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?

Yes send the letter they sometimes want to slack on the job

SSGT Markland, I too suffered from debilitating lumbar back pain. I went with using TriCare and seeing a physician away from the Va. My back was so bad that I went from an office visit straight to surgery. I am much happier now. Same thing for my right shoulder; 3 major tears across my shoulder sent me straight to surgery. To this day I still use TriCare instead of the VA.

Have you spoken with the VA's Patient Advocate at the facility you use yet?
If yes, and they didn't help you resolve the issue, I'd contact my local Congresscritter's and Senator's offices. They all probably have a Veteran's specialist on their staff that can either advise you what to do next or get their boss involved in direct communications with higher ups at the VA and encourage them to take care of you.

It should never happen. Yet it does. Don’t get political. Just get it fixed

Contact your Congressman Now!! State and at DC

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

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.

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.

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!

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!