Flat Refusal For Va Care

[john999]

Do you have other medical insurance like medicare? I think I would go ahead and get the care from someone who will treat me and make a personal trip to the congressman or senator's office. I would send the bills to Fee Base and send a copy of the bills to the congress person along with a explanation. If you can go to see the Fee Base office I would go there in person with the bills. Make a pest of yourself. How long of a drive is it to the VAMC?

[Guest jangrin]

Time,

Your post here is very moving. I'm sorry that you are having to go through the maze of VA staff who have an inability to perform thier duties.

Are you currently receiving SSDI? If you are when did they award it?

Once you are receiving SSDI for 24 months, you are eligible for Medicare. I would think that you could develop a primary care doc who could refer you to a neurologist who specializes in brain trauma through Medicare.

Jangrin

Edited December 23, 2006 by jangrin

[Pete53]

First of all if this was me I would go to a Patient Advocate to get help. They can usualy smooth over problems like this. That failing I would ask for an appointment with the Administrator at the VA and go over the problem with an assistant most likey. If still denied I would file a NOD and ask for a Hearing.

If you fail at this level than your claim will go straight to BVA. Good Luck.

[Brandy]

Time,

If you got copies of the C&P psychiatrist exam from the doctor (you need his name) who recognized that you had a head injury and said that they were to schedule you for other exams that never happened; I would contact that VAMC and ask for his direct number. Advise him that the exams he ordered never took place and you are in the same place as you were when you seen him. Ask him if what he can do to arrange to order the exams because they are needed. This recently happened to my husband with a C&P doc. He ordered two exams and said there would be another but said they would call us for the third exam, but gave us a print out for the first two with times and dates. Well no one ever called for the third exam. In the mean time I had sent the doctor a letter advising him of a couple of medications that my husband takes that the VA did not have listed. He called us and said thanks for letter and "by the way, did anyone ever call for the last exam?". We called him back (to his direct number) and told him, no they did not. We then called scheduling and she said "you missed it". I told her, no, we were there on that date for two other exams and no one ever called us for this exam. She said yes I can see that you were here for the other two exams. I was concerned that they would show my husband as a no show. She said no, don't worry about it. She said "I am the scheduler". She set him up with another appointment and he went to it.

I guess my point is at the VAMC's there seems to be a lot of miscommunication and that is probably what happened and why you did not get scheduled for the exams. The doctor is probably not even aware of this. He may want to help. I don't know what can be done now since they have already rated on it. But the doctor may be able to recommend something. Or, who knows, they could have setup the appointments and never notified you and counted you as a no show. That's what they tried to do to my husband. If we had not sent that letter to the doctor about his meds triggering the doctor's memory about this extra exam, who knows what would have happened??

[timetowinarace]

Do you have other medical insurance like medicare? I think I would go ahead and get the care from someone who will treat me and make a personal trip to the congressman or senator's office. I would send the bills to Fee Base and send a copy of the bills to the congress person along with a explanation. If you can go to see the Fee Base office I would go there in person with the bills. Make a pest of yourself. How long of a drive is it to the VAMC?

I havn't been approved for SS yet. Had a hearing last month so I'm just waiting. I do have insurance through my wife though, so I use that again. I couldn't use it much last year because I had no income to pay my copay. Without it I couldn't have gotten the testing needed to get me service connected. I'll look into Fee Base and give them what I have. It might not be untill Feb. though. Salt Lake VAMC is 150 miles south. Boise VARO is 150 miles west. Snow covered roads this time of year.

But, I like the idea of sending a copy of the bills to my A-hole Senator Craig. And to the local paper. Let him explain how he figures the VA is well funded while this 100% Service connected veteran is paying for the treatment of his in service injuries. It costs my wife $101.00 a month to keep our insurance. After the $500 deductible each year I pay a minimum (usually) $20 copay per office visit for treatment. And on top of that I pay a copay for the meds prescribed by non VA health care. If I were to drop this insurance I would recieve no treatment for my SC disability (other than antidepressants and headache meds).

HMMMMMM.

The reason the testing wasn't done by the VA was because the examiner had service connected my depression in either of the two possibilities. He needed testing to confirm his diagnoses of cognative dissorder due to in service brain trauma. And he said if the testing did not show the cognative dissorder, then my depression was caused by my then SC undiagnosed fatigue. Either way, Service connected. The only way the RO could deny the claim is if the testing was not done. It was not done, and I was denied. As soon as I had it done privatley I was granted SC.

The overall problem with VA treatment for head injury is simply funding. Brain trauma is said to be the war on terror's "signature injury". With the brain injury program a joint DOD and VA effort, the freshly injured will have priority, as they should. However, how many of these are being turned away also?

Time

Edited December 23, 2006 by timetowinarace