, Consultants, and Staff

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Suggested Citation:"Appendix M: Biographical Sketches of Committee Members, Consultants, and Staff." Institute of Medicine. 2008. Improving the Presumptive Disability Decision-Making Process for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/11908.
×

Appendix M
Biographical Sketches of Committee Members, Consultants, and Staff

Jonathan M. Samet, M.D., M.S. (Chair), is a professor and the Chair of the Department of Epidemiology of the Johns Hopkins University’s Bloomberg School of Public Health. Dr. Samet also has joint Johns Hopkins’ appointments in the Department of Medicine and the Oncology Center, and serves as the Director of the Institute for Global Tobacco Control and as the Co-Director for the Risk Sciences and Public Policy Institute. Before coming to Johns Hopkins, he was Professor and Chief of the Pulmonary and Critical Care Division in the Department of Medicine of the University of New Mexico School of Medicine. His research has emphasized the assessment of health effects of environmental pollutants using epidemiological approaches. His work addressing indoor and outdoor air pollution and occupational exposures, including asbestos and radon, has made use of risk assessment methods as a tool for translation of scientific findings into policy. Dr. Samet received his M.D. from the University of Rochester’s School of Medicine and Dentistry and his M.S. from the Harvard School of Public Health. He interned at the University of Kentucky Medical Center and then served in the U.S. Army as an anesthesiologist at Gorgas Hospital (Balboa Heights, Canal Zone) from 1971 to 1973. Following his military service, Dr. Samet completed his internal medicine residency in Medicine at the University of New Mexico and then a research and clinical fellowship at Harvard Medical School’s Channing Laboratory. He is board certified in internal medicine and the subspecialty of pulmonary medicine. Dr. Samet was elected to the Institute of Medicine in 1997 (Section 9) and has served as a member and chair of numerous committees for the National Academies. He currently chairs the Board on Environmental Studies and Toxicology. In addition, he is a member of the Committee on Science, Technology, and Law.


Margaret A. Berger, J.D., is the Suzanne J. and Norman Miles Professor of Law at Brooklyn Law School. Professor Berger’s research interests focus on scientific evidentiary issues, and she has contributed to the field of postadmission legal education by developing new approaches to the judicial treatment of scientific evidence. She has authored numerous briefs, articles, chapters in books, and books which address the topic of the admissibility and interpretation of scientific evidence. Professor Berger holds a J.D. from Columbia University School of Law. She has held membership positions on the National Academies’ Committees on Tagging Smokeless and Black Powder and the Committee on DNA Technology in Forensic Science: An Update. Professor Berger is currently a member of the National Academies’ Committee on Science, Technology,

Suggested Citation:"Appendix M: Biographical Sketches of Committee Members, Consultants, and Staff." Institute of Medicine. 2008. Improving the Presumptive Disability Decision-Making Process for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/11908.
×

and Law and co-chairs a subcommittee on the Reference Manual on Scientific Evidence. She also serves on a National Academy Committee on Identifying the Needs of the Forensic Science Community, and on a Committee on Assuring the Integrity of Research Data.


Kirsten Bibbins-Domingo, Ph.D., M.D., MAS-CR, is an Assistant Professor of Medicine and of Epidemiology and Biostatistics at the University of California, San Francisco (UCSF). She is the co-director of the UCSF Center for Vulnerable Populations and an attending physician at San Francisco General Hospital. Dr. Bibbins-Domingo received her A.B. from Princeton University and her Ph.D. in biochemistry, her M.D. and her Masters of Clinical Research from UCSF. She completed her residency in internal medicine at UCSF that included training at the San Francisco Veterans Administration Medical Center (SFVAMC) and continues to have several active collaborations with researchers in epidemiology and health services at the SFVAMC. Dr. Bibbins-Domingo’s research interests include the epidemiology of cardiovascular disease, race and gender health and health-care disparities, and the quality of cardiovascular care, particularly heart failure disease management. She has published original research on the development of risk factors for cardiovascular disease, including diabetes, impaired kidney function, and high blood pressure, as well as the use of novel biomarkers as diagnostic and screening tests for cardiovascular disease.


Eric G. Bing, M.D., Ph.D., M.P.H., is the Endowed Professor of Global Health and HIV Research at the Charles Drew University of Medicine and Science in Los Angeles. He is the Director of the Drew Center for AIDS Research, Education and Services (Drew CARES), the Institute for Community Health Research and co-director of the Center for HIV Identification, Prevention and Treatment Services (CHIPTS). Dr. Bing’s research interests include mental health care, substance abuse treatment, community mobilization, service systems, and HIV prevention research in civilian and military settings in the United States and abroad. He works with militaries in multiple countries in developing disease prevention programs for soldiers. Dr. Bing received his M.D. from Harvard Medical School and his M.P.H. and Ph.D. in epidemiology from the University of California, Los Angeles’s (UCLA’s) School of Public Health. He completed his psychiatric training at the UCLA Neuropsychiatric Institute/West Los Angeles VA Medical Center. Dr. Bing served as a member of the National Academies’ Ryan White CARE Act committee.


Bernard D. Goldstein, M.D., is the former Dean of the University of Pittsburgh’s Graduate School of Public Health and remains active as a professor in the Department of Environmental and Occupational Health. Dr. Goldstein’s research interests include risk assessment, toxicology, workplace hazards, internal medicine, preventive medicine, occupational and environmental medicine, and environmental health policy. He has conducted research on air quality and leukemia and various aspects of public health decision making. Dr. Goldstein was the founder and former Director of the Environmental and Occupational Sciences Institute at the University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School. Dr. Goldstein also served as Assistant Administrator for Research and Development at the U.S. Environmental Protection Agency. He received his M.D. from the New York University School of Medicine. Dr. Goldstein was elected to the Institute of Medicine in 1991 (Section 9) and has served as a member and chair of numerous committees for the National Academies which address subjects including risk assessment methodology, exposure to radioactive materials, and biological

Suggested Citation:"Appendix M: Biographical Sketches of Committee Members, Consultants, and Staff." Institute of Medicine. 2008. Improving the Presumptive Disability Decision-Making Process for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/11908.
×

markers. He currently serves as chair of the NRC Standing Committee on Risk Analysis Issues and Reviews, chair of the IOM Environmental and Occupational Health Interest Group, and as a member of the Roundtable on Environmental Health Sciences, Research, and Medicine. Dr Goldstein’s residency training included a rotation through the Manhattan VA Hospital.


Guy H. McMichael III, J.D., is president of GHM Consulting which offers federal relations and management consulting advice. Mr. McMichael served as a senior official in the Department of Veterans Affairs (VA) for 30 years and provided advice and direction at the highest levels of VA in the development and execution of a complex array of programs administered by the agency. During his tenure with VA, he served as Acting Under Secretary for Benefits, Acting Chief Information Officer, Acting Chief of Staff, Chief Judge of VA’s Board of Contract Appeals, VA General Counsel and head of Congressional Relations. He also served as the agency’s designated Dispute Resolution Specialist. Prior to joining VA, Mr. McMichael served as General Counsel for the United States Senate Committee on Veterans Affairs for 6 years. Following his military service in the U.S. Army, he began his public service as a Deputy Prosecuting Attorney for the State of Indiana. Mr. McMichael holds a J.D. from University of Michigan Law School. He received the VA’s Exceptional Service Award on three separate occasions and was also a recipient of the VA’s Distinguished Career Award. Mr. McMichael also serves as a Director of the Wounded Warrior Project, a nonprofit organization.


John R. Mulhausen, Ph.D., M.S., C.I.H., is the Manager of Corporate Industrial Hygiene for the 3M Company. Dr. Mulhausen is responsible for the leadership of the Corporate Industrial Hygiene organization and oversight of its programs worldwide in a $21 billion per year global manufacturing company. Prior to joining 3M, Dr. Mulhausen worked for the U.S. Army Environmental Hygiene Agency. Dr. Mulhausen also holds an Adjunct Assistant Professor position in the Division of Environmental and Occupational Health, School of Public Health at the University of Minnesota. He has presented and published in the fields of exposure assessment, industrial hygiene and industrial hygiene statistics. He was one of the editors for the American Industrial Hygiene Association’s “A Strategy for Assessing and Managing Occupational Exposures.” Dr. Mulhausen is certified in the comprehensive practice of industrial hygiene and is a Fellow of the American Industrial Hygiene Association.


Richard Scheines, Ph.D., is professor and Head of the Department of Philosophy at Carnegie Mellon University. In addition, Dr. Scheines is a professor of the Human-Computer Interaction Institute as well as the Department of Machine Learning. Dr. Scheines’ research focuses on the relationship between causal hypotheses and statistical evidence. Dr. Scheines has collaborated for more than two decades with statisticians and computer scientists on characterizing what can and cannot be learned about causal claims from statistical data in a variety of empirical settings, and to develop and implement algorithms for causal discovery that are practical and relevant. He has applied these techniques to the question of whether lead affects IQ, the efficacy of online courses, the effect of welfare reform on single mothers, and many other policy domains. Dr. Scheines received his Ph.D. in history and philosophy of science from the University of Pittsburgh in 1987, and has published 5 books and over 80 articles since joining Carnegie Mellon in 1988. Dr. Scheines was recently on the Institute of Medicine Committee on Food Marketing and the Diets of Children and Youth, where cause and effect relationships were examined involving marketing and its effects on children’s preferences, purchase requests, and diets.

Suggested Citation:"Appendix M: Biographical Sketches of Committee Members, Consultants, and Staff." Institute of Medicine. 2008. Improving the Presumptive Disability Decision-Making Process for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/11908.
×

Kenneth R. Still, Ph.D., M.S., M.B.A., F.A.T.S., C.I.H., C.S.P., C.H.M.M., is a retired U.S. Navy Captain in the Medical Service Corps. Dr. Still served as the Senior Director of Safety and Occupational Health for the Commander of the U.S. Pacific Fleet, Pearl Harbor, Hawaii, as well as the Officer-In-Charge of the Navy’s only Toxicology Research laboratory Program in Dayton, Ohio. Dr. Still retired from the U.S. Navy in November 2005 and is currently the Scientific Director and toxicology consultant for Occupational Toxicology Associates, Inc., chairs an Independent Toxicology Panel for an International corporation, and provides consulting services for several DoD programs, including the Breast Cancer Research Program under the aegis of the Congressionally Directed Medical Research Program. Dr. Still has held numerous adjunct faculty/associate professorships including the John Burns School of Medicine at the University of Hawaii, and the Uniform Services University of Health Sciences, Bethesda, Maryland. He held a visiting research scientist appointment at the Naval Health Research Center Environmental Health Effects Laboratory in Dayton, Ohio, for several years. Dr. Still’s main research interests include human health risk assessment, exposure assessment, and regulatory and mechanistic toxicology. His research addresses the areas of neurobehavioral, reproductive, inhalation/respiratory, biochemical, and occupational toxicology. He has more than 250 publications in the areas of his research. Dr. Still received his Ph.D. in chemical/physiological ecology from Oklahoma State University, his M.S. from Portland State University in the same field, and his M.B.A. from Chaminade University of Honolulu in financial management. Dr. Still holds certifications in the comprehensive practice of industrial hygiene, safety, hazardous materials management, and several environmental arenas. Dr. Still is a Fellow of the Academy of Toxicological Sciences and the American Industrial Hygiene Association. He has served as a liaison on numerous committees for the National Academies which have addressed the topics of toxicology hazard evaluation, reproductive and developmental toxicants, and acute exposure guidelines. Dr. Still has also served on many working groups for governmental agencies. He received the Vice President Al Gore Hammer Award for Reinventing Government for work on the Environmental Protection Agency Acute Exposure Guidelines.


Duncan C. Thomas, Ph.D., M.S., is the Director of the Biostatistics Division within the Department of Preventive Medicine at the University of Southern California and holds the Verna Richter Chair in Cancer Research. Dr. Thomas was Co-Director of the Southern California Environmental Health Sciences Center (funded by the National Institute of Environmental Health Sciences) and is Director of its Study Design and Statistical Methods of Research Core. His research interests include the development of statistical methods in epidemiology, with special emphasis on cancer epidemiology, occupational and environmental health, and genetic epidemiology. He is also one of the senior investigators in the California Childrens Health Study, the only long-term cohort study of the chronic effects of air pollution in children. He has published more than 200 peer-reviewed journal articles in these areas of research and is the author of Statistical Methods in Genetic Epidemiology (Oxford University Press, 2004). Dr. Thomas is a Fellow of the American College of Epidemiology and a past President of the International Genetic Epidemiology Society. Dr. Thomas received his Ph.D. in epidemiology and health from McGill University and his M.S. in mathematics from Stanford University. He has served as a member of the National Academies’ committees to review radioepidemiology tables and the biological effects of populations of exposures to low levels of ionizing radiation (BEIR V) and was a member of President Clinton’s Advisory Committee on Human Radiation Experiments.

Suggested Citation:"Appendix M: Biographical Sketches of Committee Members, Consultants, and Staff." Institute of Medicine. 2008. Improving the Presumptive Disability Decision-Making Process for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/11908.
×

Sverre Vedal, M.D., M.Sc., is a professor in the Department of Environmental and Occupational Health Sciences, Occupational and Environmental Medicine Program, at the University of Washington School of Public Health and Community Medicine. Prior to joining the faculty of the University of Washington, Dr. Vedal worked as an academic pulmonologist at the University of British Columbia in Vancouver and then at the National Jewish Medical and Research Center in Denver, Colorado. Dr. Vedal is well published in the application of epidemiological methods to evaluating the health effects of air pollution and occupational lung disease, and is funded by National Institutes of Health in researching health effects of air pollution sources. Dr. Vedal received his M.D. from the University of Colorado’s School of Medicine and his M.Sc. in epidemiology from Harvard University. He is board certified in internal medicine and pulmonary medicine. Dr. Vedal is a member of the Review Committee of the Health Effects Institute in Boston, Massachusetts, and a member of air pollution panels of the Clean Air Scientific Advisory Committee of the Environmental Protection Agency’s Science Advisory Board. Dr. Vedal served as a member of the National Academies’ committee addressing air quality management.


Allen J. Wilcox, M.D., M.P.H., Ph.D., is a Senior Investigator in the Epidemiology Branch of the National Institute of Environmental Health Sciences, where he served for 10 years as the Chief of the Epidemiology Branch. He also holds a professorship in epidemiology at the University of Bergen (Norway) and an adjunct appointment as Professor of Epidemiology at the University of North Carolina, Chapel Hill. Dr. Wilcox’s research focuses on reproductive and perinatal epidemiology, a field to which he has made methodologic as well as etiologic contributions. Dr. Wilcox received an M.D. from the University of Michigan, and an M.P.H. in Maternal and Child Health and a Ph.D. in Epidemiology from the University of North Carolina. He is certified by the American Board of Preventive Medicine as a specialist in Public Health and General Preventive Medicine. He retired in 2001 as a Captain from the U.S. Public Health Service, Commissioned Corps, where he was awarded the Meritorious Service Medal, the highest honor granted by the Public Health Service. He has twice received the National Institutes of Health Director’s Award. Dr. Wilcox has served as the President of the Society for Epidemiologic Research, the Society for Pediatric Epidemiologic Research, and the American Epidemiological Society. Dr. Wilcox has held numerous editorships, and since 2001 has served as the Editor-in-Chief of Epidemiology.


Scott L. Zeger, Ph.D., is the Hurley-Dorrier Professor of Biostatistics and Chair of the Department of Biostatistics of the Johns Hopkins Bloomberg School of Public Health. Dr. Zeger is jointly appointed to the Department of Epidemiology and served as the Senior Associate Dean for Academic Affairs. His research is on regression analysis for correlated responses. Dr. Zeger has focused in two areas: (1) when observations come in clusters, for example in longitudinal research, family studies in genetics or in sample surveys and (2) when a single time series is observed. His research has extended generalized linear models (logistic, linear, log-linear, and survival models) to be applicable in these cases. Dr. Zeger has published extensively in peer-reviewed journals and is co-author of two books. Dr. Zeger received his Ph.D. in statistics from Princeton University. He is a Fellow of the American Statistical Association and of the American Association for the Advancement of Science. He was a member of several committees for the National Academies, including the Committee on Applied and Theoretical Statistics, the Committee on Estimating the Health-Risk-Reduction Benefits of Proposed Air Pollution

Suggested Citation:"Appendix M: Biographical Sketches of Committee Members, Consultants, and Staff." Institute of Medicine. 2008. Improving the Presumptive Disability Decision-Making Process for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/11908.
×

Regulations, and the Committee on Gulf War and Health: Health Effects Associated with Exposure During the Persian Gulf War.


Lauren Zeise, Ph.D., is the Chief of the Reproductive and Cancer Hazard Assessment Branch in the Office of Environmental Health Hazard Assessment at the California Environmental Protection Agency. Dr. Zeise’s main research areas of interest include cancer and reproductive risk assessment. Her current work addresses cancer and reproductive risk methodologies and characterizations, establishment of baseline risks, and guidance for evaluating risks to the fetus, children, and adolescents from environmental exposures. She is widely published. Dr. Zeise received her Ph.D. from Harvard University. She is currently serving on the U.S. Environmental Protection Agency’s Science Advisory Board. Dr. Zeise has served as a member of numerous committees for the National Academies which have addressed topics such as air quality, assessing exposure of herbicides in Vietnam, copper in drinking water, and risk characterization. She currently serves on the Board on Environmental Studies and Toxicology and is also a member on the Committee on Toxicity Testing and Assessment of Environmental Agents.

Volunteer Scientific Consultant

Melissa A. McDiarmid, M.D., M.P.H., D.A.B.T., is a professor of Medicine and Director of the University of Maryland School of Medicine’s Occupational Health Program. Dr. McDiarmid also directs the Department of Veterans Affairs surveillance program for veterans exposed to depleted uranium. Previously, Dr. McDiarmid was Director of the Office of Occupational Medicine for the U.S. Occupational Safety and Health Administration (OSHA) in Washington, D.C. Prior to OSHA, she was an Assistant Professor of Environmental Health Sciences at the Johns Hopkins School of Hygiene and Public Health. Principal career interests for Dr. McDiarmid have been the study of health effects and toxicology of metals and environmental reproductive and developmental hazards. She has authored numerous journal articles and book chapters on various occupational and environmental medicine topics related to health-care workers, medical surveillance and management, reproductive health, and occupational cancers. Dr. McDiarmid received her M.D. from the University of Maryland, her M.P.H. from the Johns Hopkins University School of Public Health where she also completed her fellowship training in Occupational Medicine. She is board certified in Internal Medicine, Occupational Medicine, and Toxicology. Dr. McDiarmid is serving as a Volunteer Scientific Consultant to IOM’s Committee on Evaluation of the Presumptive Disability Decision-Making Process for Veterans.

Consultant

Robert J. Epley is an independent consultant working in the areas of strategic planning, training, performance management, and the operations of federal entitlement programs. Mr. Epley served with the Department of Veterans Affairs for 31 years, dividing his tenure between positions in headquarters and in the field. In VA field offices, he progressed through positions as benefits counselor and claims examiner to director of two regional offices in Detroit and St. Louis. At VA headquarters, Mr. Epley was chief of field operations for the education program, and later he served as deputy director and director of the Compensation & Pension Service. His final position with VA was associate deputy under secretary for policy and program management, where he was responsible for administration and oversight of the Veterans Benefits Administration’s business lines: compensation, pension, housing, insurance, vocational

Suggested Citation:"Appendix M: Biographical Sketches of Committee Members, Consultants, and Staff." Institute of Medicine. 2008. Improving the Presumptive Disability Decision-Making Process for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/11908.
×

rehabilitation, and education. During his tenure with VA, Mr. Epley received two Vice President Al Gore Hammer Awards for reinventing government and two Presidential Rank Awards.

Staff

Catherine C. Bodurow, M.S.P.H., holds a research faculty position at the Georgia Institute of Technology and serves as a Senior Research Scientist in the Deputy Director’s Office of Georgia Technology Research Institute. She was on loan to the Institute of Medicine (IOM) of the National Academies as a Senior Program Officer and Study Director. Ms. Bodurow also served as a Senior Scientist in the Office of Science Coordination and Policy of the Office of Prevention, Pesticides and Toxic Substances at the U.S. Environmental Protection Agency. Her research interests include exposure and risk assessment, epidemiology, and the application of real-time sensor technology in occupational and environmental exposure assessment. She has presented and published in these fields. Ms. Bodurow received her B.A. in chemistry from Kalamazoo College and her M.S.P.H. from the University of North Carolina at Chapel Hill. She has served on numerous national and international committees and chaired several national technical committees.


Frederick (Rick) Erdtmann, M.D., M.P.H., is the Director of the Board on Military and Veterans Health and the Medical Follow-Up Agency at the Institute of Medicine (IOM) of the National Academies. Prior to joining the IOM he was a career military physician in the U.S. Army. While in the military he served as chief of several large departments of Preventive Medicine at U.S. installations at home and overseas. He also was commander of the military community hospital at Ft Carson, Colorado, and later served as Hospital Commander for the Walter Reed Army Medical Center. He had several assignments at the Army Surgeon General’s Office working on military health care policies. He received his undergraduate degree from Bucknell University and his M.P.H. from the University of California, Berkeley. He is a graduate of Temple University Medical School and is board certified in the specialty of Preventive Medicine.

Suggested Citation:"Appendix M: Biographical Sketches of Committee Members, Consultants, and Staff." Institute of Medicine. 2008. Improving the Presumptive Disability Decision-Making Process for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/11908.
×

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Suggested Citation:"Appendix M: Biographical Sketches of Committee Members, Consultants, and Staff." Institute of Medicine. 2008. Improving the Presumptive Disability Decision-Making Process for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/11908.
×
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Suggested Citation:"Appendix M: Biographical Sketches of Committee Members, Consultants, and Staff." Institute of Medicine. 2008. Improving the Presumptive Disability Decision-Making Process for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/11908.
×
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Suggested Citation:"Appendix M: Biographical Sketches of Committee Members, Consultants, and Staff." Institute of Medicine. 2008. Improving the Presumptive Disability Decision-Making Process for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/11908.
×
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Suggested Citation:"Appendix M: Biographical Sketches of Committee Members, Consultants, and Staff." Institute of Medicine. 2008. Improving the Presumptive Disability Decision-Making Process for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/11908.
×
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Suggested Citation:"Appendix M: Biographical Sketches of Committee Members, Consultants, and Staff." Institute of Medicine. 2008. Improving the Presumptive Disability Decision-Making Process for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/11908.
×
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Suggested Citation:"Appendix M: Biographical Sketches of Committee Members, Consultants, and Staff." Institute of Medicine. 2008. Improving the Presumptive Disability Decision-Making Process for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/11908.
×
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Suggested Citation:"Appendix M: Biographical Sketches of Committee Members, Consultants, and Staff." Institute of Medicine. 2008. Improving the Presumptive Disability Decision-Making Process for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/11908.
×
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Suggested Citation:"Appendix M: Biographical Sketches of Committee Members, Consultants, and Staff." Institute of Medicine. 2008. Improving the Presumptive Disability Decision-Making Process for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/11908.
×
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Improving the Presumptive Disability Decision-Making Process for Veterans Get This Book
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 Improving the Presumptive Disability Decision-Making Process for Veterans
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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.

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