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?
146K
1.91K
839
490
490
0
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 5 y ago
Responses: 430
1
1
0
I think the place to start is with the medical center patient advocate. I don’t think there are many problems too complex for the VA system to handle. Also, if services are not available the VA can allow a veteran to use the private insurance they contract with which I believe is Optum. The VA has an obligation to make sure a veteran especially a Service connected veteran get the care they need. Also, I would check with the Veterans primary care physician and have them make the necessary referral preferably within the VA system because the VA specializes in veterans and veterans with complex problems in particular. The VA is closely affiliated with the best civilian research medical centers in the country.
(1)
(0)
1
1
0
I have not had that problem, so I assume it might be the area you are in or specific people.
(1)
(0)
1
1
0
No ,under no circumstances are they able to refuse a veteran or combat veteran medical treatment . They can however refer to a different doctor or they can refer to a outside / outsourced medical provider to diagnose or treat the soldier .
(1)
(0)
CPT Larry Hudson
Absolutely agree. DAV works hard to make the government keep the promises that were made. If you file and are denied, SO's will help the veteran respond to the denial. Usually there are conflicting statements in the denial which pointed out to the VA gets things moving. If that doesn't happen then the appeal course is open all the way to a judge sitting in Washington who has the final determination for or against the veteran.
(0)
(0)
1
1
0
I was wounded three times in the same action. I was an infantryman/interpreter/ FO. When I retired from the US Army and applied for CRSC they considered the GSW to my larynx as a throat injury. I had copied my health records based on advice and it was changed by the Department of the Army to LOD based on appeal. I am now covered by MEDICARE and TRICARE so my stuff is squared away. HOOAH!!!!
(1)
(0)
1
1
0
Maybe you can file a complaint with the Surgeon General, I believe there's a link
(1)
(0)
Suspended Profile
Is it due to a service connected issue that you incurred during your time in service?
1
1
0
First, has the VA acknowledged that your disability is indeed service connected and that it is 100%? If the answer is Yes, I do not believe that the VA can legally withhold treatment either by it or, if your needs exceed VA capabilities, by an outside provider(s). I also do not believe that the cost of reasonably required medical care is a recognized exception. I am now a lawyer but, I have not practiced in the area of health care law. You need to consult a more knowledgeable lawyer in this field of practice and perhaps file a suit in Federal Court. Good luck. Other comments have also provided good practical suggestions/advice. A multi pronged approach is good such as letters to POTUS and your Senators.
(1)
(0)
LTC Patrick Crow
Chris Attig, former Army Captain, is 'the man' if an attorney is needed to deal with the VA
(0)
(0)
1
1
0
I was trying to get a surgery approved for over 15 months.
The local V.A. here refused to do it, refused to send me outside to do it. I literally had a Nurse tell me that they don't "feel like the V.A. or the Tax Payers should have to cover my surgery", I got a senator involved (Dem) and they did nothing.
I found a surgeon inside the V.A. that does the surgery and was told No because the Surgeon was in a different state, even after I offered to travel and cover my expenses.
I called the White House Hotline and within a month I was schedule for surgery, due to COVID the surgery was delayed 6 months, but here I am 3.5 weeks after surgery feeling better than ever.
You can say what you want about Former President Trump and his tweets and arrogance, at the end of the day the care I received at the V.A. under his watch was significantly better than it was under the previous administration before him, and I've already seen the care tanking here under the current administration.
The White House Hotline got the ball rolling and the care we need/deserve going in the right direction.
The local V.A. here refused to do it, refused to send me outside to do it. I literally had a Nurse tell me that they don't "feel like the V.A. or the Tax Payers should have to cover my surgery", I got a senator involved (Dem) and they did nothing.
I found a surgeon inside the V.A. that does the surgery and was told No because the Surgeon was in a different state, even after I offered to travel and cover my expenses.
I called the White House Hotline and within a month I was schedule for surgery, due to COVID the surgery was delayed 6 months, but here I am 3.5 weeks after surgery feeling better than ever.
You can say what you want about Former President Trump and his tweets and arrogance, at the end of the day the care I received at the V.A. under his watch was significantly better than it was under the previous administration before him, and I've already seen the care tanking here under the current administration.
The White House Hotline got the ball rolling and the care we need/deserve going in the right direction.
(1)
(0)
1
1
0
I suggest you get in touch with me to explore this problem. My charity, http://www.RIPMedicalDebt.org, has a special interest in abolishing vet/military unpayable medical debt but also everything that happens upstream that obstructs a veterans rightful access to VA care as a matter of policy.
RIP Medical Debt makes it easy for donors to make an impactful difference in the lives of those struggling with medical debt.
(1)
(0)
1
1
0
If the Senator is not able to get an answer. Contact the Whitehouse Veterans line [login to see] . Hang in there!
(1)
(0)
PO3 Aileen Dodge
Ok so the Whitehouse Veterans line will take your complaint against a VA hospital or agency. They will assign you a case number. They will make some calls and Yes someone from the VA will get in touch with you about your complaint. That however does NOT mean your issue or problem will be solved!!!! The Whitehouse Veterans line simply looks into the complaint and make a record of the complaint. They don't actually have the ability to solve the issue you are having with the VA. They DO NOT HAVE THE POWER TO FORCE A VA HOSPITAL TO FOLLOW FEDERAL REGULATIONS OR PROTOCOL WHEN IT COMES TO THE MEDICAL TREATMENT OF THE VETERANS THEY SERVE AT THAT PARTICULAR VA MEDICAL CENTER (HOSPITAL). I know this, I am speaking from experience. The one thing that really irks the hell out of me when it come to the United States Department of Veterans Affairs is that NOTHING HAS REALLY CHANGED!!!! Sure they have made it look like things have changed but their over all attitude toward the treatment the VETERANS is still the same "DENY UNTIL THEY DIE" . So maybe they have approved more claims and gotten them through the system. But are they giving the proper medical treatment to all those VETERANS??? HELL NO!!! And the more they deny the necessary medical treatment to, over time that will equal out to LESS VETERANS to treat because the MORTALITY rate of Veterans will increase over time!!! SO there you go. It's easy to approve a disability claim, and it's just as easy to deny medical treatment to that veteran. Or to cause that Veteran so much stress in seeking treatment that over time that stress takes it toll cutting years off the lifespan of the Veteran!!! And there you go ONE LESS VETERAN THE GOVERNMENT HAS TO PAY FOR!!!
(0)
(0)
Read This Next
-
Ask questionGet expert advice and
tips for your questions. -
Post updatePost pictures, personal updates, plans, or anything you like!
Continue with Facebook 
Continue with Google