Veterans with chronic pain: The VA has decided that Vets don't need pain medication. Can the VA refuse to give a Veteran needed medication?

2015-09-24T23:18:19-04:00

I was recently informed by my VA provider, through a nurse, and over the telephone, that the pain medication that I have been taking for the last four years will be tapered, and then taken away due to a new VA directive. I have severe pain due to knee, and back problems (even with the medication), that the VA has been aware of for over 10 years, and that they have taken no other action on, until now. I am in the process of planning surgery for a total knee replacement, but that it is still a few months away. This seems to be a blanket action by the VA which in no way takes into to account the individual Veteran, or his / her level of pain. Does anyone know if there is any type of action that I can take to hold off this action, or appeal the decision?

http://www.washingtonpost.com/politics/veterans-struggle-to-renew-their-prescriptions-amid-new-opioid-rules/2015/02/18/4d42d63a-acb3-11e4-9c91-e9d2f9fde644_story.html

New restrictions on painkillers hit veterans especially hard

The VA fears overmedicating people, but some patients have said they need the drugs to function.

Response by SCPO Private RallyPoint Member made Sep 24 at 2015 11:20 PM

2015-09-24T23:20:21-04:00

I am being treated for several severe arthritic conditions. The VAMC in Omaha gives me what I need, without question.

Response by CAPT Kevin B. made Sep 25 at 2015 2:12 AM

2015-09-25T02:12:11-04:00

VA has been doing this. My compounded cream that keeps my back from taking over my life now has two ingredients that VA/Tricare won't cover so if I want to live a tolerable life, I now have to chip in $110 to keep the pain down. Recall I reported it on RP a couple months ago but didn't see any traction.

Response by PO1 William "Chip" Nagel made Sep 25 at 2015 10:50 AM

2015-09-25T10:50:08-04:00

I know there has to be a way to appeal their decision but damned if I know what it is. Not there yet just starting to feel my fingers feeling the effects of being a Navy Typist for 21 years. Keep Plugging Shipmate and I wish you luck forcing the gears of the system.

Response by SPC George Long made Sep 25 at 2015 5:57 PM

2015-09-25T17:57:38-04:00

I was just given a copy of the VA's current protocol on the dispensing of opioids and barbiturates. I cant find it right at the moment but if your primary care DR is following the directive and you still have pain you believes interferes with your life ask to be referred to a pain specialist. Additionally get an appointment with the patient advocate and discuss what is happening and have them help find a solution.

Oh my wife dropped my copy of the protocol with a hospitalized friend this am

Response by SSG John Mitchell made Oct 26 at 2015 10:00 AM

2015-10-26T10:00:43-04:00

I have to have Blood work done every 6 months just before I go to my bi-annual appointment so Doc knows I don't abuse what I have. I have never taken my pain meds as prescribed. I deal with the pain as much as I can because I HATE pain meds. My Doc knows this as it took almost 4 years before I'd let her give me anything stronger than Gabapentin. Now all I have to do for my Hydro is call. Even though technically she's supposed to see me before giving me a refill. Just before they changed the rules, I had 4 refills at one time. Supposed to take 2 a day. 60 tabs per. They lasted me almost 3 years. Problem now is I am having to actually take them closer to the way they were prescribed and I HATE IT!

Response by Cpl Chris Rice made Oct 28 at 2015 6:10 PM

2015-10-28T18:10:46-04:00

EDIT: I just caught that you have knee pain and need a TKA, they may have the every right to force your hand on this. You are putting them at a great liability, and your own life at risk continuing these particular medications without seeking resolution. I am not familiar with your full story, so feel free to disregard, but no provider VA or not is going to just give you opioids for that.

I am really sorry this is happening to you, I would suggest the patient advocate if you feel that you are being dealt with inappropriately. If you think that you may be experiencing a medical emergency you should seek care at your local ED, however you must understand that this is not the appropriate environment to seek pain management, and they will most likely not override the plan of care between you and your PCP; but will only rule out emergent situations.

This is pretty irresponsible, at the same time the problem that I have is that a lot of time these people needed intervention from a pain management specialist years prior. Opioids really are a terrible pain management strategy, it also is pretty indicative of a problem when there are signs all over the VA advertising Narcan kits.

I am surprised with our patients from the VA we see, almost none of them are on Gabapentin, lidocaine patches, Pregabalin even a Tricyclic antidepressants... A fentanyl patch which is still an opioid is still pretty gentle and have been found to be more effective and safer over the long term (Again long term) than opioids such as Oxycodone, Hydrocodone. I can understand using a low dose opioid, but every time it is the only therapy, and nothing else is even being attempted. At least this is what I would worry about with my family.

Response by CPT Judith Turner Fine made Jan 1 at 2016 1:25 PM

2016-01-01T13:25:03-05:00

I have been treated for chronic nerve pain for 17 years, This was in Florida and believe me they put me through everything to try to control the pain before they suggested narcotics. I didn't want to take narcotics, as my work in an trauma center ER showed me only the bad side of such drugs.
We moved to Kentucky to get away from the Florida weather and instantly found that they don't "do" Pain meds. First they blamed the Kentucky laws, which don't apply to them anyway and when I called them on it my doctor actually told me that they didn't use pain meds because studies had shown that "pain meds build up in your system and can eventually make you OD" I asked her why,if they build up so badly they didn't show up in blood work and she just looked away.
Another doctor told me that the DEA is responsible. They have promised to "crack down" on the use of narcotics and instead of trying, as they have been for years, to actually get illegal narcotics off the streets, they targeted the VA. He said that sooner or later someone is going to file a class action lawsuit against the DEA. If you think about it, they can now claim that they have curtailed the "drug problem" by a whopping xxxxx% in one fell swoop.
Meanwhile, here the use of herion has at least tripled.
A lot of vets I talk to locally have started drinking to try to cope with the pain. I just want the pain managed so I can live an almost normal life again, but it looks like it isn't going to happen

Response by CW3 Stephen Mills made Apr 18 at 2016 11:00 AM

2016-04-18T11:00:52-04:00

You can always get a second opinion. The VA hasn't decided that vets don't need pain meds, what they have decided is they don't want vets to needlessly get addicted to pain medication. If the doctor prescribes the pain medication you can still get it. You cant force a doctor to prescribe a pain medication though. Some meds are no longer available through the VA. There is no requirement that the VA pharmacy, or any government or private pharmacy for that matter, carry every medication available.

Response by CPT Pedro Meza made Aug 10 at 2016 4:32 PM

2016-08-10T16:32:31-04:00

rum and Coke don't need no Stinking VA approval. But I sure would like some medicinal Marijuana.

Response by SSG David Cooper made Sep 9 at 2017 10:31 AM

2017-09-09T10:31:37-04:00

Leave it to the VA to go about things the wrong way. What are blood and urine test for if they don't or won't monitor drug abuse? Why aren't addicts being treated? Why the Gestapo treatment with all vets because some bad apples abused their meds?

I forsee bad results coming from this, particularly when you purposely effect people's quality of life. I believe suicides and workplace violence will increase within the VA. I know some of these vets who are at their wits end, but hope they seek improved medical care outside the VA. This is their only hope, and there are far more than many think.

So, this is American Universal Healthcare/Single Payer healthcare? Great!

Response by PFC Justin Stout made Jan 15 at 2018 7:49 PM

2018-01-15T19:49:19-05:00

Yep. VA could care less, and somehow theres no shortage of jackasses that think we should legislate against people that follow the rules to create a "safer" world for junkies- as if we should somehow have the right to dictate what junkies put in their bodies anyway. My advice to anyone at this point would be to never join the military, because if you get hurt you'll spend your life in pain before the VA lifts a finger to do anything about it. Its complete bull shit that a VA doctor's liability should be any concern at all. The first and most important concern should be the vets quality of life, thats what that job is created for, not to employ the latest minority with a medical degree. And how many doctors in the va have killed vets with negligence? You havent seen any change have you? Because va staff know its damn near impossible to get fired. The va is a jobs program, nothing more. Its an organization built to serve vets, yet somehow most vets cant stand it- thats no accident. Statistical analysis of success rates of opioids shouldnt matter- if its working for you, if its improving your life, thats all that should matter. This is the kind of crap that happens when you arent free. People youve never met decide what goes into your body. People you see when you cant possibly avoid it, that could care less about you alter your life without consulting you. We have republicans to thank for a war on drugs thats helped absolutely no one, and democrats to thank for a unionized va, that cares far more about provider quality of life than vets. And we have dumbasses who are one bad day away from wishing they had never supported this system when they find 3 or 4 pills a day could make all the difference. Heres hoping for legal weed, and that your pain goes drastically down with a new knee.

Response by SFC Keith Frain made Mar 22 at 2018 11:49 PM

2018-03-22T23:49:57-04:00

My face is reconstructed, my neck is fused, my low back is fused, my legs are in pain, I had 4 surgeries on my knees, I have migraines...the only medications I get is Lunesta, Clonazepam. I suffer daily, but I have a 8 and 9 year olds that still think I am superman...so Superman it is. However, I am sorry for you brother, keep you head up.

Response by SFC James Coffell made Mar 7 at 2019 8:37 PM

2019-03-07T20:37:47-05:00

Deep down behind closed doors, we are liabilities, the sooner we Die off or drop off the VA health care system the more money they can save for Administration costs such as fatting up the high level GS and SES salaries. Only a very few abused or sold their pain medications, but the whole VA patient community is going to suffer. Reason why we loosing 22 vets a day to suicide. They are frustrated with this being treated like this, I have two ruptured disk in my neck, one in my back abd two blown out knees, these was owed to multiple combat deployments and 22 years of crawling in and on tanks and Bradley’s, was given 2 Vicodin’s a day to ease the pain, you would h@ve never known I took them, active at work, fishing ,family life. Got cut off, no notice, use gabapentin, been living in hell ever since, from time to time I have had my teeth implanted back from breaking a couple in Iraq. Looks like I am going rely on Jim, JAck and Bud, because the VA really don’t give a $hit.

Response by SSG Curtis Vaughn made May 8 at 2019 11:20 PM

2019-05-08T23:20:37-04:00

Had my pain meds changed had to take twice as many to get any relief. Told Dr that I only take old meds when I can't handle the pain which gives me relief. Found myself taking the new meds constantly with no relief. They think meds or surgery are the only answer. Surgery would work if we had access to the Doctor's the pro athletes have. Pain management for them is always shots, let's look a less evasive procedures. 15 minutes and on to next patient.

Response by Capt Daniel Goodman made Jul 9 at 2019 4:19 PM

2019-07-09T16:19:15-04:00

https://www.va.gov/directory/guide/keystaff.cfm?id=2001

I'd go to all three Congress local ofcs, tell all three sets of mil/vet staffs, get names and phones, send in Privacy Act (PA) requests...the site here is for all the main staff of VHA, with their main phone line, where the staff do most definitely answer the phone...I'd go to the patient ombudsmen types under social work at the VA hosp you use normally, get their names and extensions, ask for an explicit referral to anesthesiology/pain management, go also to outside anesthesiology/pain management, and have the whole thing written up, and send it all into all three Congress local ofc mil/vet staffs, as well as VHA, in addition, lemme send this, then I'll send more, OK?

keystaff.cfm

Response by Capt Daniel Goodman made Jul 9 at 2019 4:25 PM

2019-07-09T16:25:07-04:00

http://www.vetadvocates.org

This group, NOVA, saved us, we transferred our whole thing for total perm disability for me from one one the vet groups to one of their guys...the vet groups are good, truly, we know that, as are law school vet law clinics...however, for something like this, you might well need to file a claim with VA, which would obv be under the VA regional ofc (VARO) near you...that'll mean notices of disagreement (NODs), decision review officers (DROs), more NODs, filing with the Board of Veterans Appeals (BVA), waiting to see one of their judges...we did it all, six and a half yrs of it, thank God we didn't have to go to the Court of Appeals of Veteran Claims (CAVC), or higher into the Federal courts...our consult to our NOVA guy was $500, the best money we ever spent, he'd done 3 yrs active himself, and 35-40 yrs of VA-disability law, he knew more about it than God, and got us pro-bono help from another major law firm near him and us, one of their two attorneys assigned to us went with us with him to see one of the BVA traveling team judges...I know free is good, I get that, however, we learned that NOVA is pretty much among the top of the food chain for VA-disability law in the US, they have a good search engine, you can also call their main ofc, as well...trust me, and look for who they have near you, OK? If you wanna yak more, no rush, whenever you want, just lemme know, OK?

Home

Response by Capt Daniel Goodman made Jul 9 at 2019 4:26 PM

2019-07-09T16:26:26-04:00

And if you haven't used anesthesiology/pain mgmt as a specialty yet, trust me, use it, that's explicitly why it exists, precisely for stuff like you're describing, honest, OK?

Response by 2LT Earl Dean made Jul 11 at 2019 1:24 AM

2019-07-11T01:24:14-04:00

I was told the same thing and they did just that, removed pain meds even though there are days I have to have help out of bed. Low back and legs, and shoulders. It's part of the War on drugs and addictions. Good luck guys

Response by Sgt Jeff Schoolcraft made Apr 14 at 2021 7:11 AM

2021-04-14T07:11:05-04:00

I’m just done. I’m going to just let nature take it’s course and just stop receiving medical care. My second COVID vaccination is scheduled this month, but I’m not going. I have no quality of life and I don’t plan on finishing it off in agony. I’ve knocked on too many doors and walking away from the anger and bitterness this has caused me.