Veterans Advisory Board on Dose Reconstruction VBDR

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Veterans Advisory Board on Dose Reconstruction
(VBDR)
VETERANS ADVISORY BOARD ON DOSE RECONSTRUCTION
VBDR Improving communications with veterans and
resolving issues related to dose
reconstruction and claim adjudication

• Mr. Kenneth Groves
• Chair, Communication and Outreach Subcommittee
• St. Louis, MO
• September 26, 2006

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VBDR Members and Staff Attending

• Dr. John Lathrop Decision Analysis
• Colonel Ed Taylor, USA (Ret.) Atomic Veteran
  Representative
• Dr. Isaf Al-Nabulsi VBDR, Program Administrator
  

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VBDR Topics

• VBDR overview
• VBDRs activities (June 2005-July 2006)
• Recommendations to Defense Threat Reduction
  Agency and Veterans Administration
• Website and contact information

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Overview

• Appointed on June 3, 2005, to provide review and
  oversight of the dose reconstruction program and
  avenue for improving communication with veterans.
• Operates under Federal Advisory Committee Act
  (FACA) rules.
• Hold up to 6 meetings a year at various locations
  throughout the United States.
• Shall consist of no more than 16 members to be
  appointed by the Director of DTRA and VA
  Undersecretary for Benefits.

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Public Law 108-183

• Required Secretaries of Defense and Veterans
  Affairs to
• Jointly conduct a review of the mission,
  procedures, and administration of the dose
  reconstruction program.
• Take action to ensure ongoing independent review
  and oversight, including the establishment of an
  advisory board.

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Notable Features of VBDR Membership

• Range of expertise represented by VBDR members
  fully meets requirements of Public Law 108-183.
• Members have academic, government, military
  (eight are retired military) and private sector
  backgrounds.

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VBDR Subcommittees

• SC1 Subcommittee on DTRA Dose Reconstruction
  Procedures
• SC2 Subcommittee on VA Claims Adjudication
  Procedures
• SC3 Subcommittee on Quality Management and VA
  Process Integration with DTRAs Nuclear Test
  Personnel Review (NTPR) Program
• SC4 Subcommittee on Communication and Outreach

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Advisory Board Responsibilities

• The Board is required to
• Conduct periodic, random audits of dose
  reconstructions and decisions on claims for
  radiogenic diseases
• Assist VA and the DTRA in communicating to
  veterans information on the mission, procedures,
  and requirements of the dose reconstruction
  program

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Advisory Board Responsibilities

• Carry out such activities for the review and
  oversight of the Radiation Dose Reconstruction
  Program as the Secretaries shall jointly specify.
• VBDR may make recommendations on modifications
  or procedures of the dose reconstruction program
  as a result of its audits.

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The Advisory Board Does Not

• Review individual dose reconstruction cases for
  claimants.
• Serve as an appeals board for claimants.
• Help a claimant with his/her claim.
• Change or revise the provisions of the
  Radiation-Exposed Veterans Compensation Act
  law.

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What is a Dose Reconstruction?
A scientific estimate of total dose received from
personnel activities in a defined radiological
environment
Compute Dose Uncertainties and Report Dose
Associate Activities and Environment and
Calculate a Total Dose
Determine Activities and Areas Visited
Compare with Film Badge Results
Establish Radiation Environment
Dose Reconstruction Method
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VBDRs ActivitiesJune 05 - August 06

• 3 public meetings (FL, CA, TX)
• 16 subcommittee meetings
• 11 subcommittee teleconferences
• 6 press releases
• Established VBDR website with Frequently Asked
  Questions
• Established VBDR Toll-free line
• Collected testimony from about 75 veterans or
  their families

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Veterans Interaction With VBDRAs of 31 August
2006

• 108 phone calls
• 10 letters
• 41 e-mails
• All correspondence will be stored in VBDR
  database to document veterans request.
• The Board examines correspondence and makes
  every reasonable effort to present it to the
  appropriate agency and tries to come up with
  substantive answers.

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SC1 Subcommittee on DTRA Dose Reconstruction
Procedures

• Assessing dose reconstruction procedures
  (including revisions) used by NTPR contractors.
  These include the procedures for determining
  exposure scenarios, the technical procedures for
  reconstructing doses, and related documentation
  (such as Standard Operating Procedures, NTPR
  methodology reports and NTPR directives).
• Audit random samples of NTPR dose reconstructions
  to assure correct procedures are being followed
  and to ascertain the quality of reported doses
  and associated uncertainty estimates.

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SC2 Subcommittee on VA Claims Adjudication
Procedures

• Audit VA claims processing procedures, including
  interactions with VA Regional Offices, with the
  veterans filing claims, and with NTPR on dose
  reconstruction requirements and results. The
  Subcommittee is also reviewing the use of
  probability of cancer causation tables in the
  decision process.

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SC3 Subcommittee on Quality Management and VA

• Review all procedures and processes related to
  dose reconstructions, VA and NTPR interaction,
  and communications with veterans and the military
  services.
• Coordinate tasks of the four Subcommittees
• Provide recommendations to consolidate VA and
  NTPR procedures and achieve uniformity of dose
  reconstruction and claims adjudication.

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SC4 Subcommittee on Communication and Outreach

• Review mechanisms for communicating with veterans
  including
• exposure scenarios,
• technical procedures for reconstructing doses,
• claims evaluation procedures
• decisions related to radiogenic and
  non-radiogenic disease compensation.

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SC4 Subcommittee on Communication and Outreach

• Develop recommendations on more efficient and
  effective communication procedures between
  veterans, VA, and DTRA.
• Coordinate communication and outreach functions
  both internal to the VBDR and external to
  veterans for public meetings.

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VBDRs Recommendations

• On the basis of its audits and assessments, the
  Board offers a number of recommendations that
  would improve the NTPR dose reconstruction
  process and VA compensation program for veterans.
  
• These recommendations were sent to DTRA and VA in
  July 2006.

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VBDRs Recommendations for DTRA

• Develop a screening procedure for skin radiation
  dose assessments that would expedite processing
  of cases for which the doses are well below or
  above the level likely to result in a successful
  claim. Worst case upper bounds would be used to
  provide the veteran the maximum benefit of the
  doubt.
• Develop a screening procedure for prostate cancer
  cases that expedites processing of cases for
  which the doses are well below the level likely
  to result in a successful claim.

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VBDRs Recommendations for DTRA

• Perform a comprehensive analysis of uncertainties
  for all beta dose exposure scenarios.
• Hire a consultant to write a quality assurance
  (QA) plan.
• Develop and implement a QA program to be
  integrated into the current contracting process.
• Develop standard operating procedures addressing
  QA elements, including metrics.

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VBDRs Recommendations for VA

• Provide the adjudicated case outcomes to NTPR.
• Grant service connection to veterans whose basal
  cell skin cancers and melanomas are claimed to be
  as a result of participation in aboveground
  nuclear tests and service in Hiroshima and
  Nagasaki, and whose participation in these
  activities has been verified by Department of
  Defense.
• Centralize claims with radiation issues in a
  single site staffed with trained and experienced
  personnel, co-located with the Veterans Benefits
  Administration (VBA).

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VBDRs Recommendations for VA

• Establish a centralized database to track
  radiation issues with information readily
  available.
• VA provide the Board with a timetable and status
  for the development of a QA plan and program,
  including metrics, in the radiation exposure
  claims adjudication process.
• Include all validated radiation issue claimants
  in the Ionizing Radiation Registry.

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VBDRs Recommendations for VA

• Award service connection retroactively to the
  date of the initial claim for all current and
  future radiation risk activity conditions held to
  be presumptively service connected under 38 CFR
  3.309.
• Improve interaction and communication with
  veterans of Hiroshima and Nagasaki, Japan, or who
  were prisoners of war there, or who took part in
  atmospheric nuclear tests between 1945 and 1962.
• Communicate information on radiation risk and
  significance of veterans doses in relation to
  their diseases.

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Future VBDR Public Meetings

• VBDR will continue to hold public meetings at
  locations throughout the United States where
  there are large numbers of Hiroshima, Nagasaki
  and atmospheric nuclear test veterans who have
  filed compensation claims.
• Next VBDR meeting is Nov. 8-9, 2006, in Hampton,
  VA, followed by a fifth meeting in Las Vegas, NV,
  March 5-9, 2007.
• Transcripts and summary minutes of meetings will
  be posted on the VBDR website, http//VBDR.org.
• All activities of VBDR will be transparent to the
  public, meeting the requirements of FACA.

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Can I Attend Advisory Board Meetings?

• Yes. The date, time, location, and the proposed
  agenda for upcoming meetings will be publicly
  announced in the Federal Register and can be
  found on the VBDR website at http//VBDR.org.
• A news release announcing each meeting is
  disseminated to the news media and veterans
  groups. For more information, contact VBDR at
  1-866-657-VBDR (8237).

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How Can I Follow the Activities of the Board?

• You can follow the activities of the Board by
  visiting VBDR web site at http//VBDR.org.
• Or contact us at
• Veterans' Advisory Board on Dose Reconstruction
  
• 7910 Woodmont Ave.,
• Suite 400 Bethesda, MD
• 20814-3095

VBDR