ity makes it clear that there are not uniformly applied standards of quality. The committee was told that all assessments are reviewed, but there is not even simple documentation of reviews in the files (for example, date of review and signature of the reviewing authority), much less memoranda or other written documentation of the substance of the reviews.
A comprehensive program explaining QA-QC objectives and procedures should be developed and documented. The program should ensure that all doses are checked and correctly calculated, that consistent and up-to-date-methods are used, that all dose estimates are fully and adequately documented, and that backup records and calculations in files are complete, legible, annotated, and dated. All dose assessments should be documented clearly, and the veteran’s file that contains details of the calculations, backup material, and so on, should be complete, legible, and comprehensible. Any references not readily available, such as internal memoranda, should be included in the file. All entries in the file should be typed or clearly written and dated, and the author should be clearly identified. Methods of validating film-badge doses, such as routine comparisons with generic dose reconstructions or with data on other veterans who performed the same type of activity, should be part of such a program. Some QA-QC should be performed by outside experts, possibly under the direction of an advisory board.
As discussed in Section III.B, communication with an atomic veteran concerning compensation decisions is the primary responsibility of the VA Regional Office (VARO), which receives dose reports and other correspondence from DTRA. But the response time has often been lengthy, particularly before the recent effort to respond in a more timely manner. In case #32, for example, the NTPR program wrote to the VARO on October 20, 1995, apologizing at the outset for a delay in follow-up of an inquiry first filed on February 6, 1995. It appears to have taken that long for the veteran’s participation in an atmospheric test to have been confirmed and a radiation dose assessment completed. In our sample of cases, it was not uncommon for at least 6 months to pass between the VARO inquiry and the NTPR report on the results of a dose reconstruction.
When a veteran feels aggrieved, he is owed accurate and responsive communication by the government. In any effort of this magnitude and complexity, there will be errors in communication, delays, failures to respond appropriately, and questionable judgments about suitable content in a response. But there were enough lapses within the committee’s sample cases to cause concern. In some cases, intervention by members of Congress who inquired on behalf of constituent veterans or family members seemed to speed the process or to revive an investigation years after it appeared to have concluded. In a few other instances, an attorney was retained to pursue the matter on behalf of a veteran. On the whole, veterans and their families have needed patience and determination to resolve their concerns.