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 5 y ago
Responses: 430
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I think it's time to contact your Federal representatives. I am 50%, and my son is 100% but they jerked him around for months. After our congressman called it only took 3 days to "clear up the misunderstanding.
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If nothing else, get ahold of your local V.A. iraq and Afghanistan rep and have them help you out .Also this is the number too the white house V.A. report a problem and get help. [login to see] . I hope that helps. Keep your powder dry and your spirits up.
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Hello SSgt Markland. May I ask a few questions? First, did you retire with a medical discharge? Second you should be eligible for TriCare if you retired. Third, when you say the "VA", who do you mean? The VA benefits office in your state, or the big VA in Washington DC? Who has told you the VA won't do telehealth or video? As to telehealth or video via iPhone, I have a video conference with one VA specialist that's been ongoing. Other appointments are back to in-person with masks. I'm confused by your statement, "the VA continues to refuse 'at times' to even consult...". What do you mean by that? Remember that if you seek outside treatment without the approval of the VA, the government has the right to deny any claim for out-of-pocket expenses. Another thing to consider is, should you receive treatment for your problem, and it is corrected, the VA could remove the 100% rating since you no longer have that disability. An organization that you might approach is the Paralyzed Veterans of America. I'm told they are very good. I don't know whether this helps or confuses. There are attorneys who specialize in VA disability claims. The first visit is usually free. You could get an opinion as to where you stand.
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SSgt Lisa J. Markland
Thank you for trying to help. I am primarily assigned to the Washington, DC VAMC, as well as the local CBOC for some of my care. With some of my providers within the VA, this has not been an issue, but where my case medically is very complicated (rare medical genetic condition, multiple autoimmune diseases, etc.), and even with proper referrals for care within the VA itself, various departments and centers I’ve been referred to have outright refused to treat me, some refusing to even to get on a phone call. I have spoken to people all the way up to the department chiefs, who in some cases are the ones telling me it’s just “too complicated“ for them to handle my medical needs, therefore they won’t get involved. I did not know that was an option as a 100% service connected veteran! When I propose to those people that if they wouldn’t treat me at the VA facilities they should outsource me; in some cases even years later and after multiple inquiries inside and outside of the VA, I have still been refused the care. That’s where my post came from. I don’t believe the VSOs such as PVA, although they are a good one, can help with this kind of thing, but I can check at this point and I am a life member. I have gone through more than one representative, tried to useless White House hotline that just refers me back to the DC VA, and have tried to reach out through the medical center directors office, with no luck there either. It’s been immensely frustrating, discouraging, and I can’t believe for any reason this would be allowed. I’ve even done anon camera media interview (several years back now). And for whatever it’s worth, none of this care would affect my rating, which is unrelated to the care I was seeking. I am already rated 100%, so an attorney dealing with disability claim claims would unfortunately not be appropriate either. But I sure do appreciate you chiming in and trying to help!
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A complicated medical issue is NOT going to get resolved, or even get a decent answer in a forum, especially a forum like this one where everyone is a so called expert. I am an expert as I am a VA doctor and I cannot answer your question as there are complexities and nuances that go way beyond a discussion in any forum. If you’re having issues that are beyond the complexity level of your VA hospital, use Community Care. Ask your provider for the proper consults and follow up as necessary. Also get the Patient Advocate involved.
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This administration is going to help you or any other Veteran more then they have to, YOUR NOT AN ILLEGAL ALIEN!
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Sit down with a VSO from your veteran's organization and create a letter with the pertinent info about your case. Make six copies, one each for your Congressional delegates, POTUS, national level VA Hospital head and one for your personal file. At least one of the five you mail will get some attention.
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Contact: Keith Brekhus
Northern District Director
Office of Congressman O’Halleran
(Office) [login to see]
[login to see] .gov
Northern District Director
Office of Congressman O’Halleran
(Office) [login to see]
[login to see] .gov
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First name the senator who refuse to help and turn his name over to your local VFW . Second go to your local Veterans office and ask for your representative let them send your history to the VA . Third use your voice in the local media bad PR is one thing the VA fears .
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Not legally. I would make sure I am part of a service organization, i.e. VFW, DAV, State VA organization or which ever has the largest presence in your area. Also, get a new provider and get the local number for community care. If you haven't already get your SSDI or standard Medicare. There is many ways to fight this but getting the best organization with lawyers is my best recommendation...
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This POTUS may not be much help, BUT, write him a letter anyway and CC your senators and representative.
In Fact, send a copy of the letter to the United States secretary of veterans affairs. The current incumbent is Denis McDonough and he has been since February 9, 2021. As a Cabinet Member, he reports directly to POTUS. I would address the envelope and a cover letter to him.
The address is:
810 Vermont Ave, NW
Washington, D.C. 20420
In Fact, send a copy of the letter to the United States secretary of veterans affairs. The current incumbent is Denis McDonough and he has been since February 9, 2021. As a Cabinet Member, he reports directly to POTUS. I would address the envelope and a cover letter to him.
The address is:
810 Vermont Ave, NW
Washington, D.C. 20420
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CMDCM Gene Treants
I did not insult POTUS, I stated the fact he does not usually involve himself in matters like this. BUT, since you asked, in the case of the current POTUS, he has made clear his disregard for the Military.
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Normally no, but there are a number of issues involved; is it a service connected issue? Are you refusing offered care in favor of some preferred therapy you found on the internet? I had a patient that was totally convinced that worms were burrowed all through her body and picked sores all over digging them out. Did all the tests you could think of to find the “worms” to no avail but she was difficult to convince. There are folks that believe their therapy should be just how they desire in spite of standard of care or risks. I usually try to listen intently and educate the veteran to the better options. That being said getting specialty care when you are hours from a VA medical cen can be a daunting task as they sometimes ask us to prove the obvious to approve the care requested. Or ignore what we have written. I was a military physician in the past and am now backin federal service after 30 years in private practice, but if you think the VA is bad try to deal with the for profit insurance companies. Insurance company executives rival politicians in their integrity
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That seems par for course with the VA and their bloated lapsidasical bureaucracy........
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This is your opportunity to go get some quality healthcare. I had severe complications, severe health issues, I mean, I need a liver transplant, my heart arteries are blocked, I was on oxygen, and anemic, and really probably was diagnosed with about 100 and 150 issues with me. Even to this day after a liver transplant and heart bypass, I still take 350 pills a week and about 16 shots just to stay alive. I went to the military base at Lackland when I moved there to stay with family to take care of me. I’ve been hospitalized over the past five or six years to the tune of about $2 million in medical bills. Not to mention about $40,000 every six months for medicines. I tell you this, just so you know that you want the best healthcare you could get. Why go to a military doctor that graduated with a C when you can go to a doctor they graduated with A++++ and is well known in their field? Since that day, I have never seen a base doctor for anything, nor will I go to the VA. I’ve had several friends have heart problems and go to the VA, and one of them died on the table. Take this opportunity get excellent quality medical doctors in your community. It’s a blessing in disguise.
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Call the White House Veteran hot line at [login to see] . I was getting the run around to get treatment for a service connected injury and within a few days my treatment was approved.
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I feel it's totally wrong that they will not cover other doctors medications. And I can't even fathom them not outsourcing someone if they don't know what they're doing. I have been outsourced every time because personally I won't let the VA touch me.
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Suspended Profile
It's a sad day when America doesn't take care of the people who sacrificed to protect her.
As someone else stated, contact your local congressman/congresswoman.
We deserve better. Don't take their denial of service as an answer. It sounds like a breach of contract.
Remember, they spend millions of $ to put in new rocks/boulders/shrubbery/walk paths in front of their buildings but won't spend the $ taking care of the vets keeping them free.
Good luck and thank you for sharing.
As someone else stated, contact your local congressman/congresswoman.
We deserve better. Don't take their denial of service as an answer. It sounds like a breach of contract.
Remember, they spend millions of $ to put in new rocks/boulders/shrubbery/walk paths in front of their buildings but won't spend the $ taking care of the vets keeping them free.
Good luck and thank you for sharing.
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To answer, no, they can't.. they have to send you out to the community. If they deny treatment, your can actually take that up with jag and sue for lack of care. Your clinic is being fucking lazy as shit. This is why trump did what he did and was making us veterans get better care
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MSgt Earl King
SPC Steven Nihipali - Are you doing the backstroke, you are way below my paygrade, so take a walk and stop lying!!! First, it's Obama, now it's Clinton! Who's next?
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SPC Steven Nihipali
MSgt Earl King do I need to go on? You called trump a draft dodger...I don't give a shit about you stupid ass pay grade. Obama, Clinton, Biden... how many more of you precious democrats didn't serve either. Fuck outta here
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SPC Steven Nihipali
MSgt Earl King at least I'm getting some kind of stroking and it's not from Biden or Obama
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I think I went straight to the ombudsman with my problem. For some reason, the woman I spoke with wanted my husbands details, and I am sorry, he is a vet, I am the retiree!
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