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Appealing Health Care Decisions At The Va


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  • HadIt.com Elder

There is a formal appeals process for health care decisions at the VA. The VBM says it starts with the patient advocate. There are two advocates at my VAMC. One is a complete dud and liar. The other seems more serious. I am going to bring my VBM with me if they try and bullshit me. When the pain clinic decided to cut off my opiates that is a decision I intend to appeal.

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I agree with you and I am glad your doing something about those jerks.

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  • HadIt.com Elder

Appeals with the VAMC is different than other VA Appeals. You only have 30 days after a decision is made to Appeal and it will go straight to the BVA and not not pass go or collect 200 dollars.

You have to ask for an Administrative Hearing and the deck will be stacked cause the Hearing will be all VAMC Admin types.

Than it is straight to the BVA and wait a long time.

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  • HadIt.com Elder

All I know is that anything your Doc decides to do or not do is appeal able.Fee Service denied me once and I wrote a letter to VAMC Administrator and requested a Hearing which I got and than I was awarded Fee Service so that was it. If I had lost it would have been 30 days to Appeal to BVA.

A case that may help you track how it works follows

http://www.va.gov/vetapp08/files1/0809041.txt

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John999 go see you a pain Mgt doctor before you die from pain, I know what your feeling bud, us vets don't get as much crap as civilians do take your medical records in when you go see them (tell them about your reactions to the other crap they are trying to push you on) and don't you feel anything its a god damn shame someone illegals would get better care than a veteran! if it wasn't for my doctor who works at the VA ER on week ends has his own private practice and thinks its a disgrace that there is so much red tape to treat a Veteran........

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  • HadIt.com Elder

John,

1) have they denied your conditions that warant a prescription of pain medications?

2) have you made an appointment with a psychiatrist ? You may be able to get a psychitriast to prescribe something. If they do. Your PCP will not likely be able to deny the need. This will also help you before you request a hearing at the VAMC.

You can also file a formal complaint against your Dr for not properly treating your conditions that call for pain management.

Your complaint can be filed with the VAMC and the state medical health board where you live. If the complaint is serious enough, you can file a complaint against the Dr's lisence. Keep in mind you will need to find out where they are licensed. VAMC PCP's don't have to hold a licence in the state the VAMC is in, as long as they have one somewhere.

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