Posted on May 9, 2020
Can the VA refuse to treat a 100% service-connected veteran citing their case as "too complex," and also refuse to outsource them for care?
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I have a pretty 'complicated' medical case but the VA continues to refuse at times to even consult with me despite internal VA referrals for the consults. They also refuse to refer me to anyone who possibly CAN help-- or the Mission Act options don't have any providers for the care needed within hours of me. Then they refuse to cover many of the meds that outside specialists suggest, costing me >$3,000 per year out-of-pocket. Is this OK at any level and would anyone have any suggestions for how to get the needed care? This way preceeded COVID-19 issues but continues despite it. I've been told the doctors won't even agree to a telehealth or video health consult at the VA across a few departments and programs. I'd already involved a senator's office a few years back and have made almost no progress. Help, please?
Posted in these groups: 
Department of Veterans Affairs (VA)
Washington
Veteran Benefits Advisor
Team Veteran Foundation
My Veteran Community
Department of Veterans Affairs (VA) Washington Veteran Benefits Advisor Team Veteran Foundation My Veteran Community
Posted >1 y ago
Responses: 414
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SSgt Lisa J. Markland I know it's sonds a little crazy but send the White House a letter with all your complaints. It won't make it to the POTUS but he has a staff just for this. I was fighting the VA for a very complex lumbar back surgery and they kept denying it because of the very large amount of money it costs. Some guy at the VA Clinic told me that he had a simular problem and he wrote POTUS. It took him 6 months for a response but it was a great response The White House team sent a letter to his VA Clinic and told them to get it done!! I sent my letter with all that needed to be done and even a letter from the doctor telling them that I've already had 8 lumbar surgeries and will have more if not done correctly with this new methode using stem cells in cages screwed right to the vertabe 4 levels. On x-ray it looks like a roller coster, it's been just over a year since the surgery was done and the pain was gone when I came to in recovery. It worked so well the VA did my cervical surgery with the stem cells, I needed 4 levels but the VA thinks they know more that the surgeon that did it. I had that one done while waiting for lumbar approval and it was great but my doctor kept telling them I will need another surgery in about 18 months but the VA said NO!!! Well I'm now post-op 1.5 months and so far it's been great. I had this surgery during the corona-19 virus, that scared me more than the surgery itself. PLEASE give it a try, send to 1600 Pennsulvania. I sent mine to POTUS (spelled out) instead of The White House and mine took 9 months until I got a call one day from my VA clinic asking me to please come in as soon as possible to the VA clinic and go to the administraition office. I thought I had done something wrong and was probley in trouble because that's the way my luck is. MURPHY'S LAW and all that. When I got there and gave them my name I was sitting down getting ready for the usual hour wait but before my butt hit the seat thay called me back and told me that The White House has over ridden the VA denial and my auth forms were there and the doctor also got his the next day. Give it a shot you have nothing to lose. Good luck, I'll be praying for you.
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PO1 Janice Ritz
Always write the President if the VA denies it due to their inability to handle your case. They (the White House) have a VA Hot Line: [login to see] . You can also call this number 24/7/365 for help with problems/issues with the VA. Also, don't forget to contact your Senators and Representatives at the State and Federal levels. If you light a fire, the VA will respond.
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SPC Matt Ovaska
I called the Presidents hot line and fella hung up on me. I called back and a young lady offered me a coloring book. I said, Thanks but no thanks.
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VA's refusal isn't new but this level is disconcerting. Since a Senator has been involved and results aren't good, that leaves only one choice. Engage an attorney specializing VA issues.
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SN James R Redmond
To get anything done with this administration, you will have no choice but to seek an attorney for help.
The VA in PA killed my brother, so be very cautious with them, their doctors are rejects from other hospitals
The VA in PA killed my brother, so be very cautious with them, their doctors are rejects from other hospitals
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PO3 David Mabo
I get great care at my VA and they have referred me to University hospital a few times. One of my doctors is a division director at the university. I have had a lot of internal referrals based on lab results. I take an expensive medication and it took lots of jumping through hoops to get it approved. I have Medicare so I get some care outside by choice.
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SFC Domingo M.
Last June, I had a 12-hour open-heart procedure at the UC Hospital in Cincinnati. Mine was farmed out because they said they seldom do them at the VA. They even covered six weeks of rehab at a second hospital. So far, so good. I get more care at times than I really ask for and have a wonderful PCP. I was rated at 90% based on my history and have no complaints what-so-ever. My situation was backed up by my health records. I retired in 1990 and didn't apply for disability until 2017 at my wife's urging. I missed out on 27 years of care and pay. Good luck and I hope someone helps you find the right solution.
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SP6 Richard Kellar
SPC Matt Ovaska - Been going to the VA for 50 years. I have gotten that letter about missing an appointment when I didn't. Aside from that I have been treated far better than my mother might have and at 75 I am ready for combat still thanks to them, something real local with my 3 sons there to referee. Prefer an older guy with some serious handicaps. but nonetheless. I am always polite however. I cannot thank them enough for my longevity.
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SSgt Lisa J. Markland I would recommend going to DAV. Sgt (Join to see) any advice?
https://www.rallypoint.com/organizations/dav-dav-disabled-american-veterans/followers
https://www.rallypoint.com/organizations/dav-dav-disabled-american-veterans/followers
DAV
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SSgt Donna Coffin
LCDR Mike Morrissey why did the vet only get 30 days at 100%? It should have been 3 months.
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SSgt Donna Coffin
SSgt Lisa J. Markland - HI Lisa, I am the Sr Vice Commander for DAV State of Rhode Island and I also volunteer at the Providence VA helping veterans put in claims. If you still need help, let me know. Additionally you can locate your local DAV NSO and send a message for them to call you here: https://nsolocator.dav.org/
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PO3 Michael MacKay
Personally DAV dug in along with American Legion and helped me over the hump on some serious negligence from the VA...get this, in my application the main reason for re-opening and re-evaluating the injury 23 years later after the initial "0% nothing wrong with you" they had to accept my full military medical records as "New Evidence" <--- get that? New Evidence they had never looked at before. My medical records had examinations held by three separate Navy doctors all stating the same thing in 1989...in 2013 a civilian contracted doctor who was not in the "good old boys" VA "doctor" club told me the VA had given him a "form letter diagnosis form" that only had check boxes that lead to the same 23 year old willfully negligent malingering response of "0%", but he said he was allowed to make notes in the margin. He completed the real examination with his notes and when the VA received his report I know damn good and well it lined up perfectly with what was in the military medical records as they were forced to acknowledge that the disability was real and compensable...however when I filed my FOIA to receive my civilian doctors examination notes in MY MEDICAL record, the VA refused to send it to me. They are still hiding from their willful negligence by not providing the corroborating evidence, furthermore I request the official government communication between the VA representative case manager and myself from a three month period leading up to them being forced to award, because someone had hacked into my e-mail account and deleted three months worth of e-mails between me and the VA...they refused to send me those official documents claiming it would "expose the personal information of others" and yet it was only official open communication between myself and the VA official...once again, they are hiding what they did. I am half way through the 546 day delay on appeal (Why is that? Waiting and hoping for me to die?) when I finally get my day in front of a judge I hope it is an impartial person with no connection to that Keystone Cops organization, the VA.
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