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TRICARE News and Related Military Issues

Mustard Agent Exposure Remains “Indeterminate”

On July 12, The Department of Defense released the final version of its case narrative, "Reported Mustard Exposure Operation Desert Storm." This final report concludes the investigation into the possibility that a soldier was exposed to mustard agent during the Gulf War. Investigators from the Office of the Special Assistant for Gulf War Illnesses, Medical Readiness and Military deployments assessed this incident as "indeterminate."

This final report concurs with the interim narrative published in October last year. Since then, no new evidence and no new leads were developed that contradict the assessment as stated in the second interim report. However, minor editorial changes were made prior to publishing this final report.

The investigation examines the March 2, 1991, diagnosis of then-Pfc. David A. Fisher as having been exposed to liquid mustard chemical warfare agent. Among the strongest evidence supporting the conclusion that he was exposed to a chemical warfare agent were statements from well-trained medical personnel who diagnosed and treated the injury as an exposure to mustard agent. However, the only surviving evidence that supports a mustard exposure was a videotape of a MM-1 operator's screen during an examination of a flak jacket. While the videotape was evaluated in 1993 by an expert as a valid detection, further examination in 2000 revealed the sample was missing critical ions necessary for mustard presence.

In 1991, a physician and leading expert in the field of chemical warfare agent injuries concurred with the diagnosis of chemical warfare agent injury. However, in 1995 and 1999 interviews, this doctor also stated that other causes could explain Fisher's injury. Because another cause could not be found, the nature of the injury remains open. A urinalysis also failed to detect thiodiglycol, a mustard breakdown product. This result was inconsistent with
the diagnosis, but not unexpected considering the low-level of exposure. Additionally, the location of the bunker where Fisher was believed exposed was 100 miles from Iraq's nearest chemical warfare storage facility according to the CIA and the United Nations Special Committee on Iraq. The CIA and UNSCOM have reported no evidence that Iraq moved any chemical warfare agents south of Khamisiyah.

Due to the conflicting evidence, investigators are less certain and the assessment of this event remains as indeterminate.

This narrative, and all other publications of the Office of the Special Assistant for Gulf War Illnesses, Medical Readiness and Military Deployments, is posted on GulfLINK at http://www.gulflink.osd.mil/fisher_final

VA Announces New Benefit, "CHAMPVA For Life"

Improvements to the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) will bring financial relief to older survivors and dependents of some disabled or deceased veterans who face medical expenses not paid by Medicare or other third-party payers.

Called "CHAMPVA for Life," the new benefit is designed for spouses or dependents who are 65 or older. They must be family members of veterans who have a permanent and total service-connected disability, who died of a service-connected condition or who were totally disabled from a service-connected condition at the time of death. They also must have Medicare coverage.

"This improved benefit is part of VA's continuing effort to make sure the families of disabled veterans have health care when the veterans can no longer provide it," said Secretary of Veterans Affairs Anthony J. Principi. "I'm delighted we can provide prescription outpatient medication coverage, a benefit not offered by Medicare."

Beginning October 1, CHAMPVA will pay benefits for covered medical services to eligible beneficiaries who are 65 or older and enrolled in Medicare Parts A&B. The "CHAMPVA for Life" benefit is payable after payment by Medicare or other third-party payers. For services not covered by Medicare or other insurance, such as outpatient prescription medications, CHAMPVA will be the primary payer.

CHAMPVA beneficiaries who reached age 65 as of June 5, 2001, but were not enrolled in Medicare Part B on that date, will be eligible for this expanded benefit even though not enrolled in Medicare Part B. There is no change in CHAMPVA coverage for those beneficiaries 65 and older who do not qualify for Medicare.

Information about the new benefit was recently mailed to all previous CHAMPVA beneficiaries and providers who have filed claims with CHAMPVA.

People over age 65 who have never been eligible for CHAMPVA can request an application by writing to the VA Health Administration Center (HAC), P.O. Box 469028, Denver, CO 80246-9028.

Veterans and family members can also call toll-free, 1-888-289-2411, to obtain the latest recorded information, leave a change of address, or request information to be mailed to them. This phone line is available 24 hours a day.
Inquiries may also be e-mailed to hac.inq@med.va.gov

Updates about "CHAMPVA for Life" and other benefits information will be posted to VA's Health Administration Center Web site at http://www.va.gov/hac

© 2002 Texas Osteopathic Medical Association
Last updated 01/14/2004