Veterans: Are VA experts qualified?

Camp Lejeune veterans question expertise of subject matter expert doctors

ORLANDO, Fla. – Thousands of Camp Lejeune veterans are still fighting for disability benefits after being diagnosed with illness they say are from the toxic drinking water on base. Many claim the doctors that are reviewing their cases from the U.S. Department of Veterans Affairs may not be qualified to do it.

[WEB EXTRA: Former VA claims adjudicator explains process | Veteran resources]

Franklin McArthur, Jr. spent 730 days at Camp Lejeune. Nearly 50 years later, he was diagnosed with a rare form of non-Hodgkin's lymphoma called mycosis fungoid.

"I had no idea where it came from," said McArthur. "At the time, I didn't know about the Camp Lejeune water contamination situation. Nobody contacted me, nobody sent me a letter or anything."

He said it wasn't until he saw a news program about the exposure did everything make sense. McArthur said because non-Hodgkin's lymphoma is one of the conditions covered under the Honoring America's Veterans and Caring for Camp Lejeune Families Act of 2012, he filed for disability benefits with the VA. But his Camp Lejeune benefits claim was denied.

"It had to be the exposure. It had to be," said McArthur.

But the VA's doctor didn't agree. McArthur said he was shocked about the doctor's reasoning.

"He couldn't have done any research, because anyone could have done what he did," said McArthur. "Plagiarize Wikipedia and make a decision on my claim."

He said it appears the doctor cut and pasted information on mycosis fungoid from Wikipedia in his report.

"Then made to look the way that person wanted it to look," said McArthur. "Even instances where they said it wasn't genetic and he said it was. So he outright lied, actually."

McArthur is referring to a line in his denial that said: “While the causes remain unclear, most cases are genetic or hereditary."

The sentence in the Wikipedia page includes the word "not", indicating most cases are not genetic or hereditary.

Local 6 has asked the VA why a subject matter expert would need to use Wikipedia.

"The audiences for medical opinions are the Veterans Benefits Administration (VBA) raters, the Veteran and potentially the Board of Veterans Appeals judge," said Meagan Lutz, a VA representative, in an email. "The medical opinion should be written in a manner that clearly explains the elements of the case using non-technical language. The subject matter expert uses multiple sources to gather information to complete the medical opinion."

Lutz provided Local 6 with two examples of other sources she said used similar language to the mycosis fungoid information in McArthur's denial, but the language doesn't appear to be as close to the language in McArthur's denial as the Wikipedia page.

When asked about the omission of the word "not," which changed the meaning of the sentence, Lutz said: "We have notified the VBA of the misplacement of the word ‘not’ in the report."

Sandy McClelland, another Camp Lejeune veteran, said he also has questions about the VA doctor that examined his bladder cancer case.

First, he paid for a private doctor to issue him a medical opinion, after reading a VA training letter.

"It said independent medical examiners can examine you, and if they rate you, it goes right to get the benefits," said McClelland. "So I looked around for an IME, and I found one, and I went to him. Of course, this was money out of my own pocket, the airfare and the cost of it. He examined me and went through my file. He went through all my medical documents, and he said that the bladder cancer came from the water at Camp Lejeune and rated me at 100 percent."

A VA doctor in Orlando, Dr. Kenneth Myers, said the same thing after examining McClelland. The VA's website indicates Myers is board certified in emergency medicine, medical toxicology (pediatrics), aerospace medicine and occupational medicine.

But the VA denied McClelland's claim after having what it calls a subject matter expert, Dr. Gary Wilhelm, look at McClelland's case.

"He never saw me," said McClelland. "He copied a whole bunch of information from different websites, and he gave his opinion that it didn't come from Camp Lejeune."

Local 6 looked into Wilhelm's background, and according to his own LinkedIn page, most of his experience is in surgery. He has experience in orthopedic surgery and was a flight surgeon in the military, as well.

Local 6 found a lawsuit Wilhelm filed against the Army after being terminated from the orthopedic surgery residency program at William Beaumont Army Medical Center, for being "inept in the operation room." The lawsuit states Wilhelm wanted the termination and all records of that residency taken out of his official record, but a judge dismissed the case.

It appears Wilhelm has also done a residency for occupational medicine, but according to his listing on the VA's website, he has no board certifications.

"It doesn't make sense to me," said McClelland. "You got this doctor in Orlando with all these board certifications, and you got this doctor in Minneapolis that doesn't have any board certifications, and they take his opinion over the doctor in Orlando."

Veterans' law attorney Robin Hood is a former VA claims adjudicator. He said not all the subject matter experts are doctors with background in diagnosing cancer.

"I know specifically, in one of my cases, the SME is not," said Hood.

"The Camp Lejeune Contaminated Water (CLCW) SME process was developed in January 2013 to ensure medical opinions were completed by highly trained doctors with expertise in occupational medicine, environmental medicine and toxicology," said a VA representative in an email. "The SMEs receive specific training on Camp Lejeune water contamination and published scientific literature."

But Hood said he's never seen any training materials.

"I looked for whatever Camp Lejeune training I could find, and I couldn't find any," said Hood.

He said he's heard they review a PowerPoint and take a short class.

"They'll say, 'OK, who wants the extra duty? OK, you go off and get trained on this, and now this particular set of tasks is your duty,'" said Hood.

The VA maintains subject matter experts are well-trained.

"All subject matter experts are physicians, and the majority of them have graduate training in environmental medicine or occupational medicine," said Lutz. "Most of the SMEs work in the compensation and pension departments at various VA medical centers.  All receive supplemental instruction relative to this specific mission."

Hood said the VA has a lot of well-intentioned people that try to do the right thing working there, but mistakes do get made.

"They need to work smarter," said Hood. "They need to change some of their red tape, some of their processing rules. I call it rules of engagement. They need to change some of their rules of engagement if they want to transform."

McArthur said that has to change and soon.

"There's nothing more important than taking care of the people who took care of the country," said McArthur. "Nothing more important, can't think of anything. And it shouldn't be a fight to do it. It should be an honor, just like it was an honor to serve, it should be an honor to serve us." 

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