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
Don’t put all your eggs in one basket ie; consult with as many Congress there is in your state. I know first hand what a congressman and their staff when dealing with them. A couple years ago the staff at department of defense notified my wife that I was deceased and all my army retirement and VA 100 percent disability was cut off. When I went to the local VA office they agreed that I was truly alive but could not help me as they had proof that I was deceased. It was then that I went to my Congress man office( congressman) Scott and his office manager made several phone calls to all parties concerned and after two days she told the VA staff that kept telling her that they could do nothing. She told the person on the phone that I was sitting in her office and had proof that I was still alive. She got so mad with the had been talking with on the phone she told them that she wanted to speak with their supervisor or else she would see that heads would roll, needless to say the very next day she receive a call from the VA that the problem was taken care of, she than asked that individual did they have a death certificate and was told that they didn’t require one. She was told that that incident would be examined. All together I had missed four (4) months of income but with one week I received my check with back pay . Good luck and I hope you will get the same results ASAP
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Which VA? The one I go to in Florida sent a guy with a severe autoimmune disease to Johns Hopkins for a 10 day inpatient stay and paid for flights and a hotel room for his mother.
If the condition is service connected they should pay travel to the Mission Act providers in their network.
Have you spoken to the patient advocate at the facility? Have you appealed the decision to the VISN Director? That is standard procedure. The case goes to the hospital Chief of Staff if he agrees with your Doctor you can appeal to the Chief Medical Officer at the VISN. On
Some good suggestions below. I would call the VA Inspector General as well if they don't steer you into the process above.
If the condition is service connected they should pay travel to the Mission Act providers in their network.
Have you spoken to the patient advocate at the facility? Have you appealed the decision to the VISN Director? That is standard procedure. The case goes to the hospital Chief of Staff if he agrees with your Doctor you can appeal to the Chief Medical Officer at the VISN. On
Some good suggestions below. I would call the VA Inspector General as well if they don't steer you into the process above.
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Unfortunately that is today's VA fir you. They started getting this way under the obama administration. Namely more worried about the bottom line than their nandate of taking care of Veterans.
It started to improve some under Presudent Trump, but it is now going in the opposite direction again under the biden administration.
I know fron 1st hand experience. I was receiving treatment and was scheduked for knee replacement surgery this past February. Biden gets sworn into office and I get notified by the VA hospital that was going to do the surgery, "we can no longer treat you for your issue with your knee and will have ti find an outside provider fir treatment". When I went to get copies of my records and such, they told me, we are unable to locate any records of you being treated at any of our locations for your knee. Considering your records are stored on a computer system and can be retrieved at any VA hospital ir clinic.
It started to improve some under Presudent Trump, but it is now going in the opposite direction again under the biden administration.
I know fron 1st hand experience. I was receiving treatment and was scheduked for knee replacement surgery this past February. Biden gets sworn into office and I get notified by the VA hospital that was going to do the surgery, "we can no longer treat you for your issue with your knee and will have ti find an outside provider fir treatment". When I went to get copies of my records and such, they told me, we are unable to locate any records of you being treated at any of our locations for your knee. Considering your records are stored on a computer system and can be retrieved at any VA hospital ir clinic.
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Contact another Congressman, specifically some on the VA Committee. Sadly, they tend to be partisan contact someone aligned with your party designation. They may respond. A VSO( Veteran Service Officer may help. No need to pay a lawyer. Don't give up!! Your entitled to the service!
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I had a friend who went thru the same issue and it took a group of friends and organizations as well as a congressional representatives veterans aide to work on different areas of concerns.
I also brought it to the attention of another VA hospital Where she wasn’t enrolled, and advised that the VA was responsible for referrals to outsource if they knew of any specialists in their area.
To make a long story short we were able to find an out of state specialist who agreed to treat our friend with the care she needed, I don’t remember if the VA covered the costs but I believe she had to use outside insurance. To add insult to injury the VA was negligent in diagnosing her condition and it took an extra 6 months for a doctor outside of the VA to run tests and give her the proper Diagnosis and that missed diagnosis directly lead to her demise and death.
Since I’m not part of the family and I know they were looking for a lawyer to represent our friend while she was alive I don’t know what the disposition and outcome was.
Obviously this is an egregious and unacceptable policy and horrible way to treat our veterans and brings back memories of the emotional toll and mental and physical trauma perpetrated on our veteran and all of her friends who all bore the disconnected and disrespectful way she was treated.
I believe this would be one where a legislative action would be needed to make it mandatory for the VA to find an outside specialist whether nearby or out of state and cover the costs as deemed medically necessary!
I also brought it to the attention of another VA hospital Where she wasn’t enrolled, and advised that the VA was responsible for referrals to outsource if they knew of any specialists in their area.
To make a long story short we were able to find an out of state specialist who agreed to treat our friend with the care she needed, I don’t remember if the VA covered the costs but I believe she had to use outside insurance. To add insult to injury the VA was negligent in diagnosing her condition and it took an extra 6 months for a doctor outside of the VA to run tests and give her the proper Diagnosis and that missed diagnosis directly lead to her demise and death.
Since I’m not part of the family and I know they were looking for a lawyer to represent our friend while she was alive I don’t know what the disposition and outcome was.
Obviously this is an egregious and unacceptable policy and horrible way to treat our veterans and brings back memories of the emotional toll and mental and physical trauma perpetrated on our veteran and all of her friends who all bore the disconnected and disrespectful way she was treated.
I believe this would be one where a legislative action would be needed to make it mandatory for the VA to find an outside specialist whether nearby or out of state and cover the costs as deemed medically necessary!
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Vote for Trump is your only chance. Biden and his staff dont care one bit even though a phone call form his office to the VA concerning you would get you refunded and granted.
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The bottom line is that the VA can and will do whatever they want to whoever they want because they don't actually have to abide by any of their own rules or regulations, kind of defeats the purpose of even having any right? You probably will win though, eventually, but it could take over a decade to actually do so because the VA has no time constraints that they actually have to adhere to even if it is something that is "expedited" and virtually nobody in Washington or anywhere else within the government will actually help you because the VA is designed to not actually help veterans so this sort of situation is exactly how they want it to work in the first place.
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I got the same thing going on with the VA Hospital in SLC from a auto accidents and they will be paid from the settlement but they keep saying no but send me to PT and pain clinic which is like not doing any good at all and Biden Administration not going to do anything for me either suck having served my country for this type of treatment, even trying to get a rating increase is look shoot your self in the foot you jump through hoops to get denied. It seem as long as their Democrats is office the VA will not do what the promise to it serves member and veterans
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A letter writing campaign to the White House is one thought. Another, if you could get a White House news correspondent to bring up your situation at one of the daily press conferences.
Ms Psaki might be really flummoxed.
Ms Psaki might be really flummoxed.
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You should be in your Congress Persons Office. They have decided you should die.
You need a new Senator
You need a new Senator
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MUCMI’s medically Unexplained Chronic Multi-Symptom Illness: it’s defined in 38 USC 1117 as a diagnosed illness with no known cause(etiology) or (Pathophysiology). Dont let the VA fool you, without a known cause or a known pathophysiology means either one. Also the portion that’s known has to relate to you and not the general population.
Furthermore, it is already clear by your post that you are not being properly treated by the VA. There are some stellar universities that might specialize in specific disorders and open doors to therapeutic alternatives that the VA can’t provide, refuses to provide, or hasn’t hired qualified specialists who can properly provide you with the most current treatment modalities that you might need.
I highly recommend you do a lot of research, or find someone who can help you locate a facility. Don’t limit your treatment to the VA because the VA will always be a desired target of fraud by contractors or fellow employees, and unfortunately the lost funds are deducted from patient care and nothing else.
I wish you the best of luck and a future filled with helpful meaningful treatment and care.
Furthermore, it is already clear by your post that you are not being properly treated by the VA. There are some stellar universities that might specialize in specific disorders and open doors to therapeutic alternatives that the VA can’t provide, refuses to provide, or hasn’t hired qualified specialists who can properly provide you with the most current treatment modalities that you might need.
I highly recommend you do a lot of research, or find someone who can help you locate a facility. Don’t limit your treatment to the VA because the VA will always be a desired target of fraud by contractors or fellow employees, and unfortunately the lost funds are deducted from patient care and nothing else.
I wish you the best of luck and a future filled with helpful meaningful treatment and care.
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The people at the VA are being obtuse. What can they possibly be thinking or not thinking. Your issue requires immediate attention. Maybe the media would like to hear from you. Good luck!
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I have never heard of the VA refusing to treat a 100 percent service connected veteran. I believe your two best options are: give a power of attorney to the DAV to persue your issue and send a letter to the OIG Hotline with the parrticulars asking for a review, cc the letter to the House veterans affairs committee.
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Get with your congressman or congress woman to assist with your case. They will get this resolved. Good luck.
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As an RN, I would recommend you request to be treated through the VA’s community care network. I would never recommend having spine surgey at a VA hospital ( I am an OR nurse). For complex care cases I would highly recommend you get VA Sponsored community care doctor. I have been able to select my own community care doctors since I know the system and it’s worked out. I have also requested meetings with their chief of a medical department at the VA in the past so I could eliminate all the beuacratic BS and let’s them hear from me as a patient not just as a number…
The DAV Can also help in many instances as well. Don’t pay an attorney until you exhausted the VA, legion or other VSO’s
That’s why they are there as our advocate!!
The DAV Can also help in many instances as well. Don’t pay an attorney until you exhausted the VA, legion or other VSO’s
That’s why they are there as our advocate!!
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The VA can make its own rules. I was sent by the VA for a shoulder surgery after slip-and- fall at a B&B whose steps were out of city code. It required 3 surgeries in 18 months, so I effectively had no use of that arm for 18 months. Bathing, dressing, going to the bathroom, tying my shoes and cooking required help, sometimes from perfect strangers. After 2 years, we settled. The attorneys got their 40%, and after the payment for expert witnesses, travel costs and the cost of household help, almost half of my settlement money was gone. To add insult to injury, the VA billed me $70,000. THEY ONLY PAID $7,000 FOR ALL THEY WERE BILLED. So they paid 10% off what they were billed, then billed me 100% off what they were billed. The White House Veterans Hotline passed my concerns on, and I was told that the VA was allowed to do this. I also wrote my congressmen and got the same answers.
I don’t understand how the VA can bill for more than they paid, but apparently they can.
I don’t understand how the VA can bill for more than they paid, but apparently they can.
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I AM deeply sorry to hear about your troubles. I had been dealing myself with the VA. I am also p&t 100 SC.
It is a shame that our representatives "suck" in their jobs!. I have lost dear friends while waiting for help! From
The WH, VA and our elected officials whom they say they care about "the troops", what a bunch on BS. If I was you I would call the TV news and let the people know about the disrespect from the VA, the WH and elected officials!. They are quick for a photo op with serviceman. I met Clinton myself down in Haiti on 2010. He refused to shake hands or talk to the troops. I met Bush, Obama, Trump and they all show disdain for all of us!
My men asked why they behave like that? and I have to lie to then by telling these men that they were to busy with running our country but not busy enough for photo Ops.
I deeply sad about what your going thru, I myself had tried for 7 years (and counting) to be help by the VA. However, do not give up!!!. We are soldiers and when the mountain is too steep, slippery, cold and hot ; we still conquer the summit. Get the news involved in your struggle because theirs no because there is no more "concerning " when the population learns about their immoral and disgraceful towards us and the disservice that they do to us!!!
We all love our country served with honor and pride. When giving a task a mission we took charge head-on and accomplish the mission. No burocratic red tape and no waiting for "cowards" to act!!!.
Keep the fight going. It's not easy and is sad, frustrating, demoralizing but is nothing compared to our resilience and commitments to accomplish the mission.
Get the
It is a shame that our representatives "suck" in their jobs!. I have lost dear friends while waiting for help! From
The WH, VA and our elected officials whom they say they care about "the troops", what a bunch on BS. If I was you I would call the TV news and let the people know about the disrespect from the VA, the WH and elected officials!. They are quick for a photo op with serviceman. I met Clinton myself down in Haiti on 2010. He refused to shake hands or talk to the troops. I met Bush, Obama, Trump and they all show disdain for all of us!
My men asked why they behave like that? and I have to lie to then by telling these men that they were to busy with running our country but not busy enough for photo Ops.
I deeply sad about what your going thru, I myself had tried for 7 years (and counting) to be help by the VA. However, do not give up!!!. We are soldiers and when the mountain is too steep, slippery, cold and hot ; we still conquer the summit. Get the news involved in your struggle because theirs no because there is no more "concerning " when the population learns about their immoral and disgraceful towards us and the disservice that they do to us!!!
We all love our country served with honor and pride. When giving a task a mission we took charge head-on and accomplish the mission. No burocratic red tape and no waiting for "cowards" to act!!!.
Keep the fight going. It's not easy and is sad, frustrating, demoralizing but is nothing compared to our resilience and commitments to accomplish the mission.
Get the
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Lisa, I’m retired civil service and worked for the VA for many years. Seen it all. Best course of action… if you’re having problems getting needed care or referrals, make an appointment with your local Congressional delegate. You’ll probably talk to a staffer at first… that’s ok as they handle most inquiries anyway. Take all relevant medical records with you. Be specific as to what the problem is, how long it’s been going on, who you’ve seen and talked to, etc. The more information you have the better. Explain your frustrations. Once the VA gets the Congressional inquiry letter, they generally move swiftly to clear the matter up as they don’t like them hanging over their heads. They usually have a “suspense” date of 45 days to take some action. Follow up with your Congressional staff to stay on top of it, and also to say Thanks for their help!
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