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The V.A. needs more mental health therapists.

Why are all of our appointments 4 or more months in the future? Were told we have to be rated at100% for many of these appts like dental and podiatry. Yet when we've appealed our disability ratings 4 or more times over 30 years and finally get the 100% rating, we still can't get these appts. What happened to the policy that if we couldn't be seen withing 30 days by a VA provider that we'd get a community care referral? It's not happening. When I specifically asked for a referral due to the lengthy appt. delay, I was refused. Wholistic health? We can't get dental care, yet we have a new dental clinic in Knoxville Tennessee. I'm told the VA has a hiring freeze. Why pay a lease and utilities on a building when it can't be staffed?
The VA is wasting humongous amounts on paper. For instance, 1 prescription comes with at least 6 pages of paper with our personal data printed on each page 5 times. Likewise, when we go to a community care appt, the facility receives mounds of paper with our personal information, a lot of which isn't even pertinent to that particular appt. Oftentimes, staff at the facility will discard most of the paperwork. So where does fraud, waste, and abuse come in? When Physical Therapy ordered me a special scrub device for my feet for the shower, I received scrub brushes that are used in the Operating Room, but they cant be returned. My particular brush had to be reordered, so more expense and delays. It doesn't make sense

My question is regarding VA/DoD Resource Sharing Agreements (RSA)* and their limitations and/or execution/understanding by VA physicians and the administrative staff.

Specific to my situation - why can't I take a radiology or laboratory order from a VA Community-Based Outpatient Clinic (CBOC), which is co-located with a Military Treatment Facility (MTF), to the MTF's radiology/laboratory department to be fulfilled (especially if there is an existing sharing agreement between the CBOC and the MTF)? Instead, VA facilities must be used regardless if there is a delay or travel involved to use them.

Background:

In order to expand its capacity to provide outpatient primary care, the VHA has established approximately 1,400 CBOCs under the regional VAMC. Many of these CBOCs are co-located with a MTF and have an established RSA.

I don't know what the RSA covers for other facilities, but specific to my situation (I am assigned to the Washington VA Medical Center and see my primary care at the Fort Belvoir VA Clinic*) there might be a disconnect in execution.

The specific use case/example that I've experienced is I would see my VA Primary Care Manager (PCM) for a complaint. The PCM might order blood work and/or an X-Ray. My CBOC schedules all lab draws as the facilities are limited and those appointments are usually a few weeks in the future unless there was a cancelation. In order to have any radiology performed you must travel to the VA Medical Center (VAMC) the CBOC belongs to which for me is about an hour average travel.

In most cases I throw up my hands in frustration and go outside the VA system and/or use an urgent care facility.

The oddest part is that the MTF will do labs and radiology from outside physicians as long as I provide them with the order (I have TRICARE Select for my family, and they have had labs and x-rays performed numerous times by bringing in the provider's order). Every time I've requested an order from the VA provider or their staff, I've been informed that it's not possible and I must use the VA's resources.

I researched if there was a RSA in place and was able to see on the VA/DoD Medical Sharing Office (MSO) webpage* that one between the VA clinic and the Belvoir MTF had been established. Strangely, when I started sending inquiries to the MSO about the RSA (of which none were ever responded to), the list of established RSAs disappeared from online access.

As far as I can determine in my discussions with the clinic providers/staff and the VAMC patient advocate, the RSA only applies to the facility being present at the MTF, but no other resources at the MTF can be accessed (which doesn't match up with the information provided online about the RSAs).
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* VA/DoD Sharing Agreement - https://www.va.gov/VADODHEALTH/DoD_Sharing_with_VA.asp
* Fort Belvoir VA Clinic - https://www.va.gov/washington-dc-health-care/locations/fort-belvoir-va-clinic/
* VA/DoD Medical Sharing Office - https://www.va.gov/VADODHEALTH/Medical_Sharing.asp

Why is the PACT ACT process so screwed up. One way communication. If I have questions I call the [login to see] and get a different answer every time. I have been waiting 19 months.

I had the same problems these other Vets have with communicating with the Community Care and a civilian Provider

Why do the VA's "doctors" not recognize the fact that RFD airmen/aviators must stay flight current just like the active-duty airmen/aviators? I keep getting denied a claim of hearing loss & tinnitus although I flew the UH-1 & UH-60 helicopters for nine (9) years??? The doc at VA was under the impression that Guard pilots only fly once a month or during "summer camp". Reserve & Guard aviators must stay just as current in their designated aircraft as AD airmen. Y'all need to educate the old farts who pretend to be "doctors" at your facilities.

Community Care is a broken system. Veterans are accruing medical debt as in-network providers (with authorizations) bill private insurances. Veterans are also being billed by ER in network facilities, again, causing debt with many accounts going to collections. Community providers also lack education on how to coordinate Veteran care causing delays in care. What are we doing to improve the community care program?

Living OCONUS and on the FMP is very different than in the States. 99.99% of the time when I receive a letter from the VA which requires an answer with in 30 days, I am screwed from the beginning. Let's say the letter is dated 1 October, yet I receive the letter on 20 October (which has been the norm) I am behind the eight ball to begin with. The very first thing I need to do is request an extension which takes time. Can't the VA figure out or give a different time for those of us on FMP, say 45 days? Would be more realistic. Maybe someone from the VA needs to live OCONUS for a while and understand what we have to go through.

I've been fighting my VA case for backpay since 2008, the original case goes back to 1992. In 2020 I was awarded 100 T/P. The claim is now basically about 28 years of back pay. There has been so much that has happened, but the Reader's Digest version is this... My attorney believes the claim will be back paid to 1992. (I'm hopeful but not holding my breath, because this part of the claim is headed back through the regional Boise VA from the BVA. The Boise Regional VA has been a nightmare.)

First they have managed to break up my original claim and turn it into about four separate claims. In the process, I've been called a liar (and my claim denied) by Boise VA personnel several times regarding my claim, because until 2011 the fact that the USS Tarawa was almost hit by a scud missile in Desert Shield/Storm was classified. They kept telling me it was impossible because the Tarawa was never in theater, and I either don't remember correctly or was lying... I was called a liar by Boise VA Personnel because the Boise VA couldn't locate my Walla Walla VA medical records pertaining to me participating in the Gulf War Control Group when I was discharged. I was even awarded a zero percent disability by the Walla Walla VA in regards to the study back in 1992, but the Boise VA took it away from me when I moved, because they couldn't "find" my Walla Walla records. They said, "There was no Gulf War Control Group" and the disability was issued by mistake. Eventually the Walla Walla records were "found" all-be-it several years later... Nothing changed, other than they don't say I'm mis-remembering or lying anymore.

Hell I was even awarded 50% for a portion of the claim. It was granted under the legacy claim going back to 1992, but the Boise VA refused the back pay because they said it was a new claim. There was no break in the claim and it even shows "GRANTED" under my legacy claim on VA.gov. The VA answer? File another appeal and start the process all over...

Last month I had a hearing with a BVA Judge, it was the first time in this claims process I felt I have been treated fairly. The BVA Judge was awesome. That said, apparently the BVA Judge can only grant service connection, now unfortunately (if service connection is granted) the case goes back to the Boise Regional VA to determine effective date. My attorney said we will most likely have several more appeals over the effective date.

My question is - Why is there no accountability in the VA to treat Vets fairly? There is no one to file a complaint with, no one to speak to about anything when or while the claims process goes off the rails? The only thing we can do is file another appeal... Start the entire process over and over. Everything seems to be about extending the claim out as far as they can, and making the process as hard as it can be made. If I get mad because I'm being called a liar, or frustrated over being shined on, I'm told I have an obvious mental health issue. Then they want to medicate me into quiet compliance... The process shouldn't be this way.

Why does the Federal Government tax active and retired military pay. Congress wrestles with how little they want to increase our pay and then take some of it back in taxes. Instead of taxing us when they want to give a 3% pay raise make it 2.5% and not tax us. I also believe they need to get rid of the Survivors Benefit Plan. It is really set up bad and should be a reduced life insurance policy that can go to the members dependents and not just his wife. Also if the wife dies before the service member the money goes to no one and that is actually stealing from the member. I appreciate your time in answering these questions.