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Illinois Va System Sticking It To Me.

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I am a regular Army veteran who was medically discharged in 2003 (after 3 yrs active duty), for L4 - L5 disc ruptures, plantar fascitis (both feet), and elbow tendonitis (no rating). I was given 30% disability for my back and feet and I have been fighting/waiting since 2004 for my rating to go up. I saw a VA neurologist in September 2008 about my ruptured discs (L-4, L-5) (in the last year the pain has caused me to switch to a different job at part-time) After looking over my last MRI and examining my reflexes (knees), he found that my nerves/reflexes had degenerated to the point that my right leg did not respond to the hammer. He told me I needed surgery (laminectomy) to halt the loss of feeling/reflexes in my leg. I received a letter from the Danville (IL) VA fee basis office with a voucher to see a civilian neurosurgeon. I did some homework online, found a great, nationally recognized, neurosurgeon at Rush Hospital in Chicago, and went to my first appointment. The doc told me what the VA neurologist told me and we set a date for surgery. I called the fee basis office and gave them the surgery date, but they told me I had to get approved by my primary care provider before I could schedule a surgery. I had to cancel the surgery and get approval, which my primary dr gave me, and then try to re-schedule the surgery. The neurosurgeon wasn't happy with my cancellation (plus he has a huge client list) and I wasn't able to re-schedule with him. I found a neurosurgeon THREE DOORS AWAY from my VA medical center about six weeks ago and tried to get approval to see this dr. I jumped through all the hoops in the proper order this time (seeing my primary dr and the VA neurologist again in the process), getting my MRI films and med records sent to the new neurosurgeon, and last week I got a call from fee basis telling me to have the new neuro send his "notes," to my primary dr. I have not even seen the new neuro, but he has looked at my MRI, and he has notes on me. Last week I got a letter from the VA hospital (150 miles away, one-way), telling me to show up there next week for physical therapy!!!

It seems that my primary dr has disregarded the recommendations of two neurologists and recommended physical therapy! I have never been able to talk to him directly unless I make an appt.; I always have to talk to his nurse, who treats me like dirt.

I tried to get hold of a VA advocate most of the day last Friday, but the two who serve my area were both out of the office all day.

Who do I talk to to get authorization to see a neurosurgeon?! I'm WAY past the need for physical therapy; my right leg has lost feeling in my big and second toes! I've spent the last 5+ years trying to get authorization for surgery, and now they yank it away! ANY suggestions?!

Troy

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You need to get a copy of the notes that the neurologist sent to the VA. As well I would get the neurologist to state that the surgery is necessary and not an optional procedure.

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  • 1 year later...
  • HadIt.com Elder

I don't know a whole lot about this area--

It seems to me that you might be able to get the neurosurgeon currently handling your case to at least talk to the VA primary care physician.

Another approach might be to have surgery approved due to progressive nerve damage on a "emergency" basis, even at a non VA facility.

Finally, a lawyer might be able to get the VA moving by instituting a claim for malpractice, alleging damage caused by failure to properly treat in a needed and timely manner.

It's also supposedly possible to work within the VA system, but it sounds like this is not working very well.

It (on the face) sounds like you are disabled and unable to work due to service connected problems that are increasing due to lack of proper and timely medical care.

Where is your VA primary care physician? Local? It sounds like therapy will just aggravate the situation further.

It is a very good idea to get the neurosurgeon to write something to this effect, and take it to the primary care physician. You might also ask who scheduled the therapy.

I am a regular Army veteran who was medically discharged in 2003 (after 3 yrs active duty), for L4 - L5 disc ruptures, plantar fascitis (both feet), and elbow tendonitis (no rating). I was given 30% disability for my back and feet and I have been fighting/waiting since 2004 for my rating to go up. I saw a VA neurologist in September 2008 about my ruptured discs (L-4, L-5) (in the last year the pain has caused me to switch to a different job at part-time) After looking over my last MRI and examining my reflexes (knees), he found that my nerves/reflexes had degenerated to the point that my right leg did not respond to the hammer. He told me I needed surgery (laminectomy) to halt the loss of feeling/reflexes in my leg. I received a letter from the Danville (IL) VA fee basis office with a voucher to see a civilian neurosurgeon. I did some homework online, found a great, nationally recognized, neurosurgeon at Rush Hospital in Chicago, and went to my first appointment. The doc told me what the VA neurologist told me and we set a date for surgery. I called the fee basis office and gave them the surgery date, but they told me I had to get approved by my primary care provider before I could schedule a surgery. I had to cancel the surgery and get approval, which my primary dr gave me, and then try to re-schedule the surgery. The neurosurgeon wasn't happy with my cancellation (plus he has a huge client list) and I wasn't able to re-schedule with him. I found a neurosurgeon THREE DOORS AWAY from my VA medical center about six weeks ago and tried to get approval to see this dr. I jumped through all the hoops in the proper order this time (seeing my primary dr and the VA neurologist again in the process), getting my MRI films and med records sent to the new neurosurgeon, and last week I got a call from fee basis telling me to have the new neuro send his "notes," to my primary dr. I have not even seen the new neuro, but he has looked at my MRI, and he has notes on me. Last week I got a letter from the VA hospital (150 miles away, one-way), telling me to show up there next week for physical therapy!!!

It seems that my primary dr has disregarded the recommendations of two neurologists and recommended physical therapy! I have never been able to talk to him directly unless I make an appt.; I always have to talk to his nurse, who treats me like dirt.

I tried to get hold of a VA advocate most of the day last Friday, but the two who serve my area were both out of the office all day.

Who do I talk to to get authorization to see a neurosurgeon?! I'm WAY past the need for physical therapy; my right leg has lost feeling in my big and second toes! I've spent the last 5+ years trying to get authorization for surgery, and now they yank it away! ANY suggestions?!

Troy

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  • HadIt.com Elder

Troy, At present, I am really disgusted with the VA medical system --at least the one I am currently enrolled in. It's my understanding that not all VA Medical Centers are created equal: some veterans actually have very positive experiences!

This week, I drove 100 miles one-way: to spend 10 minutes with a very part-time VA doctor, that I waited 4 months to see.

Unfortunately, I did NOT like him (told me my memory problems could be masked with a bottle of blond hair dye --no kidding). But since my medical problem will require surgery (parodid tumor), I have re-enrolled in another VAMC. It will take another 4-12 weeks before I get to see the next VA doctor. The VA gave me a fee-base card but only authorized $125.00 month. When I have asked for other services, they want to talk about "the budget". It SUX.

Anyway, don't know if this will help much, but I have attached the VA Fee Base directive in response to your question: Who do I talk to to get authorization to see a neurosurgeon?! The answer is the VAMC Medical Director. S/he has the authority to authorize your fee-base surgery. Send a Certified Letter to the VAMC Director.

I also suggest that you have your VA Neurologist (or any other mmedical professional) write a note to the effect that physical tx is contra-indicated and may actually worsen your SC medical condition. Just throwing some ideas around ... Hang in there. You need the surgery and the VA must provide that for you, by Law. Chuck alo suggested you talk to an attorney about filing a TORT against the VA. You may suggest that course of action to the VAMC director, in a nice way ... Here's a quote from the VA Fee Base Directive, and the attched pdf file. ~Wings

PS I'll attach the pdf to the next post, for some reason I am stuck in a box that doesn't have that option.

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  • HadIt.com Elder

x

x

x

Can not find the option for attaching documents??? Help from Mods???

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  • HadIt.com Elder

Troy, call your VA main number and ask to speak to the patient advocate and tell them the situation.

They should help you.

John

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