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Denial Of Treatment

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catt02189

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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

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suggestion only...i would write a complaint through the IRIS system about the level of care..sub-standard! next write a letter to the DIRECTOR/VA Hosp.... on the bottom, place...CC:Senator ?,CC:VA Deputy Undersecretary of Health, CC:Joint Commission/JHACO, CC:St. Pete Times Newspaper or local Paper, CC: State of ???,Dept of Health and Human Services...Then See What Happens!!!! Watch how fast your help arrives!!! good luck,William n

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Cat

If you are rated 100, would your husband and family not be elig.

for CHAMPVA? If I could I would get the medical treatment at a

private hospital. To depend on the VA for medical treatment is

a crap shoot. There are just to many folks chasing too few

medical resources.

Best of luck,

Dobie

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"How can a consult be rejected? That sounds crazy to me."

to me too-

If his SC got worse since the VA made that statement he could file a Section 1151 claim.

My husband was set for WU/RO CAD in 1988.

It took me a long time to figure out what that meant on a discharge certificate.

He collapsed on the job at VA and was rushed to ER and they diagnosed him with sinus infection with no follow up care.

The WP RO/CAD was for a consult by a cardiologist to work himup for testing for cardiovascular disease- the EKGs they did at this time clearly were abnormal and yet this "consult" never occurred, they never even told him about the EKG results and sent him sudafed for the next 6 years.

I found a sinus x ray in his med recs that was done shortly after all this and it was completely normal.

In your case -By not giving him the consult they could have made his condition get worse.If they did and you have medical proof that it has gotten worse (it must have if he was to have surgery)you can file a Sec 1151 claim.

"No workman's comp because VA s/c."

??? a SC disability prevents a vet from getting Workman's comp?

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PS my husband was in quite a state one day during VA day treatment program- he clearly needed to be admitted for high levels of stress-VA refused to admit him-

My Congressman got him admitted within 20 minutes-

how is your Congressman or woman to deal with-do they have a veteran's liason person?

This was my former Congressman, a veteran himself and he sure jumped on the VA when they did this.

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  • HadIt.com Elder

I have had my share of consults that my Doctor ordered and never happened. Not even the courtesy of telling me that I would have to wait or what.

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