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 5 y ago
Responses: 430
I ran into a similar case with my father ,81 yrs, in Mobil Alabama where he was beaten and robbed. Had fractured ribs and a punctured lung and the VA Doctor was telling him the pain was in his mind. so I brought him to St. Louis, MO where V.A. here is fantastic and he was treated and recovered. Not all VA are the same. This is what I did you might have to to do something diffrent.
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Did you get the surgery ? If not then consider not doing it and start with a inversion table. I will post a doctor mri and share notes of diagnosis and what my therapy has been like. It works
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I am a 100% disabled Veteran as well.. You need to contact your local congressman or senator again and keep contacting them and get them involved now. Go public to the local TV stations and tell them straight up, the V/A is refusing to treat a service connected disabled Veteran in the Seattle location. Mark my words, that starts getting attention and heads will start spinning big time.. thus you also need to make sure you have all your ducks in a row and paperwork ready to be seen.
I had a situation but in my case, my local V/A stepped and I was referred to some of the nations top specialist for my surgery.. Not every V/A is bad and it sounds like you are stuck with one that still is.
You should also contact your V/A representative agency, (PVA, DAV or whomever you use)
I had a situation but in my case, my local V/A stepped and I was referred to some of the nations top specialist for my surgery.. Not every V/A is bad and it sounds like you are stuck with one that still is.
You should also contact your V/A representative agency, (PVA, DAV or whomever you use)
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Call the VA White House hotline @ + [login to see] . The VA works on a system of triage and is dangerously underfunded. Basically, I feel like your situation falls outside of what they are willing to spend money on. It's basically on you to force them to give you the care you have earned.
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Try looking into War Related Injury and Illness research venue. Most Primary care dr's have no clue as to where to send us veterans with complex health issues. I was in Texas a few years back in the same boat as you...came across an article WRIIS. Tere are 3 facilities.2 on the east cost and the third on the west coast.. all costs were covered( flight, taxi, lodging and meals). VA in Palo Alto California. Search "War related Illness and injury" for info.
Good luck, and don't give up. VA is good, they just don't know everything we have medically.
If the VA doesn't have meds prescribed by your non VA dr's, look for discounted assistance. I have a Pain Management Pharmacist that I speak with on a monthly basis.. he helped me get meds that the Primary Care couldn't. Again good luck
Good luck, and don't give up. VA is good, they just don't know everything we have medically.
If the VA doesn't have meds prescribed by your non VA dr's, look for discounted assistance. I have a Pain Management Pharmacist that I speak with on a monthly basis.. he helped me get meds that the Primary Care couldn't. Again good luck
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It has been over a year, is there any updates or are you still getting the run around?
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Did you know that the White House has a special phone number for veterans medical complaints? I called it and it works wonders. I had my problem resolved in less than 24 hours. When calling them have all of your facts in order. [login to see] .
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You could contact the Patient Advocate's Office, your Case Manager, and continue to contact the Senator's Office. Another option is to contact the White House Veterans Affairs Office at + [login to see] .
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It seem you did everything by list to get medical care from the Veterans Affair to contacting a Senator. By getting support for treatment with a 100% disability, but you were denied of treatment because of cost? My belief is something in between is missing, like what about Tricare? Are you retired? Do reside near an “MTF”? Did you comply with the VA by enrolling into “Myhealthvet” including the website? Do you constantly complain to your healthcare provider oh yeah medical needs? Question, do they listen to you or ignore you? Reason of these questions, because I had think outside the box to take care of your well-being. When I retired, I return to my home town near the MEPS Station domicile. It made sense and seem right but not really. Most veterans including Vietnam veterans and other Campaign veterans that served reconsider a relocating to another state that would take care of veterans needs. Myself, was one of them near several military bases, and a Veteran Administration. It help veterans and military retirees to choose PCM doctors and be assigned to a visitation in VA to be tailored to your medical needs. And that was best decision that I made and my family realize that that was the right decision I made to relocate nearby military installation. You don’t have to take my Word but it doesn’t hurt to do some sole searching for your medical needs. Take care.
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I seem to have better luck utilizing Congressional assistance when dealing with the VA. Even then, the Congressional Rep will only call and ask them their side of the story and tend to not do much. If you have a more effective Congressional Rep, then that Rep can get something done, because if it is definitely service connected, they are supposed to do whatever is needed to the best extent possible to take care of the issue. Under Trump, you probably would've had more success going the White House route, but Biden barely knows where he's at, no less the difference between the Pentagon and the VA. Like with anything governmental, especially the VA, you have to keep going at them. Find the chain of command through the VA. Go to the people/person in charge of the facility that is telling you know, then the region, and so on, and so forth. Don't stop, keep the pressure on, because they are full of poop.
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I have similar conditions. Possibly not as severe but serious nonetheless. I have had to fight and finagle everything I have gotten from the VA. We are talking about 18 years with them. Now that things have progressed to a point there isn't much they can do to fix me, they toss pills at me for the pain. Also if you make enough noise you will be referred to the mental health dept where they will if you allow it, you will be turned into turn a walking ZOMBI. That is what the VA Does best. Medicate and Isolate. Now about Community care referenced in your comment. I have a skin condition that they have refused to help with for over 10 years. Notice I said HELP with, not treat. Oh, they tossed placebos at me. I was told by two separate pharmacists in two different cities working for different companies that they were placebos and noting more. It took me, having to pull some strings when the VA had to cancel an apt with Dermatology and delay it for 5 months, to get an appointment with a community care Dermatologist. It took about 15 minutes with both the nurse and nurse practitioner to get a probable diagnosis and a biopsy. After the results of the biopsy came in it was confirmed that I have psoriasis. I was offered medications for it. Now going back to the VA, they refused the meds that the outside prescribed. The Rheumatology dept offered a different med, but stipulated that he needed the results of the biopsy which the VA had never gotten. Also that the Inhouse Dermatology dept would have to approver even that med. Then when I got to the inhouse dern dept, she didn't even know why I was sent back to her. NOT A CLUE! I might eventually get the meds but I will be on my death bed when they finally get around to it. The VA does what any gov agency does and they do it well. Bureaucracy.
and placebos. But always remember if you make yourself an advocate for your own treatment, you will be seeing a shrink and probably told to take mind-numbing ZOMBI drugs. Again MEDICATE & ISOLATE!
I have tried VISN19, the VA hospital, and clinic here in Denver, and am a frequent flyer at the Wash. D.C. hotline. The best answer I get is, "Well the VA isn't perfect"! Not only not perfect, barely adequate. They have thousands of interns, Doctors that couldn't get a job anywhere else, and the rejects of society who are more involved in how to be polite at the VA and social injustice of the vet, but medicine, ain't going to happen.
and placebos. But always remember if you make yourself an advocate for your own treatment, you will be seeing a shrink and probably told to take mind-numbing ZOMBI drugs. Again MEDICATE & ISOLATE!
I have tried VISN19, the VA hospital, and clinic here in Denver, and am a frequent flyer at the Wash. D.C. hotline. The best answer I get is, "Well the VA isn't perfect"! Not only not perfect, barely adequate. They have thousands of interns, Doctors that couldn't get a job anywhere else, and the rejects of society who are more involved in how to be polite at the VA and social injustice of the vet, but medicine, ain't going to happen.
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Request a referral to Walter Reed National Military Medical Center in Bethesda Maryland or Balboa Naval Hospital in San Diego. Both are top tier facilities internationally and both routinely treat veterans of all branches. I am a Neurosurgery patient at Bethesda and don't even have a service connected disability. Getting my second surgery in 2 years day after tomorrow. Chief of Neurosurgery says that he has resources that almost no other hospital in the world can match, would cost tens of thousands of dollars and I won't be charged any more than my non-service connected co-pay of $50.
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Have you tried talking to your patient rep?? Or the VA AG/IG... I've never heard of a problem being too complex for VA to at least refer to community care. Legally they cant refuse treatment. Just like when you were in the military.. Now there are times when theres only one dr within hours to treat specific problems.
If y0ur problem is service connected and you're 100%, you shouldn't be spending 1 cent on meds....
If y0ur problem is service connected and you're 100%, you shouldn't be spending 1 cent on meds....
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Lisa, this post was a year ago, can you give us a follow-up on the current status of this issue?
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1SG Eddie Smith
My initial thought after reading this post is NO, VA cannot. As of June 2020 the mission act is now federal law, if the VA cannot provide the service you need then your VA primary care provider must refer you to an "in-network" non-VA medical provider, and as 100% SC Veteran you will have no co-pays.
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Contact you congress person and/or senator, provide copies of everything you have I am sure you will get results.
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