Denial Of Treatment

[catt02189]

This is rather a long story, but hopefully I can keep it brief, but may omit a few important details in the process. I would like some suggestions on how to proceed with this because I am lost at this point.

In 1999, my husband had reconstructive surgery on his left shoulder at the VA hospital. Claim was lost and wasn't pursued at the time. In 2004, he refiled and was given service connection 10%. He is a paramedic. His job is to treat and LIFT patients. His shoulder has acted up since the surgery. In July, he left work early (first time ever) because the pain in his left shoulder became so severe he couldn't do his job. Saw primary at VA. Ortho referral. Saw ortho same week at VA hospital. Note from both unable to work and pain meds prescribed, MRA ordered. First MRA available September 11. Sent paperwork to Regional office with both letters from doctors that couldn't work asking for a temp upgrade. HAH ! MRA switched to fee based and done August 21 - labrum tear. Then we wait. Can't get ahold of primary. VA refuses to pay until day surgery is done. No workman's comp because VA s/c. Finally talks to primary to get release to return to work because falling through cracks. Primary refused to release to work. Loses job, insurance, benefits. Finds new job. Goes back to work. Still no appointment given from VA. Finally, November 12 sees ortho for five minutes to be given a referal to yet another ortho department further away because this VA hospital can't do this surgery. More waiting. Called yesterday to be told by primary that the consult was rejected and that he should be put on anti inflamitories. Now, he has been for 6 months. He has returned to work since the VA can't take care of the mess it created and we have 5 kids. Don't know how much damage he has done to it further his only light at the end of the tunnel was that this surgery would make the pain stop. For six months, I have been watching him live with unbearable pain and popping narcs like they are candy and everyone passing the buck.

We have contacted 2 Senators offices one that is a presidential nominee candidate. Gotten no where. Talked to SO. gotten nowhere. Talked to regional office, patient advocates, head of hospital...nowhere.

This seemed real simple to me. You put someone out of work - you put them at 100%. They need surgery to put them back off of 100% - you do the surgery. You don't keep prescribing them narcs and have them lifting patients an average of 45 or more people a week. My husband loves his job and just wants to be able to do it.

Thank you,

Andrea

[william n]

This is rather a long story, but hopefully I can keep it brief, but may omit a few important details in the process. I would like some suggestions on how to proceed with this because I am lost at this point.

In 1999, my husband had reconstructive surgery on his left shoulder at the VA hospital. Claim was lost and wasn't pursued at the time. In 2004, he refiled and was given service connection 10%. He is a paramedic. His job is to treat and LIFT patients. His shoulder has acted up since the surgery. In July, he left work early (first time ever) because the pain in his left shoulder became so severe he couldn't do his job. Saw primary at VA. Ortho referral. Saw ortho same week at VA hospital. Note from both unable to work and pain meds prescribed, MRA ordered. First MRA available September 11. Sent paperwork to Regional office with both letters from doctors that couldn't work asking for a temp upgrade. HAH ! MRA switched to fee based and done August 21 - labrum tear. Then we wait. Can't get ahold of primary. VA refuses to pay until day surgery is done. No workman's comp because VA s/c. Finally talks to primary to get release to return to work because falling through cracks. Primary refused to release to work. Loses job, insurance, benefits. Finds new job. Goes back to work. Still no appointment given from VA. Finally, November 12 sees ortho for five minutes to be given a referal to yet another ortho department further away because this VA hospital can't do this surgery. More waiting. Called yesterday to be told by primary that the consult was rejected and that he should be put on anti inflamitories. Now, he has been for 6 months. He has returned to work since the VA can't take care of the mess it created and we have 5 kids. Don't know how much damage he has done to it further his only light at the end of the tunnel was that this surgery would make the pain stop. For six months, I have been watching him live with unbearable pain and popping narcs like they are candy and everyone passing the buck.

We have contacted 2 Senators offices one that is a presidential nominee candidate. Gotten no where. Talked to SO. gotten nowhere. Talked to regional office, patient advocates, head of hospital...nowhere.

This seemed real simple to me. You put someone out of work - you put them at 100%. They need surgery to put them back off of 100% - you do the surgery. You don't keep prescribing them narcs and have them lifting patients an average of 45 or more people a week. My husband loves his job and just wants to be able to do it.

Thank you,

Andrea

just one's opinion...get a hold of Bill Levesque @ st.pete times/tampa office and tell your story..the best to you..william n

[catt02189]

Thank you, but we are no where near Florida.

[Berta]

Sounds like my VARO, My former SO and 2 VAs in NY-

"Called yesterday to be told by primary that the consult was rejected and that he should be put on anti inflamitories."

you mean they rejected a surgical consult?

Something is wrong here-was a formal claim for TDIU benefits filed when he was completely out of work due to this SC disability -which got worse?

Is there any pending claim for higher rating?

[john999]

If he has medical insurance go see a private orthopod and get it done right. This BS could go on for months. I would not take my cat to the local VAMC for surgery. I would not even let them give me an injection. You can get workers compensation for the injury because even though the injury was SC the job he does now aggravated it. Do you have an workers compensation lawyer? I would consult with one pronto. It is illegal to fire someone who is injured by direct or aggravation of a pre-existing injury form work duties. I had a service connected injury that was aggravated by work and I got workers compensation. Usually, you must choose one or the other.

[catt02189]

Sounds like my VARO, My former SO and 2 VAs in NY-

"Called yesterday to be told by primary that the consult was rejected and that he should be put on anti inflamitories."

you mean they rejected a surgical consult?

Yes, they rejected a surgical consult.

"Something is wrong here-was a formal claim for TDIU benefits filed when he was completely out of work due to this SC disability -which got worse?"

On a statement of support of claim form this is a names removed copy of what was filed July 24:

I currently have a 10% service connected rating for my left shoulder. I am requesting an increase in rating for my left shoulder due to the following:

On July 14, 2007, my left shoulder began to become increasingly painful. On July 15, 2007, I left my job as a paramedic at PLACE OF EMPLOYMENT at 2 pm due to the increasing pain. My shift started at 7 am and was to continue to 7 am the following morning. I took my vacation day for July 18, 2007, my next scheduled 24 hour shift, due to intense pain in my left shoulder and scheduled an appointment with the local VA Clinic. On July 19, 2007, I saw Primary Care provider in the local VA Clinic. She scheduled an appointment in BLANK with the orthopedic doctor, prescribed Tramadol HCL 50mg 2 tablets 3 times a day for the pain (30 pills plus 180 pills sent in the mail), and put my left arm in a sling. On July 24, I met with the orthopedic doctor in BLANK. He wrote the enclosed letter for my job and told me to continue with the Tramadol. When I told him I would be unable to perform my job without using my left arm or drive to work while taking Tramadol, he told me I needed to take it up with my primary care physician. He scheduled an MRA to be done as soon as can be scheduled.

I went to the Decatur VA clinic to meet with my primary. Letter is enclosed.

In conclusion, I have been unable to work since July 15, 2007, am currently unable to use my left arm which is required for my job as a paramedic on an ambulance, and am taking Tramadol the effects of which do not allow me to drive or perform my duties as a paramedic.

With following attachments:

Letter from ortho stated: the above named patient has been advised not to do work involving overhead activities, pulling/pushing, or lifting over 25 lbs. weight for approx. 2 months.

Letter from primary stated: Patient is unalbe to work until further evaluation with MRA of shoulder at which time a long term treatment plan will be written.

Is there any pending claim for higher rating?

[catt02189]

Your profile says: 70% PTSD, 100% IU. Is that your husband's VA rating or yours? If it's his, he cannot work, or loose his IU status.

What did I miss ?

My rating.