VA Sec. McDonough on benefits for veterans exposed to burn pits, preventing vet suicide

President Joe Biden has vowed to improve veterans’ access to health care, prevent their suicide, and specifically provide benefits to those exposed to toxic air through burn pits while serving in the military. Nick Schifrin talks to Denis McDonough, the veterans affairs secretary, about those goals and how former service members have responded to the administration's efforts.

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  • Amna Nawaz:

    President Biden has vowed to improve veterans' access to health care, prevent veterans' suicide, and specifically provide benefits to those exposed to toxic air while serving in the military.

    Nick Schifrin talks to the Veterans Affairs secretary about those goals and how former service members have responded to the administration's efforts.

  • Nick Schifrin:

    Last month, the White House announced a new model designed to provide benefits to more veterans who were exposed to toxic air. Many of these veterans lived and served next to so-called burn pits, where service members incinerated everything from tires to batteries.

    Veterans groups argue the pits created toxic smoke that afflicted service members with higher-than-average rates of asthma, bronchitis, even cancer. But many veterans' claims that their illnesses were caused by their service have been denied.

    The man tasked with changing that is Denis McDonough, secretary of the VA.

    Welcome to the "NewsHour." Thank you very much.

    Denis McDonough, U.S. Secretary of Veterans Affairs: Thank you for having me.

  • Nick Schifrin:

    I want to begin with some statistics that show the scope of the problem.

  • Denis McDonough:

    Yes.

  • Nick Schifrin:

    Since the Gulf War in the early '90s, through this year, of 1.31 million veterans who filed a claim for a respiratory illness caused by their service, more than 40 percent of claims were denied. That's according to internal VA data that we obtained.

    From the Gulf War through this year, of more than 111,000 veterans who filed a claim for cancer caused by their service, more than 64 percent were denied. And according to VA testimony last year, VA has denied 78 percent of disability claims of toxic exposure from burn pits.

    Why so many denials?

  • Denis McDonough:

    Look, I look at the 30 years a little differently.

    This president, President Biden, is the first president in those 30 years to presumptively link certain conditions and begin paying benefits and providing care based on those — that presumptive link for veterans.

    Now, when you think about the number, we and the — the president announced in May that we would cover three presumptions — conditions, asthma, sinusitis and rhinitis. We anticipate 300,000 veterans will apply for those conditions. Already, more than 7,000 have applied, and somewhere around 70 percent of those applications have been approved.

    I don't know if, at the end of the day, we will be at full 70 percent. But the point is that it is long overdue that this gets done. This is the first president in 30 years to do it. And we're going to stay on top of it until, as your introduction suggested, this is fixed.

  • Nick Schifrin:

    And to understand the problem, we have to diagnose it, though.

    If you could, why do you think this has been such a problem for so long?

  • Denis McDonough:

    Look, I think that people have been trying to establish a scientific connection to these exposures.

    And the level at which you establish that connection is really important. But we have made a determination, based on the president's guidance, that, as with everything else we do at VA, we should establish a threshold at which your condition should be considered caused by your service, provided that it is as likely to have been caused by your service as by anything else.

  • Nick Schifrin:

    Your report for rare cancers is due in about two months or so to the White House.

    Then you will consider a model for other illnesses, including constrictive bronchiolitis. How many veterans suffer from constrictive bronchiolitis? And how will they prove it, given that often it can only be diagnosed with a lung biopsy?

  • Denis McDonough:

    So, a lung biopsy itself is so invasive as to be dangerous to the health of the veteran.

    So we're coming up with new ways to do that. I don't know that there will be ready then. But, again, we want to establish the presumption, if we can. And, ideally, we will be able to do that without putting the veteran at further risk.

  • Nick Schifrin:

    In speaking of veterans groups ahead of this interview, they say there is a perception born from the data we looked at before that veterans assume their claim will be denied.

    How do you defeat that assumption?

  • Denis McDonough:

    Look, it breaks my heart.

    And part of the reason that I wanted to come talk to you is I know that a lot of our veterans watch this program, especially your all's reporting on this.

    And what I would ask our veterans is, please come to us. File your claim. The act of filing your claim is important for your claim. But it is also important for your battle buddies, because we can use data analytics and data science to establish these connections, in the hopes that we can continue to grant at the rate of 70 percent, which is the experience since these three new presumptives for the first time in 30 years have been proceeding.

    I hope that continues.

  • Nick Schifrin:

    Let's move to veteran suicide rates; 65,000 veterans since 2010 have died by suicide. That is eight times the number of U.S. service members killed in Iraq, Afghanistan, and the war on terror.

    One of the focuses of the groups working on this is creating a physical distance between any veteran having suicidal ideation and a firearm, physical distance between the firearm and that person.

    How do you do that?

  • Denis McDonough:

    We're working through two very aggressive public campaigns, one that says, don't wait. Reach out. Come to us, and we will come up with a plan even if you're not in a moment of crisis.

    The second one has to do expressly with firearm safety. And what we have said through a concerted public advertisement campaign on television, through social media, and then through earned media like this is, we have said, that moment of suicidal ideation can be fleeting. As difficult as it is, it can be passed.

    And so we want at that moment for there to be some distance between the veteran and a firearm. So, we have all sorts of established processes, including gun locks, that we have provided now, almost 10,000 of them, to veterans, to veterans' families, so that they can safely store their weapons.

    This is a very simple step by step that we think that we can take.

  • Nick Schifrin:

    Let's talk about your motto.

  • Denis McDonough:

    Yes.

  • Nick Schifrin:

    Let's take a look at that right now: "To care for him who have shall borne the battle and for his widow, and his orphan."

    "To care for him." There's a movement to convince you to change that.

  • Denis McDonough:

    Yes.

  • Nick Schifrin:

    Will you?

  • Denis McDonough:

    It's not my motto. It's a quote that goes back to the second inaugural address for President Lincoln.

    We will change the motto. How we do it and when we do it is going to be important, most particularly the how we do it. We're talking to veterans now about what their expectations are. I'm not a veteran myself, OK? And I'm also not among the fastest growing cohort of veterans, women veterans.

    So, we're talking to veterans, including women veterans, about their expectations. When that process is done, then we will make some announcements.

  • Nick Schifrin:

    But, just be clear, you are determined to change it, so that it doesn't just say "him"?

  • Denis McDonough:

    It's not that I'm determined to change it. It's that I will change it.

  • Nick Schifrin:

    And, finally, I want to show you a photo to end on.

    I want to show you Major Ian Fishback, retired veteran of Iraq and Afghanistan, blew the whistle on detainee abuse in Iraq. He struggled with mental health. And, eventually, a court ordered him put on medication, placed in an adult foster care facility. And that is where he died in mid-November at the age of 42.

    His family was trying to get him help, including from the VA.

    What do you think his story says about how this country treats its veterans?

  • Denis McDonough:

    My heart breaks for Major Ian Fishback and for his family.

    We became aware of the circumstance that Major Fishback was in, was not what we call an enrolled veteran. But a lot of that stuff doesn't really matter, at the end of the day.

    What I want is for all of our veterans and all the veterans' family members to know that we're here for them.

    So, please, let us know when you're in a time of crisis.

  • Nick Schifrin:

    Do you think he fell through the cracks? Do you think — do you fear others are falling through the cracks?

  • Denis McDonough:

    I mean, we're working to get to the bottom of precisely what happened in the case of Major Fishback.

    As I have said, my heart breaks for him. I think the family is aware of how strongly we feel about this, how strongly I feel about this.

    Do I think other veterans have fell through the cracks? Until we're at zero veteran suicides, I will think that veterans are falling through the cracks. We owe them much better than that. And that's what we're going to do.

  • Nick Schifrin:

    Denis McDonough, thank you very much.

  • Denis McDonough:

    Thanks, Nick.

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