VA secretary discusses health care overhaul helping veterans exposed to toxic burn pits

A major overhaul of Veterans Affairs is making it easier for veterans who are sick from exposure to burn pit smoke and other toxins to get treatment. In the past, veterans had to prove their sicknesses were connected to their service in the military. But with the passage of the PACT Act, that has changed. VA Secretary Denis McDonough joined Amna Nawaz to discuss the reform.

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  • Judy Woodruff:

    A new law known as the PACT Act overhauls how the Department of Veterans Affairs processes disability claims for veterans sickened by exposure to smoke from burn pits and other toxins in Iraq, Afghanistan and elsewhere.

    Amna Nawaz talks with the man in charge of carrying out this major reform.

  • Amna Nawaz:

    In the past, veterans had to prove their sickness was connected to their service in the military, something often almost impossible to do.

    But with the passage of the PACT Act, a veteran now only must prove they were deployed to one of the countries listed in the act and have one of 23 different medical conditions, such as brain cancer, asthma or chronic bronchitis.

    Let's discuss this now and other issues facing former service members with Veteran Affairs Secretary Denis McDonough.

    Mr. Secretary, welcome back to the "NewsHour." Thanks for being here.

    Denis McDonough, U.S. Secretary of Veterans Affairs: Thank you for having me. I'm really thrilled to be here.

  • Amna Nawaz:

    So, the president, as you know, signed that act three weeks ago.

    The VA has said, I believe, it won't begin processing those claims until January of next year, 2023. So, how quickly will veterans who are seeking benefits under the PACT Act, how quickly can they expect to receive them?

  • Denis McDonough:

    We will not begin processing these claims until January 1, because we have a bunch of steps we have to take, new regulations to establish. We're in the process of doing that now.

    So that's basically as quickly as we could do it. Importantly, though, when the president signed that bill in August — just last month in August, every condition will be effective as of that date. So the important thing for our veterans to know is, please file now, irrespective of your claim, irrespective of your condition.

    And we will make sure that we begin compiling those claims immediately. We will begin processing them in January. How ready will we be? We are — we have been preparing for this. We have been in the process of hiring 2,000 additional personnel. We're going to require a couple thousand on top of that.

    We have been working on automating claims. Claims in many instances which had been taking months are now taking days. Now, that's still technology that we're getting up to speed.

    And then, of course, we're looking at the process itself to make it more efficient, more straightforward, more transparent. So, we have work to do.

    (CROSSTALK)

  • Amna Nawaz:

    Yes.

  • Denis McDonough:

    We have work to do. But we're going to be ready for this.

  • Amna Nawaz:

    It's still four months before you begin processing, right?

  • Denis McDonough:

    Correct.

  • Amna Nawaz:

    And my understanding is, as of last month, you still had a backlog of pending claims of over 950,000.

    So what is the timeline for when veterans could expect to receive those benefits?

  • Denis McDonough:

    Yes, good question.

    The backlog of claims right now — and the backlog is defined as a claim that's been pending for 125 days or longer — is 145,000 claims, not 945,000, 145,000 claims.

  • Amna Nawaz:

    And what's very quickly? Weeks? Months?

  • Denis McDonough:

    Well, again, I'm not going to — I'm not — until we see individual claims, I'm not going to make any commitments right now on the show here.

  • Amna Nawaz:

    OK.

  • Denis McDonough:

    But here's what we're doing is, we're hiring up. We're making this process more clear and straightforward. And we're automating it.

    We shouldn't be the only organization in the country…

  • Amna Nawaz:

    Got it.

  • Denis McDonough:

    … in the age of the Internet that's not automating claims. We're going to do that.

  • Amna Nawaz:

    Yes, but no timeline just yet to share?

  • Denis McDonough:

    I'm not giving you a timeline today.

  • Amna Nawaz:

    OK.

    There are still holes I should ask you about. I know we have talked about this before on the show. There's a condition called constrictive bronchiolitis, which basically destroys the small airways. There's no treatment. There's no cure.

  • Denis McDonough:

    Right.

  • Amna Nawaz:

    Under the metrics that the VA currently uses, you have to establish what's called a disability rating. And that then can help grant some benefits to the veterans.

  • Denis McDonough:

    Right.

  • Amna Nawaz:

    People who have this do not qualify for anything. They have to appeal to get something.

    And I believe back in July, you said you were looking into this.

  • Denis McDonough:

    Yes.

  • Amna Nawaz:

    So have you closed the loophole?

  • Denis McDonough:

    So, we have been working on this issue of constrictive bronchiolitis.

    One of the issues is the test to prove existence of constrictive bronchiolitis is actually as intrusive in many cases as the disease itself.

  • Amna Nawaz:

    Right.

  • Denis McDonough:

    And so I don't have news on that yet.

    We will continue the process we established when we came in, before Congress acted, at the president's direction, to ensure that we're getting all the available science on all of these conditions.

  • Amna Nawaz:

    But you haven't yet changed the way that the disability rating is assigned for this?

    In other words, nothing about the process has changed about this?

  • Denis McDonough:

    Except that the statute signed by the president…

  • Amna Nawaz:

    Yes.

  • Denis McDonough:

    … ensures that this will begin to be processed on January 1.

  • Amna Nawaz:

    I do want to ask you about some new numbers we saw today in the headlines, the new Pentagon survey released about sexual assault in the military.

    And we know Department of Defense has been collecting these for 16 years. The latest numbers have risen sharply. They're the highest that they have ever been. Just take a look at some of these, as I'm sure you know.

    Sexual assaults among women service members grew 35 percent from 2018 to 2021; 8.4 percent of women, 1.5 percent of men say they have been a victim of a sex crime, and only about one out of every five troops end up reporting their assault.

    So we're talking about over 35,000 active-duty service members. What is the VA currently doing? What more should be done to support the physical and the mental trauma of those survivors?

  • Denis McDonough:

    First of all, the numbers are obviously concerning. Any individual incident of what we call military sexual trauma is one too many, first point.

    Second point, this has been a priority for us, both in terms of ensuring that veterans feel safe to come in to VA to seek care, making sure that active-duty service members who want to come into a vet center to get support, mental health support, because they have been — they are a survivor of this kind of activity.

  • Amna Nawaz:

    Do you find people accessing those services?

  • Denis McDonough:

    We do. We do.

  • Amna Nawaz:

    Do you know how many claims have been filed with those MST counselors?

    (CROSSTALK)

  • Denis McDonough:

    I don't have a number, a claims number in front of me.

    But there's two things I want to make sure that we're making clear, one, claims. And we are dramatically improving our ability to make those determinations and to make them in a way that's reassuring to and supportive of survivors.

    The second thing is, we have ongoing services today available not just for veterans, but also for active-duty service members who are victims of military trauma at our vet centers. We have vet centers in every state across the country.

    If there is an active-duty service member or if there is a veteran survivor of this kind of treatment, we urge them to come in to get care.

  • Amna Nawaz:

    I'd like to ask you too about abortion access since Roe was overturned.

  • Denis McDonough:

    Yes.

  • Amna Nawaz:

    We know the VA cares for, what, about 300,000 female veterans of childbearing age.

    And, in late July, you said you were closely watching to see how states reacted to see if there was what you called a diminishment of services. And, since then, we have only seen more states enact further restrictions. So you have been waiting to see if the VA is in a position to offer abortion services.

    Do you have everything you need to make that decision? Will they begin offering abortion services in VA hospitals?

  • Denis McDonough:

    I don't have any announcements to make on that tonight.

    We are — as I said, shortly after the ruling, and as we have been looking at — frankly, since we saw the leaked opinion now many months ago, we are making an assessment on the impact on veteran patient safety. That is our number one priority across…

  • Amna Nawaz:

    What does that mean? Does just include access to abortion services?

  • Denis McDonough:

    That means whether our veterans have access to the care that they need when they need it.

    And so our reproductive services to date have not included abortion counseling or abortion services. We're looking at whether, in light of the restrictions now in many states across the union, whether, in order to ensure patient safety, their life, their well-being, their health, that we're taking a look at whether we need to be in a position to offer those services.

    That's — we're taking that very, very seriously. That's priority number one for us at VA.

  • Amna Nawaz:

    Have you spoken to the president about this?

  • Denis McDonough:

    I have not.

  • Amna Nawaz:

    Is this something that you see that the VA is able to step in and provide those services anytime soon?

    And, as you mentioned, that leaked draft opinion was several months ago. The ruling itself was in June. You have been looking at this. When do you feel you will have the information? And you believe you have the legal authority as well.

    When could you move on this?

  • Denis McDonough:

    It's not that I believe we have the legal authority. It's that we do have the legal authority. So…

  • Amna Nawaz:

    So, if you have the legal authority, I guess the question most people ask is, why haven't you done something?

  • Denis McDonough:

    In fact, it's the question you're asking.

    And I'm telling you, I don't have an announcement for you today, but I'm looking at this very, very seriously.

  • Amna Nawaz:

    Secretary of Veterans Affairs Denis McDonough, thank you for joining us. Always good to have you here.

  • Denis McDonough:

    Thank you, Amna.

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