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?

Yup, yup and yup! But still having to fight like crazy for so much of this.

Well, you have to fight the VA no matter waht, as its the Gov, lol

Yup, I've got years and years of this in writing. I keep annoyingly strong documentation of everything (at least annoying for the VA). Thanks for the suggestions!

Thanks, Patrick--- I'll connect here and then by email. I really appreciate you trying to help. I'm open to any ideas that might work!

Great i wait to hear from you.

Please reach out to me, I know a Lawyer right near you that may be able to help you, ok, Please EMail me, ok

Hi Linda--- are you sure the CITC care doesn't cover travel and meds? I just read a whole thing on the Rx's provided through the CITC referrals and it seems very recently this changed to where you can get some filled that way vs the VA itself, or reimbursed. I'd have to dig online to find the info but it's under the revised MISSION Act, I believe. Try telehealth (phone appointments) if you can't connect using the VA Video Connect app. Many of my providers can't use it either so they've been OK just calling, at least during this pandemic. Hang in there yourself-- and feel free to reach back out if I can help you also. Thanks for being part of this conversation.

I also have used the community care outsourcing. As long as the VA sent/authorized you to to see the provider, the VA with handle the prescription. Take to the pharmacist and advise they you were referred there by the VA. Travel is also covered, but make sure you get a "work excuse" from the office visit showing you were seen in the office on (such and such) date. This will needed to be attached to your travel voucher form, otherwise the VA travel will deny the reimbursement claim. They have to be filled within 30 days or the will be denied.

Yeh, I've done that, now with a second senator (the first took over when my prior congressman's term ended). Appreciate your help!

Thanks, Gary! I'm in Maryland but get most of my care at the Washington, DC VAMC. Thanks for your help and suggestion!

If they refuse care...

I'd think being 100% service-connected/Priority 1 as a vet that this wouldn't be such a fight with them. I think our DC VA is just overwhelmed and under-staffed in general and nobody wants those jobs. We seem to lose all the great employees over time. I've made a list of the suggestions you have and wanted to say, "Thanks!" for the help and advice. Everyone's been so awesome here. I didn't even know some of these offices existed.

Thanks for that suggestion. For VCU do you mean Virginia Commonwealth University or something else? Richmond is hours away (one direction), but I'd go anywhere that could get me the care and supplies I've been needing from the VA system. They have never offered to cover my housing when I wasn't inpatient there. Do you work there? Where I live (based on my county) we only have a choice of two main VAMCs, DC or Baltimore. They can send you other places in the VA system if referred out from an internal doctor.
I was trying desperately to get sent to the VA's Tampa Pain Program-- and after months of waiting they also refused to take me based on "complexity" (I hate hearing that but know I have a difficult medical case, but many vets do). I'm still trying to get outsourced based on that refusal of care, now about 3-4 years later. I've also heard Martinsburg is better run but don't see that I can change to them overall. Both DC and Baltimore take about the same driving time although Baltimore is further (our Beltway traffic is the worst, esp toward DC). They opened a CBOC about 20 minutes from me but my new PCP there only lasted three months and it's taken about a quarter year to find a replacement who seems very nice and willing to help, but is only very part time. They only have very limited CBOC services unfortunately, but they've all been very helpful there when I can connect. The DC VA sent me to Richmond for inpatient spinal cord injury care in 2012 and of all things I was sexually assaulted there during a procedure. This was witnessed by female medical personnel who were in the room, which I also reported several times in writing and in person, even begging the referring doctor from the DC VA to report it also; this was one issue still outstanding with the last senator's office I tried using because it could have prevented others from being hurt if someone would have just done something years ago. The entire facility for that unit was not at all female-friendly, even unlockable toilet/shower areas that were male-only (aka unisex) and the room was covered in various body fluids, never got my meds worked out during the entire admission and they never fed me more than trays of puddings and Jello-type stuff (I have food allergies but no reason to not have real food for that many days) . It was a horrible experience for several reasons even beyond that. If I didn't need to rely so heavily on the VA to cover meds and supplies, since I have commercial insurance and Medicare, I'd run the other direction. A week doesn't go buy where I'm not buying things myself or covering costs. It's all very stressful. Thanks for your suggestions! Sorry I write such long replies!

SSgt Lisa J. Markland I believe that all you need to do is go to your patient advicate office and request a transfer. If the docs are granting you proper medical care, or you disagree, that is what the patient advocate office is for. You can also go to your local american legion or Dav post and seek out a service officer. They, too, are able to assist and you do not need to be members of either organization in order to receive their services. If your circumstances are indeed complicated, if you choose this route, bring with you a CD copy of your med records, dd214 and any other supporting docs, and call ahead to schedule an appointment with the SO, ensuring you have enough of their time to explain the circumstances. The SO are highly trained veteran volunteers that are there to assist with navigating the beauracratic red tape. This is what yhey are there for and they are rquired to follow HIPPA and all that jazz.

PFC Tonya Meunier - I have tried for years both through our VA's "red phone" system directly to the patient advocate as well as by leaving voicemail and even leaving them a written request and as odd as it sounds, the only patient advocates who have responded over many years and attempts told me they couldn't help. Not sure what they are there for if not to advocate for patients! Where I live I have only had a choice of the Baltimore or DC VAMCs and have been assigned to both over the years. Now there's a local CBOC and the DC and Baltimore systems are so overwhelmed they are requiring I be seen through the CBOC whenever possible... yet the CBOC has VERY limited services and as of this past week I'm onto my THIRD PCP in only a few months' time. Before this I'd only had two PCPs over all the decades since my discharge and they were awesome. I almost can't imagine starting over because my case is legitimately medically complex (non-VA docs get overwhelmed with some of my rare and complicated diagnoses and give up before they start to help-- where the VA is sort of stuck treating me... at least in theory). It's funny you mentioned the CD: I did a Go Fund Me page a few years back to find the money to get my entire 30+ years of documentation on disk. I regularly download my entire Blue Button chart for the same reason. My C-file is volumes and volumes thick, but I got a nice person at one VA appeals hearing to give me that on disk (yay!). Our local DAV (I'm a life member) hasn't been under good leadership in years but used to be very helpful. I joined the AL just about a month ago at the suggestion of some of the vets here, so I'll reach out to them next. I really appreciate your help and suggestions!

SSgt Lisa J. Markland So, suggestion 1: take all your blue botton downloads and save them to a flash drives asap. If your computer crashes, those files will be gone right along with it and keep those drives in an envelope in a secure place. Plus freeinh up that space on your computer will make it run better. Second, YES, get with the SO at your legion post. Very important. They can assist you better about how to get what you need. Good luck with everything! I am glad to have been able to assist.

I contacted the patient advocate, and they said they couldn’t do nothing for me

Nope, all mainstream. Even within the VA. I'm really not sure why this is happening, let alone so often. Thanks for the reply.

SSgt Lisa J. Markland years ago I had some issues also. Finally I went for the throat and got my state senator and congressman involved by making a phone calls for answers. Within two weeks and it was favorable. Hope this could work for you