The West Michigan Veterans Coalition quarterly meeting was on December 3, 2014. The presentations focuses on toxicity on the battlefield, Chapter 1 - Agent Orange Exposure and how to complete a fully developed claim. The second part of the presentation was presented by Michigan Works about their Area Community Services and Employment and Training Council (ACSET) and Jobs for Veterans State Grant. The third presentation was on podio and the new WMVC website.

1. December 3, 2014

2. Agenda
9:00 a.m. - 10:00 a.m. - Networking, Coffee & Donuts
10:00 a.m. - 10:10 a.m.
– Pledge of Allegiance
– Announcements
– Recognition
10:10 a.m. - 10:50 a.m.
– Toxicity of the Battlefield: Chapter 1 Agent Orange Exposure - Mark
Kane, Ph.D.
– Access to Benefits - Carrie Roy, Manager, Kent County Veterans Affairs
10:50 a.m. - 11:05 a.m.
– Michigan Works! - Veterans Services Program
11:05 a.m. - Noon
– Podio Demonstration - Natalie Harris
– WMVC Website
Mission
To improve the lives of veterans, their families, and anyone that served in the Armed Forces by connecting them to all available services and
resources throughout West Michigan.

3. Thank you!
• Kevin Stotts – Talent 2025
• Brandi McBride – Goodwill Industries, Talent 2025
• Patrick Owen – SDI Consulting
• Erik Olgeirsson – SDI Consulting
• Thomas Koziol – Web Design

4. Toxicity on the Battlefield
Chapter 1: Vietnam War
Chapter 2: Gulf War
Chapter 3: OEF/OIF/OND

5. * DISCLAIMER
Information during this presentation is for educational
purposes only—it is not a substitute for informed medical
advice or training. You should not use this information to
diagnose or treat a mental health problem without
consulting a qualified professional/ provider.
5

6. Chapter 1: Agent Orange
West Michigan Veterans Coalition
December 3, 2014

7. Overview
 The Dark Shadow of Agent Orange
 What is/are dioxin(s)
 VHA response to Vietnam War
 Presumptive conditions
 Exposures of special groups
 The future
 Resources
 Questions

8. The Dark Shadow of Agent
Orange

9. Operation Ranch Hand
“Ranch Handers” motto was
“only you can prevent a
forest”
 Operation Ranch Hand was a U.S. Military operation
during the Vietnam War lasting 1962 – until 1971
 Inspired by the British use of Agent Orange during
the Malayan Emergency in the 1950s. “Operation Trail
Dust”
 Spraying an estimated 20 million U.S. gallons to
deprive the Viet Cong of food and vegetation cover
 95% of the herbicides and defoliants used in the war
were sprayed by U.S. Air Force as part of Operation
Ranch Hand
 5% sprayed by the U.S. Chemical Corps, other
military branches, and the Republic of Vietnam using
hand sprayers, spray trucks, helicopters and boats,
primarily around U.S. military installations.

10. Herbicide (Agent) Orange (1)
2,4-Dichlorophenoxyacetic acid 2,4,5-Trichlorophenoxyacetic acid
 1:1 mixture of 2,4-dichlorophenoxy acetic acid (2,4-D, 50%)
and 2,4,5-trichlorphenoxyacetic acid (2,4,5-T, 50%)
 2,4,5-T was used extensively as an herbicide in forestry and
agriculture domestically and abroad starting in the 1940s.
 Shipped to Vietnam in 55-gallon steel drums with an orange
stripe around the middle
 ~12/19x106 gallons used in Vietnam = A.O.

11. Other Herbicides Used in Vietnam
“Agent Blue”
Cacodilic Acid
“Agent White”
Picloram
Dibenzofuran

12. Heavily Sprayed Areas - Map
 Inland forests near the demarcation
zone
 Inland forests at the junction of the
borders of Cambodia, Laos, and
South Vietnam
 Inland forests north and northwest of
Saigon
 Mangrove forests on the
southernmost peninsula of Vietnam
 Mangrove forests along major
shipping channels southeast of
Saigon

13. Politics
 In 1970 - Concerns about the health effects of exposure to
Agent Orange
 A study reported the incidence of birth defects in laboratory mice
given high doses of the herbicide 2,4,5-T. TCDD, a dioxin
contaminant of 2,4,5-T, was isolated as the actual cause of the birth
defects
 In 1971 - Congress ordered the end of Herbicide Agent spraying
when two studies showed birth defects and other endocrine-related
pathology in rats
 The herbicide was banned completely in 1985 by the
Environmental Protection Agency
 In 1991 – Congress enacted the Agent Orange Act, giving the
Department of Veterans Affairs the authority to declare certain
conditions ‘presumptive’ to exposure to Agent Orange/dioxin.
Veterans who served in Vietnam eligible to receive treatment
and compensation

14. Federal Response to Vietnam
 1970s - Agent Orange examination and Agent Orange Review
 1980s – Epidemiology/Case law/Legislation
 VHA EES; CDC
 1991 – Agent Orange Act
 1960s – 2011 – Scientific Study
 1980s – Air Force Ranch Hand
 1990s et. seq. – NAS/IOM biennial AO Report

15. Presumptive Conditions
 Acute and Subacute Peripheral Neuropathy A
nervous system condition that causes numbness,
tingling, and motor weakness. Under VA's rating
regulations, it must be at least 10% disabling within 1
year of exposure to herbicides and resolve within 2
years after the date it began.
 AL Amyloidosis A rare disease caused when an
abnormal protein, amyloid, enters tissues or organs.
 Chloracne (or Similar Acneform Disease) A skin
condition that occurs soon after exposure to
chemicals and looks like common forms of acne seen
in teenagers. Under VA's rating regulations, chloracne
(or other acneform disease similar to chloracne) must
be at least 10% disabling within 1 year of exposure to
herbicides.

16. Presumptive Conditions (2)
 Chronic B-cell Leukemias A type of cancer which
affects white blood cells.
 Diabetes Mellitus (Type 2) A disease characterized by
high blood sugar levels resulting from the body’s
inability to respond properly to the hormone insulin.
 Hodgkin’s Disease A malignant lymphoma (cancer)
characterized by progressive enlargement of the lymph
nodes, liver, and spleen, and by progressive anemia.

17. Presumptive Conditions (3)
 Ischemic Heart Disease A disease characterized by a
reduced supply of blood to the heart, that leads to chest
pain.
 Multiple Myeloma A cancer of plasma cells, a type of
white blood cell in bone marrow.
 Non-Hodgkin’s Lymphoma A group of cancers that
affect the lymph glands and other lymphatic tissue.

18. Presumptive Conditions (4)
 Porphyria Cutanea Tarda A disorder
characterized by liver dysfunction and by thinning
and blistering of the skin in sun-exposed areas.
Under VA's rating regulations, it must be at least
10% disabling within 1 year of exposure to
herbicides.
 Prostate Cancer Cancer of the prostate; one of
the most common cancers among men.

19. Presumptive Conditions (5)
 Respiratory Cancers Cancers of the lung, larynx,
trachea, and bronchus.
 Soft Tissue Sarcoma (other than Osteosarcoma,
Chondrosarcoma, Kaposi’s sarcoma, or
Mesothelioma) A group of different types of cancers in
body tissues such as muscle, fat, blood and lymph
vessels, and connective tissues.

20. Other Military Exposures
 Korea - In or near the Korean demilitarized zone
anytime between April 1, 1968 and August 31, 1971
 Thailand - Vietnam-era Veterans whose service involved
duty on or near the perimeters of military bases in
Thailand anytime between February 28, 1961 and May
7, 1975 may have been exposed to herbicides and may
qualify for VA benefits.
 Waterways
 Inland
 Costal
 On-shore
 Blue water*
*Veterans who served on open sea ships off the shore of Vietnam during Vietnam War are
sometimes called “Blue Water Veterans”

21. Women Veterans and Offspring
 Am J Ind Med. 2000 Oct;38(4):447-54.
 Pregnancy outcomes among U.S. women Vietnam
veterans.
 Kang HK, Mahan CM, Lee KY, Magee CA, Mather SH,
Matanoski G.
 A comparison of self-reported pregnancy outcomes for
4,140 women Vietnam veterans with those of 4,140
contemporary women veterans who were not deployed
to Vietnam.
 There was no statistically significant association
between military service in Vietnam and index
pregnancies resulting in miscarriage or stillbirth, low
birth weight, pre-term delivery, or infant death. The risk
of having children with "moderate-to-severe" birth
defects was significantly elevated among Vietnam
veterans (adjusted OR = 1.46, 95% CI = 1.06-2.02).
 The risk of birth defects among index children was
signficantly associated with mother‘s military service in
Vietnam.

22. Covered Birth Defects (1)
 Achondroplasia
 Cleft lip and cleft palate
 Congenital heart disease
 Congenital talipes equinovarus (clubfoot)
 Esophageal and intestinal atresia
 Hallerman-Streiff syndrome
Cleft lip and cleft palate
Hallerman-Streiff
syndrome
Achondroplasia
Congenital talipes
equinovarus (clubfoot)

23. Covered Birth Defects (2)
 Hip dysplasia
 Hirschprung's disease (congenital megacolon)
 Hydrocephalus due to aqueductal stenosis
 Hypospadias
 Imperforate anus
 Neural tube defects
Neural tube defects
Image of Spina Bifida

24. Covered Birth Defects (3)
 Poland syndrome
 Pyloric stenosis
 Syndactyly (fused digits)
 Tracheoesophageal fistula
 Undescended testicle
 Williams syndrome

25. Death from Agent Orange
 Surviving spouses, dependent children and dependent
parents of Veterans who were exposed to Agent Orange
and died as the result of diseases related to Agent
Orange exposure may be eligible for survivors' benefits.
 http://www.publichealth.va.gov/exposures/agentorange/
benefits/survivors.asp

26. NAS/IOM Veterans and
Agent Orange – 2012
 Veterans and Agent Orange: Update 2012 -
http://www.iom.edu/Reports/2013/Veterans-and-
Agent-Orange-Update-2012.aspx
 Released: December 3, 2013
 Veterans Review of the Health Effects in Vietnam
Veterans of Exposure to Herbicides (Ninth) Biennial
Update

27. Resources
 Agent Orange Registry Health Exam for Veterans
http://www.publichealth.va.gov/exposures/agentorange/benefits/registry-exam.
asp
 VHA Agent Orange Home Page
http://www.publichealth.va.gov/exposures/agentorange
 Vietnam Veterans of America Home Page
http://VVA.org
 The VVA Self-Help Guide to Service-Connected Disability Compensation
for Exposure to Agent Orange –
http://www.vva.org/Guides/AgentOrangeGuide.pdf

28. Thank you!
Mark S. Kane, Ph.D. Licensed Psychologist
Fellow Michigan Psychological Association
Riverview Psychological Services, P.C.
drmskane@gmail.com 616-464-0811 28

29. Fully Developed Claims for
Dioxide Exposure
Presented by Carrie Roy

30. Different Methods of Filing
• Ebenefits
• Self
• Law Firms
• Accredited Veterans Service Officer

31. Forms Needed to File
• DD214
• VA Form 21-526EZ
• DBQ (specific to claimed condition)

32. Where to find Accredited VSOs
• http://macvc.net/
• http://www.michiganveterans.com/
• Kent County Department of Veterans Affairs 82
Ionia NW STE 380, Grand Rapids, MI 49503
616-632-5722

33. Area Community Services
Employment and Training Council (ACSET)
Mission
Create opportunities for economic self-sufficiency for low-income,
economically disadvantaged, elderly, disabled,
unemployed and underemployed individuals, and
dislocated workers.

34. MI Works! System
Michigan Works! Agency
ACSET, as the Michigan Works! Agency (MWA) for Kent, Allegan & Barry Counties……
• Services offered at each location are designated to prepare job seekers
for employment and connect potential applicants to employers
• Assistance filing for unemployment benefits
• Individual Job search assistance and training opportunities to qualified
job seekers
• Kent County: Two full service centers and one satellite center
• Allegan County: One full service center, one satellite center
• Barry County: One full service center

35. MI Works! System
Michigan Talent Connect
• Pure Michigan Talent Connect – a collaborative effort of the State
of Michigan’s Workforce Development Agency (WDA) and the
Michigan Economic Development Corporation (MEDC). Pure
Michigan Talent Connect serves as the state’s labor exchange
system.
– Internet-based website, available 24 hours a day
– Allows job seekers to list their qualifications & interests
– Allows job seekers to see available jobs throughout Michigan
– Allows registered employers to search for qualified talent

36. MI Works! System
Services
• assessments of skill levels,
aptitudes, abilities, and support
service needs
• information on local service
providers
• help filing claims and evaluating
eligibility programs or aid
• job search and placement
assistance, career counseling
• up-to-date labor market
information
• workshops
For job seekers

37. MI Works! System
Business Services
Michigan Works! is a Demand-driven Workforce System
• Business Services Representatives work with employers within industry
sectors such as manufacturing, information technology, agriculture / food
preparation and health care
• Maintain partnerships with regional economic development agencies and
educational institutions to provide the most comprehensive solution to
current and future employment demands
• Talent Development Specialists who are able to connect job seekers
directly to community employers

38. MI Works! System
Services
• labor exchange services
• recruitment assistance
• applicant screening
• job postings
• testing services
• job fairs / employer of the
day events
For employers

39. MI Works! System
Programs – Trade Act
• Program available to former employees who have lost their jobs
as a result of foreign competition
• Available for companies specifically approved by the U.S.
Department of Labor
• Aim is to offer adversely affected workers with opportunities to
obtain skills, credentials, resources, and support needed to
become reemployed
• Services offered include: training, job search assistance,
relocation assistance, alternative Trade benefits for mature
workers, & Health Care Tax Credit
• More information is available at: http://doleta.gov/tradeact/

40. MI Works! System
Programs –Workforce Investment Act (WIA)
Three separate funding streams to serve
• Adults
• Dislocated Workers
• Youth
• One-on-one job search assistance with a certified
Career Coach
• Free workshops and resume assistance
• Individual Training Accounts for in-demand training up to 12 months and
$6,500 for all eligible customers
• On-the-Job Training reimbursement available to employers
• Work Keys assessments and other Career Guidance tools
• Mentoring, goal-setting and work experience for youth

41. MI Works! System
Programs –Workforce Investment Act (WIA)
Priority Services to Veterans and Eligible Spouses:
• Have the option to work with a Career Coach who is also a veteran
• Income qualify for WIA services or receiving or exhausted UIA benefits
• Active Military Service / discharged under “other than dishonorable”
conditions
• Provides a copy of DD214
• Eligible Spouse
• Service member is missing in action, captured or forcibly detained
• Veteran has total service-connected disability, per VA evaluation
• Veteran died of a service-connected disability
• Veteran died while a total service-connected disability, per VA evaluation, was in existence

42. MI Works! System
State of Michigan
Veterans’ Services Division
To deliver intensive employment services to a targeted veteran population as an
integrated partner with the Michigan Works! Agency, in accordance with the intent of
the Jobs for Veterans State Grant program.

43. MI Works! System
Veterans’ Services Division
Jobs for Veterans State Grant
The Jobs for Veterans State Grant (JVSG) assists eligible Veterans and
Spouses reduce/remove barriers to employment by providing intensive
employment services at Michigan Works! Service Centers through funding
for Disabled Veterans’ Outreach Program (DVOP) Specialists and Local
Veterans’ Employment Representative (LVER) staff.
DVOP Specialists and LVERs are state employees whose salaries and
benefits are funded through U.S. Department of Labor formula grants to
the states, District of Columbia, Puerto Rico, Virgin Islands, and Guam.

44. VSD Regions
Region 1
Prosperity Regions: 1, 2, 3, 5, 6
Number of DVOP Specialists: 11
Region 2
Prosperity Regions: 4, 7, 8, 9
Number of DVOP Specialists: 16
Region 3
Prosperity Region: 10
Number of DVOP Specialists: 18

45. MI Works! System
Veterans’ Services Division
The State of Michigan employs 45 DVOP Specialist who are located within
MI Works! Service Centers throughout the state.
As an integrated partner within the MI Works! Service Center the DVOP
Specialist provides intensive individualized employment services, within a
case management framework, to an eligible veteran population who are
unlikely to obtain employment without receiving such services. Services
include, but not limited to:
• Development of an action plan to meet employment goals
• Vocational guidance
• Job search assistance
• Direct referral to other services needed to reduce/eliminate barriers to
employment

46. MI Works! System
Veterans’ Services Division
Priority of Service
All Veterans and eligible spouses are entitled to Priority of Service in any
program funded, in whole or part, by the U.S. Department of Labor.
Meaning Veterans receive services at the MI Works! Service Center before
or instead of a non-covered person.
When a Veteran or eligible spouse identifies themselves as such the MI
Works! staff informs them of their entitlement to Priority of Service and
describes the full array of services.
• At the point of entry the Veteran’s (or eligible spouse’s) eligibility for
DVOP services is determined. If eligible the Veteran is referred to
the respective DVOP Specialist. If NOT eligible the Veteran will be
referred to an appropriate program/service.

47. MI Works! System
Questions?

48. An Overview of Podio
How Coalition Members Can Navigate
and Use Podio to Better Serve
Veterans, their Families and Caregivers

49. The Need
Implementing the “No Wrong Door” philosophy
• Service providers need to be identified
• Their information has to be collected
• Service providers have to come together to educate one
another
Collective Efforts
• Effective Coordination of Services
• Integration of Services

50. Collaborative Tool Requirements
Gather Information Share Information
Foster
Communication
within the VCAT
Produce
Informative
Products that Aid
the VCAT’s Mission

51. The Focus of Today’s Demonstration
Podio’s Functionality
• Coalition Based Service Provider Directory
• Assistance and Support Requests
• Collaboration Space for Working Groups
• Veterans’ Resources and Events

53. Coalition Based
Service Provider Directory
• Allows member service providers to collect
each others information.
• The ability to search and filter the directory to
locate services for helping veterans.
• Organization and Coalition Member Directory

54. Assistance and Support Request
• Allows member service providers to request
support or assistance with helping a Veteran.
• Ability to document case management
(randomized ID number) with multiple
providers assisting in the resolution process.
• Can store completed requests for others to
reference navigation routes to obtain services.

55. Collaboration for Working Groups
• A space for VCAT working groups to
collaborate remotely, store resources,
document projects and capture action steps to
achieve the groups objectives.

56. Veterans Resources and Events
• A central location for member service
providers to locate events, documents, and
helpful websites to better serve our Veterans,
dependents and caregivers.

57. Workspace Example

58. Any Questions?
Natalie Harrison
Natalie.Harrison@altarum.org