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: 433
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They will try if you don't push back! Contact your Congressman! Now tactic of forcing Vets to have a telehealth conference for hands on treatment such as injections, Xrays etc.
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SSgt Lisa J. Markland
SMSgt Sheila Berg - Yeah, I agree (I think within 30 days of an inquiry)-- that's why I involved a second senator. This has been a crazy ride, for sure. The last senator's office failed to even write the letters, or at least they totally refused to provide me a copy of anything other than one that had gross misstatements as did the VA's response, so now the second senator's caseworker is getting all my info and working on it (and will run it by me and provide a copy). I sent a FOIA request to the VA for what the prior senator said they'd sent but have never even gotten a response to that. The gov't seems to just be a mess lately. Thanks for the follow-up!
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SPC Joshua Dawson
SMSgt Sheila Berg - They can absolutely refuse the request because every single one I have ever contacted eventually just stops replying to me at all without ever doing anything about the situation.
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SPC Joshua Dawson
SMSgt Sheila Berg - Like how I contacted one of my senators about how the VA illegally lowered two of my static disabilities directly after I became 100% permanent and total in an attempt to lower me below 100%. I even sent multiple letters with copies of all the diagnosing information showing when they were diagnosed and that they were in fact designated as static disabilities and that I was already rated 100% permanent and total and that they lowered the conditions without even having a single physical exam relating to the conditions, I never even got an initial reply about this issue.
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SSgt Lisa J. Markland
My last congressman was helping and then finished his term and my case got dropped. I'm now working with a second senator's office. Do you think a senator vs congressman would be better for this? Thanks for helping!
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Hi Lisa,
Your situation sounds very familiar----it took me 3 years to to convince the VA that I was entitled to receive CRSC for my field training accident----I needed some special/magic piece of paper and was given the runaround over & over & over, but with a great deal of persistence, I finally prevailed. I enlisted the help of a senator but did not find his staffer was of any real help. Of course, the next time I flew to DC to visit my grandchildren and he was headed home to SC on the same plane I had just arrived on, I was able to talk to him personally and apprise him of the difficulty I had in getting his intern/staffer to help me resolve my issue. So you may want to go to your Senator's office and meet with him or her in person, rather than dealing with an intermediary. I also went to my local DAV (also a lifetime member) to enlist his help in helping me obtain the magic piece of paper I needed to get the CRSC---he had no idea what I needed, was very nice and walked me over to another office that wrote the Army for help---they sent me additional copies of my DD 214 with a snarky little note advising me to look through my records at home as I probably had a copy of my DD 214 (yes, at least a 100 copies on hand). I thought that the DAV rep. was clueless but I went along with him anyway just in case he knew something I didn't. I filed an appeal with the appeals officer at the VA Administration office in the town where I live, and that finally helped; however, I should clarify that I am an RN and he happened to be the husband of one of my RN colleagues and long-term nursing friend, which is how I happened to get his personal cell phone number and direct access to him.
My advice is write your congressman---every one in your state, write the President, contact the Inspector General----be persistent. Some VA's are much better than others---I can say that as a Veteran who has used the services at 3 different VA's as well was an employee at the VA and has first-hand knowledge of how things work internally. You may have go to another VA.
When I got hurt, I went to medical records at Brooke Army Medical Center and requested a complete & total copy of my records----the lady kept asking why I wanted it as they don't usually do this---I went over FOIA and my right to request and receive a copy of my records, and offered to pay the going rate for copying my records; she went round & round & round with me, and nothing I said influenced her. Fortunately, at that time, I was a resident of a state where our Senator was very much a champion of his constituents. When I finally said, did I happen to mention to you that I am a resident of SC and my Senator is Strom Thurmond? She replied, I'll have those records for you tomorrow. With an election coming up, this might be a good time to visit your senator in person!
Write POTUS! He has made some long-needed changes in the VA system and I bet he would help you if he knew the situation.
Good luck & let us know how things work out!
Nancy Hudson, CPT/AUS/RET
Your situation sounds very familiar----it took me 3 years to to convince the VA that I was entitled to receive CRSC for my field training accident----I needed some special/magic piece of paper and was given the runaround over & over & over, but with a great deal of persistence, I finally prevailed. I enlisted the help of a senator but did not find his staffer was of any real help. Of course, the next time I flew to DC to visit my grandchildren and he was headed home to SC on the same plane I had just arrived on, I was able to talk to him personally and apprise him of the difficulty I had in getting his intern/staffer to help me resolve my issue. So you may want to go to your Senator's office and meet with him or her in person, rather than dealing with an intermediary. I also went to my local DAV (also a lifetime member) to enlist his help in helping me obtain the magic piece of paper I needed to get the CRSC---he had no idea what I needed, was very nice and walked me over to another office that wrote the Army for help---they sent me additional copies of my DD 214 with a snarky little note advising me to look through my records at home as I probably had a copy of my DD 214 (yes, at least a 100 copies on hand). I thought that the DAV rep. was clueless but I went along with him anyway just in case he knew something I didn't. I filed an appeal with the appeals officer at the VA Administration office in the town where I live, and that finally helped; however, I should clarify that I am an RN and he happened to be the husband of one of my RN colleagues and long-term nursing friend, which is how I happened to get his personal cell phone number and direct access to him.
My advice is write your congressman---every one in your state, write the President, contact the Inspector General----be persistent. Some VA's are much better than others---I can say that as a Veteran who has used the services at 3 different VA's as well was an employee at the VA and has first-hand knowledge of how things work internally. You may have go to another VA.
When I got hurt, I went to medical records at Brooke Army Medical Center and requested a complete & total copy of my records----the lady kept asking why I wanted it as they don't usually do this---I went over FOIA and my right to request and receive a copy of my records, and offered to pay the going rate for copying my records; she went round & round & round with me, and nothing I said influenced her. Fortunately, at that time, I was a resident of a state where our Senator was very much a champion of his constituents. When I finally said, did I happen to mention to you that I am a resident of SC and my Senator is Strom Thurmond? She replied, I'll have those records for you tomorrow. With an election coming up, this might be a good time to visit your senator in person!
Write POTUS! He has made some long-needed changes in the VA system and I bet he would help you if he knew the situation.
Good luck & let us know how things work out!
Nancy Hudson, CPT/AUS/RET
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SSgt Lisa J. Markland
That's so great you landed on the same plane! I'm very glad you were able to work things out. I did meet in person with the last caseworker but it's hard to get to the senator him/herself. And I know this new one I've contacted personally, although it's been many years since I used to see him (long before he became a senator). Thanks for your help!
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SPC Joshua Dawson
It took me 12 years to get them to allow me to have reconstructive neck surgery when I had been hit in the neck with shrapnel from a mortar attack while being deployed. By the time they finally let me have the surgery the neurosurgeon let me know afterwards that one of the vertebrae in my neck was worn so badly that it only had about ten percent of it left. Needless to say I have a lot of permanent nerve damage because of all this but yet they would not allow me to be treated while I was still in the Army, my unit actually illegally retained me past my contract and forced me to go on another combat deployment knowing I was injured, and then they wouldn't even let me have a physical when I came back and they were finally letting me out process. They just kept telling me that I would have to seek treatment through the VA once I got out. Then the VA spent years telling me that it wasn't that bad and just blowing me off with motrin. Then they finally let me have an MRI of my neck and come to find out I had three vertebrae pushing on my spinal cord right where the shrapnel had hit me. I was originally injured on my first combat deployment in 2005 and my unit retained me in service until 2008, the entire time I was not able to get treated. Then the VA made me jump through hoops and did not allow me to have the surgery until December 2017, then they turned around and denied my claim for temporary total disability because I had to be off work for 3 months to recover from the surgery so I had to take out a massive personal loan. The VA still to this day will not pay me the temporary total disability pay.
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In this case you should write to the head of the Dept of Veterans Affairs for decisive action. We do have a responsive government; you can quote Freedom of Information Act to see what's up.
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SSgt Lisa J. Markland
Do you think I should try the Secretary of Veterans Affairs or were you thinking another office? Sure appreciate the help!
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Sounds like u r doing everything by the book. Always keep a log of dates and times. Keep pounding at them. Never give up. Good luck.
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CPT Nancy Hudson
Great advice----keep a detailed record of who you talked to and the date time, etc. of when you talked to them! Nancy
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SSgt Lisa J. Markland
I sure do! I grew up in a family of lawyers, which is what saved me in 31 years of claim appeals. I have so much documentation that it's in the many thousands of pages (scanned it all to disk a bit ago because it was way too much to give anyone-- a TMI thing at some point). I'm pounding away!
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I have subscribed to VA's OIG news letters for over a decade. The VA tends to be a whole bunch of independent entities, disconnected from their overall stated mission & often times, ignoring the laws made by Congress & the President. The routes you can go to is the Office of Special Counsel (OSC.gov) who may be able to help. There is also you veteran service organizations, lawyers, & even the new media. And even thought the VA is a federal system, at times they have purposely limited their care to what the state they are located in handles. Move to another state & literally the difference in care can be life or death.
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SSgt Lisa J. Markland
I agree entirely. I filed online and by phone with the VAOIG years back and also never got a reply other than the automated letter they'd received my report. I've never thought of using the OSC! I have reached out to a few VSOs and the media (did one interview that aired locally on a major network but they never did the promised follow-up interview). A lawyer would likely be next if this new caseworker can't move things forward. DC's VAMC is supposed to be the "Flagship VA" since that's where dignitaries, etc. go-- but so much for "supposed to's!" Thanks for the great suggestions!
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Also send letters to your US Rep in Congress and your US Senators. The squeaky wheel gets the grease.
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SSgt Lisa J. Markland
Yup, I'm on that one. New senator's office involved as of last week and a new, much more senior and knowledgeable caseworker. Sure hope they can help. It's crazy the VA itself (all the way to dept chiefs) tells me to do the same or even use the WH Veterans Hotline. We shouldn't have to fight this hard for benefits we are "entitled" to.
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Welcome to the club. Had a heart attack in 2018, after 2 years they decided not to cover my heart attack! They used a lot of codes why but it seems to me that something else is in the mix.the propaganda says one thing and then there's the TRUTH.
Homeless again.
Homeless again.
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SSgt Lisa J. Markland
That's horrible also. This shouldn't happen. If you need some financial resources to help you out please DM me here. I compiled a list to help others and I'm happy to share it. It will get you free or low-cost care, meds, dental, phones/plans and even a car or bills paid. I'm a retired clinical social worker and had also been a vet w/o benefits for too long (decades ago), and only got $200/month SSI for a bit, lived out of my car and had to get free food from community pantries, etc. I always try to help vets in need (like you all have done for me here!). Have you also tapped into the VA's programs to shelter and help homeless vets?
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Cpl Bruce Stott
SSgt Lisa J. Markland lisa thank you for your concern but I am doing ok, my wife told me it is for the anastiesus
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SPC Joshua Dawson
Our government officials would rather make sure that people that enter this country illegally are well taken care of then this country's veterans.
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I agree with SSgt Tullis. I would resubmit my congressional to my Senator's office again and give them a second chance. After that then I would contact an Lawyer who has knowledge of your rights as a Veteran and is familiar with VA laws.
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SSgt Lisa J. Markland
Thanks-- I've got a new senator involved now with a senior/managerial-level caseworker. Otherwise it may be lawyer time. I'm just (nearly) out of steam. Been fighting with them far too hard for far too long over my claim, care, meds, prosthetics, etc. It shouldn't be this hard, especially at 100% SC.
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