New Clothing Allowance Procedues

[SonnyBurnett]

When the allowance became available for more than one appliance, I filed for a 2nd in July 2012. I recieved my 1st allowance, but never the 2nd. Yesterday I recived a letter from the prostehtics dept. denying my caim. The letter stated I could file an appeal on a form that was not enclosed, or call them to talk. Here is their new deal. Because I filed for a 2nd, I am no longer static and have to file every year. Also, after reviewing my record, both appliances need to be proved to them that they wear out my clothes. And because I take care of them and dont replace them every year, they suspect I am not wearing them consistenly. (Wow -they are not only techs, they are also doctors & detectives there too). The chief told me I can write an appeal or meet with them. I choose to meet. They want me to bring in my appliances and the "worn out clothing."

They appear to be making up rules as they go along. This is happening at the Bay pines (St. Pete, Fl.) Va Medical center.

Any thoughts on this? I told them I may bring an attorney, they said they need to know his name, because they would need to have one present also.

[meghp0405]

That's happening at many of the prosthetic clinics. Since they are the authority and have the final say on who receives and who doesn't receive it. The blurb in the 38 CFR that covers clothing allowances is extremely vague, which is why these clinics are able to get away with what they are doing. There goal is to save money, more especially since a vet can apply for additional CA's. I have read the policy letter that mentions what you stated about applying for the additional clothing allowance where if you were static, that is no longer the case and you have to file for each CA, each year.

Also, I have seen where a doctor ordered an appliance for a patient, the prosthetic folks denied that order and issued something else that would better serve him (in this case) and his disability. Unfortunately, the issued brace was not one that met the criteria for the CA award.

And yes, there is fraud going on with this award (I'm not saying that you committing fraud). Is what I am saying is, there are veterans that go out to a civilian doctor, obtain a prescription for a brace, and never wear it, but they are normally the first that apply for it each year.

The prosthetic clinic has the daunting task of weeding those individuals out, if that is even possible.

[SonnyBurnett]

They are acting like its coming out of their own pocket. Them telling me to bring clothes that have been damaged by my braces, reminded me of the OJ Simpson trial. The glove that didn't fit. No one told me i'm suppose to save torn up clothing to have to prove it one day? Fortinatley I do have clothing that has been destroyed by the braces. I have a feeling this is not going to go well anyway.

[meghp0405]

been there done that, last year they told me I had to bring in clothing that had wear and tear due to the brace I wear. They also told me that I had not been in there for two years. So when I brought additional shirts and the 2 boxes of braces that I still have not used, this guy appeared dumfounded and told me that I was approved.

I believe (my opinion) that they are looking for any and all ways to cut down on this allowance since the approval of 2 or more went into effect. Actually, I did find out that the money comes out of the prosthetic clinic's budget. They did not budget for the additional clothing allowances which now they are in a scramble to find money, and what a better way, deny us veterans that have been receiving this allowance for years (15) in my case.

As always, the disabled veterans take it in the shorts, while the VA management has these out of touch conferences and pay raises/bonuses.

[etoolz]

Yes, I was told the same thing when inquiring of filing for another clothing allowance for my afo. I wear a knee brace and am static for the clothing allowance. I wanted to know if my clothing allowance was for both, or which one.

He said, "likely both, as both are on same leg". I said, "but I know someone who gets a clothing allowance for his afo, which is the same as mine, and another person that has the same knee brace and he get's one, so it appears they must surely be seperate."

He then asked me about my static and I said, "yes I'm static and I have been for many many years." He then asked when was the last time I got a new knee brace, I told him and he said, "that should have worn out by now, there's no way it lasted this long if you wear it daily."

Due to my service connected disabilies and secondaries my knee and leg swell to serious sizes, even with hose on, and on those days, when I'm having a flareup also of my other disability I don't move much and I just lay around.

I said, "my legs dead, the plates and screws holding my leg together are in such a scattered fashion below the knee I can't get a knee replacement due to growth over screws and plates, and they can't break the bones to take that out, so I'm facing an amputation once my knee splits apart, etc."

And he's wrong, my knee braces last about 7-10 years, even my Army issue Lennox Heal brace is still kicking, it's been fixed once, but it's HARDCORE!

I told him this and he said, "oh that's not VA issue, neither is the soft one you said you have".

I told him I wear a soft one, it's hinged but soft he said, "that's not allowed".

The thing is, sometimes have to sleep with it on, the soft one as my knee will go out of joint, my other knees now bad, a zero % on it for like 9 years, which I'm going to file for as it's getting seriously worn as well.

Anyways, he tried to tell me, I have to get a new one more often, and not ever wear the other ones and even if I'm sedentary, I have to wear the other one DAILY to keep my clothing allowance.

I guess I could say, "well if they have no idea which they are paying me for, the afo or knee brace, I still can get it, as always due to foot brace then", which has broken, and I have to wear daily and especially when at VA, etc, otherwise, people like him start saying, "ohhhh now you're not wearing your foot brace!"

Yes I've needed one for some time, but they give me the run around, and finally I have an appointment to get a new one.

Whether I gimp around without it, or with it, I have a dead foot, TOTALLY DEAD! I call it my dead foot as it's bad, really bad. Total foot drop, when cold it turns blue to purple, and needs 3 socks, also I have causalgia. When I have a flare, it goes from a usual 3 to about a 7, to where I can't watch a video, read a book, etc, etc, It's total chaos for me as the flames lick up and down my leg. I have actually went outta my head before a few times during bad flares, and I drive my wife crazy with my moaning and kicking and it's just a living #e!! when that happens.

The VA is vicious. I can't believe the things he, the "supervisory prosthetic rep" told me and implied.

He might take away my "clothing allowance now" which has been static for about 22/24 years.

I don't get it. He made some sense and a lot of illogical erroneous assumptions based upon what he feels should be normal appliance protocol.

He has no service connected disabilities and is not retired. I have combat mos, LD time of war/national emergency, direct result of orders, due to performing duties, service connected disabilies. And there he is, angry he has hundred of claims to process suddenly for "those who are trying to get more than one clothing allowance".

Like I said, some days I can't walk, I have to use crutches around my apt.(my wife and I have seperate apartments due to my sleeping arrangements).

I have to sleep a certain way on the floor on a bedroll due to serious spinal deformities and a very bad neck injury.

Sorry for such along winded rant. I have a story to tell and I'm sure it's common now after reading similar horror stories on the web which are popping up everywhere.

I've also dealt with "lying" c and p doctors, which took years to resolve, after they were fired or resigned due to being caught lying and outright fraud.

Like having veterans lift their feet with their hands then saying they can lift foot and it's all better.

No VA file, which is noted in c and p. As a matter of fact, I've never had a c and p where my VA file was present and to question it can lead to a c and p suddenly being stopped//cancelled which does not look good in your "file" then.

I once met two BVA reps at a local Denny's as they went over my Army records vs. their c and p records, when then proved to be exactly the same readings as mine,(15 years later)but they had a doctor saying, "nope they are different"(at the time of the Denny's c and p followup), all reversed, loss of use of limb back, etc.

Took them another 4 years to finally pay me the retro and fix the entire fiasco.

The two BVA reps weren't doctors, they were laywers we found out later.

I once had a BVA appeal review at the VOC REHAB center where I was told I had to take a sedentary job//training and not anything involving my foot or leg, etc, (by VOC REHAB COUNSELOR), all the while the BVA reps are also there, listening, while they once again took "loss of use of limb" away, etc.

So I said, "let me take heavy construction, obviously I'm fine" to which the VOC REHAB COUNSELOR said, "you can't, your foot's dead, you wear and AFO!"

It's insanity here! People see my knee and leg and say, "man that looks painful, what's wrong with it?" I say, 13 screws, a plate and pins holding it together where the bones exploded out, severing the nerve bundle." Then I show them my claw foot, that's flat as a pancake, no muscles in it and totally dead yet the VA is constantly, always trying to take away the "loss of use of limb."

They do, then it's reversed, it's like a game they play.

I don't get it, I know vets getting 50, 60, 70, even 80% that are out jogging, working out, they are jocks! Yet they have a field report of a serious sprain to back, to leg, shoulder, hip etc. They have never had surgery, they don't have to do Physical Therapy because, "they do it themselves by staying active" and the docs and specialists are always, "keep up the good work!".

Yet my foot brace splits or pops a rivet and I take it in, they are all running around, "LOOK, LOOK IT'S A MIRACLE, HE'S HEALED, CALL THE BVA, CALL THE REGIONAL, HE'S WALKING WITHOUT HIS AFO!!!!!!!!!!!!"

I am sorry for rambling, I'm just really really upset over something that happened to me at the VA hospital. I was a student, doing my externship for voc rehab. For 7/9 months my back was getting worse, ALL OVER, not just my service connected lower back. A hump developed on my upper back, and something started to go wrong with my neck.

Within months I was totally unable to do any sort of study or work. The hospital did MRi's, xrays, all kinds of physicals, nothing was wrong.

I slowly became paralyzed on my right side, bowels and bladder issues, my head was stuck at a seriously painful position. My hand slowly went numb, within a month it was hard to use it, my bad dead foot leg started to go totally numb, all over, then patches of my right side went totally numb.

Then it happened. I was going to see my doc furiously, begging for help. Her notes and records all say I'm crazy, insane, and nothings wrong with me, the hump is imaginary, it's all in my head.

It all came to a "head" a few months after she gave me a clean bill of health. I was crippled pretty bad, Jan was my physical I was told to go back to training. I was at the VA doing my externship, but they couldn't keep me as I had to take too many breaks, I was having the hand issue and I couldn't stand for such long periouds of time.

SO they transferred me to another place for records. They dropped me within a day, due to me being twisted at an odd angle and just standing around, unable to do anything.

The voc rehab specialist had over 7 months of constant emails, me begging for help, the VA saying it was all in my head.

ANYWAY, I ended up being taken by my wife who was living in another town. I was close to VA going to school, etc, training within VOC REHAB, I had my own apartment.

I went to VA emergency. I was immediately taken in, only to be yelled at and the nurse slapped me across the face screaming, "snap out of it". She said she had to do that, the only thing was, I was seriously seriously gimped up as I had been for a few months, but I was in serious condition as it was suddenly hard to breathe and something was seriously seriously wrong, I was getting these zaps and shocks to my right arm and leg.

I ended up being told I was fine, it was "dissassociative disorder, the MRI was fine, I was fine, I was having an anxiety attack".

It was that night, I called my wife and said "please come and help me, I think this is it, I'm going to have to kill myself".

So she came fast, what takes a couple hours took 40 minutes. Oh and my records for that night say I was fine after counseled by doc, left saying I felt much better.

ANYWAYS, I was taken to another hospital in our hometown.

2 hours away, took us 40 minutes again.

I ended up having an emergency surgery to take bone, cartilage out, and disc material and all that stuff that leaks out slowly and chokes off the nerves.

I was lucky, very lucky. I have a "diplomat" of Neurology fix me. He said he had never seen anyone in total radiolickapathy before, or whatever it's spelled.

He said my neck was locked due to nerve damage, etc, and he could not believe my story.

I ended up being given a chemical scan of my back//neck.

I was in bad shape after months of this.

He cut me open, the nerves were now totally trapped//crushed and dying. The fluid and "pulp" from discs had leaked down into all kinds of place, cartilage was jammed here and there.

TO make this massive story shorter, in the end he sent the VA a horrid letter, totally telling them he's never seen such a scene in his life. He said it was unfortunate I was left to develop this condition and it would take years to heal and get back use of my damaged parts and that he doubted if I'd ever be able to work or be able to al;fja;ljfa;lj

Never mind. I am only telling it in pieces, to read my VA records, my voc rehab emails, back and forth to the VA, etc, and those responses, and read then this "diplomat of neurology" critique of it all is a great read.

The VA merely had put me on interupted status, then an "independent living contract" due to not being able to finish school, and that's the last I've heard of it.

Aside from a pep talk that yeah sure, we screwed up big time, but even cripples can ski now!!!

If I think I'm going to sue the VA, think again, accidents happen, entire va files are deleted and then lost, entire peoples records, deleted, lost and all my records, well; if they have accidently lost all mine, who's to say mine are valid and legit?

I am left to rot on 60% and spec mnthly comp for loss of use of foot.

1 day after I came home from the hospital though and I emailed my voc rehab counselor that I had surgery and he was going to be amazed, 7000 dollars was dumped into my bank.

And I had been given my 40 percent combined for loss of use of limb back after having it taken away 17 years before, off and on.

I'm sorry for my intense, longgggggggggggggggggggggggggggg winded rant, and my back and forth with my story.

Forgive me, please.

THIS is just part of my story though. I should write a small pocket book. Like I said, I'm telling it very very limited. The emails and records are such a lovely read, I have them all organized by date and time, and it's actually the most hilarious,horrifying story, at least to me.

Sorry if my long winded rant angers you.

Thank you for reading it if you happen to.

[etoolz]

The VA is spending a lot more by forcing Veterans who get clothing allowances to get new appliances yearly now, just to get their "multiple" clothing allowances, than they would be if they allowed veterans to just get their allowances and perhaps every other year or whatever, give them a physical//review while they are at VA for lab work or a Primary Care visit.

This, "well if you are going to try to get more than one allowance, fine, but every year you're getting fitted with a new AFO, new knee brace and crutches", is absurd, but that's the "deal" put before veterans who wear an multiple devices.

This will really rack up a serious yearly bill for the cost to do this.

Proving the VA would rather spend money to belittle and show veterans just who is in charge of the VA, rather than get serious about Veterans benefits and care.

Again please forgive me for this early am's rant, I had a very long day at the VA and I'm disgusted, I've always had a terror of the place, and to say "they are out to get me" sounds like paranoia but actually, yes, yes they are out to get you if you are seeking or on benefits and don't work for their system, or are someone in administrations "family and friends network".

[JayBrown1]

I appeal a denial of one of my clothing allowance because they said my brace was old and needed to be replace. They also said my brace should have expired in six months to a year. I contend that I was still wearing the brace and it fit me and was still helping me. The BVA agreed with me and granted my clothing allowance. This happen in 2012 and the decision was made by the board in 2014.