The Sec Bob Mcdonald Really Cares About Veterans!

[ctbenja1015]

After emailing Bob my appeal went to administrative revue, 30 days later 90% went to 100% P&T. Was also having problems with a VA loan, Director of VA loans is a great resource, Mike Frueh, mike.frueh@va.gov . Actually had the Chief of Policy for VA Loans get in touch with me. After we spoke actually called and talked to my mortgage broker and the underwriter to clarify some issues. Seems the VA may be headed in the right direction.

[Chuck75]

It's both encouraging and discouraging that it's possible to actually get the VA to behave in a manner that shows what it should have been doing for decades.

Encouraging because veteran's needs are being handled in a much more timely manner, and it seems much more fairly than in the past.

Discouraging because it's obvious that the VA's "standard" way of doing things is NOT WORKING in the needed manner, forcing extraordinary measures on the part of both veterans and VA upper management to "Get It Done".

I sincerely hope that the coming year will see major changes that benefit veterans, without the "poison pills" that many past changes have had.

Many were intentional (give with one hand, take away with the other) changes that did not accomplish what was really needed and required.

The recent "40 mile" legislation might be considered a case in point. A veteran residing within 40 miles of ANY VA medical facility is automatically considered to be not eligible

for coverage under the provisions of the new law. Even when the VA medical facility cannot provide the needed care or services.

Instead, a VA physician or other authorized person must approve use of outside care on a case by case basis, much as the older "Fee paid"

system.

Sadly, the start of the process involves the VA PCP level sending an outside care "request" up the line, usually to a VAMC.

Since the VA PCP care level is usually running in overload, the administrative delay can easily get to be longer than desired or even medically required.

I strongly suspect that veterans need to make a major effort to get this changed by legislation amending the current law, by adding a capability requirement

that modifies the current 40 mile limit. It can be argued that the VA is currently mis-interpreting the intent of congress, to it's perceived advantage, and veterans pay the price. (Again!)

The current insurance and Medicare ongoing changes that involve ever increasing "out of pocket", and "co-pay" amounts further increase the need and urgency for change.

Just one fairly common "procedure" associated with IHD and it's ramifications usually involves a one or two day hospital stay. The "Out of Pocket" and "Co-Pay" costs have increased over the last decade from $50-100 to typically and significantly much more than $1000.

Edited December 25, 2014 by Chuck75

[ctbenja1015]

Chuck75, I have found that using the secure messaging on myhealtheVet has been very useful. You can email your PCP or specialist to get the references and/or appointments, they have to respond within 72 hours and it leaves a documented trail you can use if you need it. I have been able to get referrals without seeing my PCP. It has also grown a report with my PCP. The next thing I have done is go to the ER at the VA, then someone has to see you in x number of days. I will also call everyday to check for cancellations if things are not going quick enough. I know it doesn't address the co-pay issue, but it has made it very useful in getting treatment in a timely manner.

[Chuck75]

Chuck75, I have found that using the secure messaging on myhealtheVet has been very useful. You can email your PCP or specialist to get the references and/or appointments, they have to respond within 72 hours and it leaves a documented trail you can use if you need it. I have been able to get referrals without seeing my PCP. It has also grown a report with my PCP. The next thing I have done is go to the ER at the VA, then someone has to see you in x number of days. I will also call everyday to check for cancellations if things are not going quick enough. I know it doesn't address the co-pay issue, but it has made it very useful in getting treatment in a timely manner.

Unfortunately, use of the secure messaging system is spotty at best by my local clinic and even the supervising VAMC. Part of the problem is that the PCP providers "move around", and the last treating PCP may not be the current one. E Mail forwarding seems to be an unused option.

To show how things can get screwed up, I often receive notices from another VAMC that I've never been at or had anything to do with.

Secure messaging might be a useful tool if used correctly, and the time is available to do so.

Even so, the VA's process complexity causes problems. After the PCP submits a consult request to the supervising VAMC, there is an additional delay caused by that part of the process. Any time you add steps, particuliarly to the VA's administrative processes, the result is more delay.

One local veteran, (female) has been fighting for over a year to obtain needed outside complex surgery for a tumor, and finally has it scheduled.

In the middle of her case was a statement by a VA "cardiologist" at the area VAMC claiming that there was nothing wrong with her heart, when there are

electrocardiogram results to the contrary, and the results match other symptoms. Naturally the resulting problems required a VA medical review of the case,

and eventual approval. This kind of thing, obviously, proceeds mainly at the VA's pace, not at a speed dictated by other considerations, such as a veterans need..

Edited December 26, 2014 by Chuck75

[foreveryoung]

I have emailed Secretary Bob McDonald the beginning of Dec. 2014, on a few issues and had great success. The VA called me directly to

help me with some issues. I emailed Mr. McDonald again to thank him for his help. Didn't get a reply, but if he got the first email he got that one as well.

I'm glad he is answering emails and helping other Veterans. It's been a long time coming. Hope he keeps up the great work.

[john999]

In a completely dysfunctional system when you get thrown a bone you believe that you have a major break though. As long as the VA is staffed by people whose training is that veterans are guilty of fraud unless proven otherwise the claims system will be adversarial. As long as the health care system is run on behalf of the almost one million VA employees then we will continue to get crappy care which is dangerous and substandard. One guy who answers a few emails via his horde of assistants is not going to change a basically corrupt and incompetent system. Why can't we get a card equal to Medicare? The answer is that it would put thousands of VA workers and junior doctors out of work. There would not be a steady supply of lab rats for medical students from nearby universities to cut on and experiment on to hone their skills so they can make a million bucks a year in private practice. I am going to email Bob about the awful care I have been getting from my VAMC (charity hospital) and even Fee Base and see what he has to say. The only way for me to get more compensation is to get a lot sicker and that I don't want. I got my P&T based on mental health issue and I see a VA shrink for 20 minutes every ten weeks. Does anyone believe this is psychotherapy? Yet, my shrink states that I was provided with psychotherapy and medication therapy. No wonder PTSD vets never get better. I paid for private weekly group therapy for 20 years after I got back from Vietnam. The VA had nothing worthwhile for me. In this sense it is too late for me. I paid out of my pocket 95% of my dental, medical and vision care over the last 40 years. Now I am almost 65 years old and I am not going to die in some VA hospital.

John