BETRAYED BY THE VA Thomas Alan Bowman Sr. asked his country for help. He got silence. Sign the demand →
Dear Doug Collins

The C-123 Reservists: The Spray Planes Came Home From Vietnam, and the Dioxin Came With Them

They never set foot in Vietnam. Their war was a cargo hold in Massachusetts, Ohio, and Pennsylvania — an aging Fairchild C-123 Provider that had spent the previous decade spraying Agent Orange over the jungles of Southeast Asia and now flew airlift and aeromedical missions for the Air Force Reserve. The spray tanks were gone. The chemical was not. Between 1972 and 1982, by the Institute of Medicine's estimate, some 1,500 to 2,100 Air Force Reserve personnel trained and worked on those aircraft, eating, sleeping, scrubbing, and breathing inside fuselages whose interior surfaces still carried residue of 2,3,7,8-TCDD — dioxin, the contaminant in Agent Orange. When they sickened and asked VA for the same presumption of exposure granted to veterans who served in Vietnam, VA told them, for years, that dried dioxin residue was not "biologically available" and could not have harmed them. This page is the record of what the science showed, who carried the fight, and what the rule that finally ended it did — and did not — pay for.

The service and the promise

Operation Ranch Hand was the Air Force’s herbicide-spraying campaign in Southeast Asia, flown from January 1962 until the spraying ended in 1971. Its aircraft were Fairchild UC-123 Providers, fitted with internal tanks and spray booms, flying low and slow over jungle canopy, roads, and crops to strip the cover and food supply of enemy forces. Military Times, summarizing the record, puts the Agent Orange alone at more than 10 million gallons sprayed by C-123s between 1962 and 1971. The Institute of Medicine’s 2015 report records that the Ranch Hand formulations included 2,4-D and 2,4,5-T, and that the 2,4,5-T carried TCDD — “an unintended contaminant that was later determined to be a human carcinogen.”

The men and women on this page are not the Ranch Hand crews of Vietnam. They are the crews who inherited the airplanes. When the spraying stopped, part of the Ranch Hand fleet — the IOM report puts the aircraft at about thirty — came home, was stripped of its spray gear, and was reassigned to Air Force Reserve units for routine work: military airlift, medical transport, and cargo operations, as VA’s public health account describes it. The reservists who crewed them were pilots, navigators, flight engineers, and loadmasters; ground maintenance crews who washed, repaired, and rebuilt them; and aeromedical personnel who flew patients in them. Their service was stateside, unglamorous, and, by every account given at the time, considered safe.

The promise made to them was the ordinary one, with a specific statutory shape. Under the Agent Orange Act of 1991, a veteran who served in Vietnam and later developed a listed condition did not have to prove exposure; exposure was presumed. The reservists’ position, when illness came, was simple: the exposure had happened in the line of duty, inside a government aircraft, on government orders — the fact that the aircraft had done its spraying in an earlier war, for earlier crews, should not move their exposure outside the promise. For years, the institution’s answer was that there had been no exposure worth the name at all.

What happened

The residue was real, and it was measured. The IOM report records that air and wipe samples taken between 1979 and 2009 from Ranch Hand C-123s showed residual chemicals from the herbicides sprayed in Vietnam still present on interior surfaces. One aircraft became the emblem of the whole case: the C-123 known as “Patches,” tail number 56-4362, named for the hundreds of battle-damage repairs it carried out of Vietnam. Sampling of Patches in 1994, when it was being prepared for indoor display at the Air Force museum in Ohio, found TCDD in its interior. Retired Air Force Major Wesley T. Carter — an aeromedical technician and flight instructor, and a medical services officer, who flew in the C-123s with Westover’s 74th Aeromedical Evacuation Squadron from 1974 to 1980 — put the point the way the crews lived it, in remarks reported by Military Times: “We ate in that plane, slept on the floor, lived in it on tactical deployments, and it was too contaminated for public display?” Before Patches could be displayed, a hazardous materials crew had to scrub it down. The men who had flown it for years had worn no protection at all.

Carter became the carrier of the fight because he became its researcher. Sick himself — he has spoken publicly of his prostate cancer and heart disease — he noticed the pattern among his fellow Westover reservists, founded the C-123 Veterans Association, and spent years pulling the government’s own documents out through FOIA requests. Reporting based on those documents described tests from 1994 and 1996 showing at least 11 of the 16 C-123s at Westover testing positive for dioxin, one labeled highly contaminated a decade after retirement. The crews’ own accounts, recorded in the IOM’s review of the C-123 Veterans Association’s testimony, describe aircraft that arrived from Vietnam needing extensive rehabilitation, with reservists scraping residue out of the interiors and washing the aircraft down with soap, brushes, and pressurized spray equipment.

The independent science arrived in stages, and each stage pointed the same way. In 2012, the Agency for Toxic Substances and Disease Registry — part of the Centers for Disease Control and Prevention — compared the 1994 Patches samples against the Army’s screening guideline, as the IOM report itself recounts: an average TCDD surface concentration of 636 ng/m², a factor of 182 above the screening guideline of 3.5 ng/m², “which corresponds to a 200-fold greater cancer risk than the screening value.” In 2014, researchers publishing in Environmental Research — Lurker and colleagues, including Columbia University’s Jeanne Stellman — modeled the crews’ exposure from the wipe samples and concluded that the potential for dioxin exposure “is greater than previously believed, and inhalation, ingestion and skin absorption were likely to have occurred during the post-Vietnam era.” Stellman stated the contrast directly: “The VA concept of a ‘dried residue’ that is biologically unavailable is not consistent with widely accepted theories of the behavior of surface residues.” The Air Force, meanwhile, disposed of the evidence. In 2010, the service destroyed the remaining aircraft — 18 of them, cut down and smelted — which Air Force documents, as reported by Military Times, connected to concern about potential liability for Agent Orange. A 2009 memo by Dr. Alvin L. Young, the herbicide consultant whose work underpinned VA’s position, had lobbied for the planes’ immediate destruction in part to avoid attracting media attention to the stateside veterans’ health claims, as the Connecticut Health Investigative Team reported. The aircraft were melted into scrap while the claims were still being denied.

What the institution did afterward

VA’s position, stated on its own C-123 exposure pages and quoted in the reporting of the time, was that “although residual TCDD — the toxic substance in Agent Orange — may be detected in C-123 aircraft by sophisticated laboratory techniques many years after its use,” the existing studies supported “a low probability that TCDD was biologically available in these aircraft,” and that exposure “is unlikely to have occurred at levels that could affect health.” The interpretation behind that position, as the IOM report documents, came from Young and Young (2012, 2013) — reports prepared for VA’s Compensation Service describing the residues as “dry” and immobile. VA generally denied the reservists’ claims submitted from 2011 onward, and required anyone it did consider to show exposure on an individual, factual basis. The Agent Orange Act’s presumption stopped at the Vietnam border these veterans had never crossed.

The human cost of the delay is stated as an attributed count, because that is what the record supports: according to Carter and Vietnam Veterans of America, at least ten C-123 crewmen who flew the aircraft after the war had died of cancers commonly linked to Agent Orange by January 2015; in June 2014 the two organizations had already charged, in a joint statement, that at least ten exposed veterans had died after being denied VA care. One case has a name and a paper trail. Lieutenant Colonel Paul Bailey, a C-123 pilot, won recognition in 2013 when a VA decision review officer wrote that “the preponderance of the evidence suggests you were exposed to herbicide onboard U.S. Air Force C-123K aircrafts” — the first of Carter’s group, by the association’s account, to prevail without a Board of Veterans’ Appeals fight. Bailey died of prostate cancer in October 2013.

VA itself commissioned the study that ended the argument. The Institute of Medicine released Post-Vietnam Dioxin Exposure in Agent Orange-Contaminated C-123 Aircraft on January 9, 2015. The committee was candid about the limits of the record — sampling was sparse, taken long after the reservists’ service, and exact exposure estimates could not be derived — then rejected VA’s position on the science. Based on physicochemical principles, the committee “rejected the idea that the dioxin residues detected on interior surfaces of the ORH C-123s were immobile and effectively inaccessible to the Reservists as a source of exposure,” and stated “with confidence that the AF Reservists were exposed when working in the ORH C-123s and so experienced some increase in their risk of a variety of adverse responses.” The measured residues fell, it found, in or above the range in international guidelines where caution is warranted. Of the Young and Young interpretation VA had relied on, the committee found the description of TCDD’s chemical properties and its propensity for dermal absorption to be “inaccurate,” and the claim that hexane would be required to remove TCDD from the aircraft surfaces to be “conjecture and not evidence-based.” TCDD, the committee explained, exists in this setting as a very dilute contaminant expected to behave as a subcooled liquid rather than a solid — not immobile at all. The committee also found the surface-sampling methods reliable, while the air-sampling methods were not. Exposure, it concluded, could have come through multiple routes: inhalation of resuspended particles, ingestion by hand-to-mouth transfer or contaminated food and water, and skin contact.

Congress pressed the point home. In February 2015, a bipartisan group of senators led by Richard Burr of North Carolina and Jeff Merkley of Oregon wrote to VA asking it to reverse the denials; in April, senators took on VA’s further argument that reservists whose diseases appear years after training might not qualify as veterans at all — an interpretation their letter called one that “leads to absurd results.” MOAA recommended in congressional testimony in May that Congress and VA act on the IOM report. In June, Senators Merkley, Sherrod Brown, and Ron Wyden placed a hold on the nomination of VA’s Under Secretary for Health designee until VA released its decision. Secretary Robert McDonald decided the question in the veterans’ favor, and Burr’s verdict on the process stands in the record: the effort “has not been one of the agency’s finest hours,” and “it shouldn’t have been this hard or taken so long.”

VA published the fix as an interim final rule in the Federal Register on June 19, 2015 — announced the day before so benefits could begin immediately — amending 38 C.F.R. § 3.307. The rule presumes herbicide exposure for an individual who “regularly and repeatedly operated, maintained, or served onboard C-123 aircraft known to have been used to spray an herbicide agent during the Vietnam era,” a standard the regulation itself defines: assignment to an Air Force or Air Force Reserve squadron permanently assigned one of the affected aircraft, with an Air Force Specialty Code indicating flight, ground maintenance, or medical crew duties. VA’s guidance covers service from 1969 to 1986 — for reservists, the named locations are Lockbourne/Rickenbacker Air Force Base in Ohio (906th and 907th Tactical Air Groups; 355th and 356th Tactical Airlift Squadrons), Westover Air Force Base in Massachusetts (731st Tactical Air Squadron and 74th Aeromedical Evacuation Squadron), and Pittsburgh International Airport in Pennsylvania (758th Airlift Squadron); active-duty personnel who served where a contaminated C-123 was assigned, with regular contact through flight, ground, or medical duties, are covered as well. And the rule closed the reservist eligibility trap directly: if a member of this group develops a condition on VA’s Agent Orange list, VA presumes the condition began — was disabling — during the member’s Reserve training, establishing the service as active military service for VA purposes. Compensation claims could be filed for any of the 14 conditions VA then recognized as related to Agent Orange, with health care, and dependency and indemnity compensation and burial benefits for survivors. The American Legion reported the projected cost at more than $47 million in disability benefits over ten years.

Where it stands now

The presumption the reservists fought for is now ordinary VA law and practice. The regulation’s C-123 paragraph remains in 38 C.F.R. § 3.307, and VA’s compensation pages still direct Air Force and Reserve personnel who regularly and repeatedly operated, maintained, or served onboard the Ranch Hand aircraft between 1969 and 1986 — and who have an Agent Orange-related disability — to apply. The defined class won the thing it asked for: exposure is no longer theirs to prove.

What the victory did not include is equally specific. VA stated at the time that claims would not be awarded retroactively: the general effective date was the rule’s publication date — June 19, 2015 — not the date of a veteran’s original, denied claim, with an exception only for claims still pending. There was no Nehmer-style readjudication reaching back to the years of denial, and no back pay for the years in which men like Paul Bailey were told their exposure was not biologically possible. The presumption is also bounded by its own definition: the designated units, duties, and specialty codes. A crew member outside that frame is returned to proving exposure individually, on a factual basis, case by case — the ground the whole class stood on before 2015.

Carter closed his account of the fight with a request that was not about the C-123 crews at all: a careful review of VA’s actions, as he wrote to Secretary McDonald and Under Secretary Allison Hickey, “to insure that toxic exposure veterans never again face such an unhappy struggle.” That request — an accounting for how a consultant’s theory, contradicted by the government’s own samples, governed claims for years — is the one line of this ledger the record does not show as answered. The men themselves are a dwindling class: of the 1,500 to 2,100 the IOM counted, Carter observed in 2015 that perhaps only a few hundred remained to be found. The rule stands ready for each of them, and for their survivors. It does not go looking for them.

The ledger

The accounting, in three lines — what the record shows has been done, what it shows has not, and what is still being sought.

What has been done

What has not been done

What is being sought

The record, on video

Four films: ProPublica’s investigation, built around Carter himself and the consultant whose theory VA followed; ITN’s 1967 report from inside Operation Ranch Hand, recorded while the spraying was underway; a history of Agent Orange and the C-123 war; and the trailer for the PBS Independent Lens documentary on the Agent Orange catastrophe and the people still fighting it.

The fight itself. ProPublica's short film on Wes Carter, the C-123 veterans' campaign, and the consultant whose account of dioxin VA relied on for years. (ProPublica.)

Ranch Hand, as it happened. ITN's March 1, 1967 report from Da Nang: C-123s spraying the jungle, the crews who flew the missions, and the scientists' warnings about the chemicals — raised at the time, on the record. (Frontline by ITN.)

The weapon in brief. Simple History's account of Agent Orange — what it was, how the C-123s of Operation Ranch Hand delivered it, and what followed for the people exposed to it. (Simple History.)

The longer war. The official trailer for *The People vs. Agent Orange*, the PBS Independent Lens documentary following two women — in Vietnam and in Oregon — still contesting the herbicides' legacy decades after Ranch Hand ended. (ktaverna2, the filmmaker's channel.)

Sources

Part of Betrayed, Not Forgotten — this site's accounting for the service members and veterans their own institutions failed. Videos are embedded from their publishers; nothing here is re-hosted.