Reimbursement For Medical Bills

[tdak]

Is there a certian paragraph or law I can quote when writing to get reimbursement for back medical bills??? I am writing a letter to DVA for back medical bills from surgery and I was wondering if there was something I should quote?

thanks.

[Pete53]

You should deal with Fee Service or something like it at your VAMedical Hospital. I recommend that you take your bills and go to see them. Take your award letter also.

You might have to hang tough but you should get your money.

[Chuck75]

Are the bills--

For treatment of a service connected medical problem?

Was/is the VA capable of providing the treatment?

Was the surgery a result of malpractice by the VA?

Actually , the general veteran's laws and VA regulations are againt the veteran in this area, and are designed to limit the government's liability and cost.

Is there a certian paragraph or law I can quote when writing to get reimbursement for back medical bills??? I am writing a letter to DVA for back medical bills from surgery and I was wondering if there was something I should quote?

thanks.

[tdak]

Chuck,

The bills were for brain surgery for my service connected injury,yes.

and NO, the VA would not do this particular surgery, well they could, do this surgery, but not for this particular illness. There are only a handful of neurosurgeons in the entire country who will even attempt this surgery.

I had to call at least 20 different neurologists just to find one to point me in the right direction to find a neurosurgeon who knew about enough about my illness to even talk to me. It is Chiari Malformation. They have all heard about it, it's the fact that they don't want to treat you, because they don't know enough or haven't ever treated enough patients. It is a rare condition, so if they indeed mess up, they don't want a malpractice suit on their hands.

Now if I waited until the VA approved me for my claim (which I am still waiting on pending issues for over 2 years later)), I would be totally paralized on the left side (not just permanent loss of use and sensation) and I would be in a wheelchair right now. Thats how bad my growth was. As of the 18th of this month it will be 2 years since my surgery and I have many issues still and always will. Surgery for Chiari is not a cure, it is merely a temorary fix for the moment, there is no cure, but it did stop the herniation of the brain from growing, which in my case was a huge factor, because it was to my 2nd vertabrea.

In any case, I think they should do something, at least make a deal with them on my behalf, because I don't want to lose my doctors because of unpaid bills (insurance did cover most of it) that is not fair to me.

[Chuck75]

There is language in the regs that permits (with Secretarial Approval) the VA to pay if they so choose. (Hardship, etc.)

On the other hand, standard VA practice is to deny any responsibility for the cost if you --

Have any medical insurance.

Did not notify the VA beforehand and get "approval", or in an emergency situation notified the VA within 72 hours after the event.

Evidently, it's not uncommon for the VA to refuse payment even when the call(s) were made in accordance with the regs. Or, payment of some low ball amount instead of something reasonable.

Remember, the system is setup to save the government money first, and only second or third to provide the veteran with some level of medical care.

In theory, it's possible to get some money out of the VA for something like this. I really doubt that you will be able to do so without a really smart lawyer, extensive research, and expert help in preparing the claim.

Chuck,

The bills were for brain surgery for my service connected injury,yes.

and NO, the VA would not do this particular surgery, well they could, do this surgery, but not for this particular illness. There are only a handful of neurosurgeons in the entire country who will even attempt this surgery.

I had to call at least 20 different neurologists just to find one to point me in the right direction to find a neurosurgeon who knew about enough about my illness to even talk to me. It is Chiari Malformation. They have all heard about it, it's the fact that they don't want to treat you, because they don't know enough or haven't ever treated enough patients. It is a rare condition, so if they indeed mess up, they don't want a malpractice suit on their hands.

Now if I waited until the VA approved me for my claim (which I am still waiting on pending issues for over 2 years later)), I would be totally paralized on the left side (not just permanent loss of use and sensation) and I would be in a wheelchair right now. Thats how bad my growth was. As of the 18th of this month it will be 2 years since my surgery and I have many issues still and always will. Surgery for Chiari is not a cure, it is merely a temorary fix for the moment, there is no cure, but it did stop the herniation of the brain from growing, which in my case was a huge factor, because it was to my 2nd vertabrea.

In any case, I think they should do something, at least make a deal with them on my behalf, because I don't want to lose my doctors because of unpaid bills (insurance did cover most of it) that is not fair to me.

[Sgt eve]

Hi, I too am trying to get the VA to reimburse for medical payments/co-pays. When I find something out Monday I'll let you know what they say about it and I'll ask where it can be found in writing.

That's great you got awarded SC for Chiari Malformation. I did a small research project on that and other birth defects in babies. Are you ok now? Hope so.

Edited November 3, 2007 by Sgt eve

[tdak]

Sgt. Eve,

Most people have hereditry Chiari, but not all. Mine is considered acquired, due to a serious car accident with head trauma and I had stitches and a concuscion and it displaced my odontiod bone (medically proven, of course, that's how I ended up with the service connection) so now I ended up worse, because when I had the surgery I had other complications because of the previous car accident problems. In any case, it took a lot of paperwork on my case and a lot of doctors. All I have to say is thank goodness I kept all of my dotor records since, forever, because that is what saved me )at least that and the doctors statements)

Good luck to you and keep me posted.

And thanks again everyone for the well wishes. As for seeing Mickey...I can't do any of that even if I wanted to. It takes too much out of me.I would rather stay home and hang with my family.

.

Hi, I too am trying to get the VA to reimburse for medical payments/co-pays. When I find something out Monday I'll let you know what they say about it and I'll ask where it can be found in writing.

That's great you got awarded SC for Chiari Malformation. I did a small research project on that and other birth defects in babies. Are you ok now? Hope so.