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Flat Refusal For Va Care

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I had brought this up to my senator when I went to him for my claims issues. They would only address one issue at a time and ignored the rest.

I'm rated 100% P&T for dementia, cognative dissorder, depression, and residuals due to head injury.

VA has never evaluated me for this. It was a C&P Doc that found it. Before it was an "undiagnosed fatigue". The C&P doc told me what testing I needed and such. He requested the testing and further eval but it was never done. I went to private docs for the testing and evals he said I needed. When I re-opened, I did it with private tests and records. I was granted without another C&P.

Anyway, the first time I went to the Vet clinic here, the mental health NP (primary) said she had no knowledge of what to do with me. Not even a referal to Salt Lake. So when I had made trips to SL VAMC I walked in to mental health. Made appointments that were canceled and so on for a couple months. Finally made a fuss on a walk in and got an initial eval. I was supposed to be seen by someone there but somehow that got changed and I was sent back to the local clinic NP that said she couldn't help. Now she says she's all I got.

So, no local or regional help except to prescribe me anti-depressants.

Now I have gone back to those that were helping before. I see a private psychiatrist that has gotten my meds right. I see the psychologist that did my neuro-psych testing. Next month I start seeing an occupational therapist to help me learn other ways to do everyday things to improve my quality of life. I should be seeing a speech pathologist because my verbal IQ is in the severely handicaped range, though my language tests above average. The list goes on. These are "by the book" treatments from VHA policies. But even though it is documented in the testing and my C&P exams, my VA care providers are not educated to recognise it. I do not know why I don't get referals for experienced treatment. I'm litterally told "to seek treatment in your community and pay for it yourself".

This is the letter my senator got from me before my claim was approved.

To Whom It May Concern:

Why am I being refused VA care? Why was I told that the VA does not need to assess my head injury-brain damage? Why was I told to continue using private medical help for a service connected injury when I have no means to pay for it? My damaged brain is slow, but over time I have become aware of how important the answers to these questions are.

Jan 6 1991, while on perimeter guard in a base camp in a forward position in Saudi Arabia, I was struck on top of the head by a 10# sledge hammer falling about four feet.

I was air evacuated to 5th Fleet Hospital where I awaited air evacuation to Landsthul, Germany. I still have been unable to obtain records from the 5th Fleet Hospital.

At Landsthul, I was evaluated, Diagnosed with Post Concussive Syndrome.

As symptoms had diminished and I was told that it was unlikely I would have any further problems, I requested to return to my unit in Saudi.

I did return to my Unit and participated in the ground assault of Iraq.

(It is important to understand that under this kind of stressful situation it is unlikely I would have noticed even a moderate difference in my ability to function. Any confusion or whatnot I would have contributed to the fast pace and stress of combat.)

Within a couple of days after the ceasefire and surrender of Iraq, my Unit turned and headed to Port. Being the first Armored Unit in country, we were the first to leave.

(Again, a fast paced and emotional event. We kicked ass, now we’re going home!)

Once back in the States, my original ETS was about 30 days out. I chose to take it as I had plans of becoming an Air Traffic Controller with the FAA. Testing I had done early in 1990 had shown I had an aptitude for it, and I had taken my study book with me to the desert.

(Once again, a rush to get things in order and a stressful environment.)

My problems started to become apparent almost immediately after returning home to Pocatello.

Five weeks back home and divorce was filed from wife of five years.

Excited to pursue a career in ATC, I flew to Seattle and failed the test miserably. I could not understand it at the time. It was so easy for me before.

I was having a difficult time finding and keeping employment.

Family and friends would suggest that my personality had changed.

I was weak, shaky, tired, daily headaches and I would sleep 14 to 16 hours every day.

Family finally convinced me to go to the VA to see what was wrong.

I did go sometime in Sept. 1992. There had to be something someone could do. There I gave allot of blood, tried to explain my problems. The Doctors said they could find no cause for me to feel this way. They said maybe I should go to mental health. So I did. I saw a psychiatrist that asked allot of questions. Then he said I have no disorders and I should go to the Doctors. I went home knowing as much as before I went. They pretty much acted like I was making it all up, and no one offered to look any further. Why go back? I wanted help. Not to be called a liar.

(Keep in mind that I am now cognitively quite slow)

Four months later, I have no job because I sleep 16 hour a day. I have no friends because they have decided it was not worth the risk of being around me because I was constantly in physical confrontation with others. I knew I needed help but refused to be a burden on my family who was already keeping me fed and paying my bills.

Everyone told me they thought I had Gulf War Syndrome. That something was wrong. The VA had said nothing was wrong with me. I had no insurance. But, I did have some pride left, and was not going to live off of others, while they watch me suffer. I had to do something. I decided to leave and needed a way to take care of myself with little or no effort. So I drove away and robbed a bank. Jan. ‘93

Right or wrong did not or does not matter. I did not care if I got away. I did not care if I got caught. Either way, I was back in control of my own life. And it worked. For five years my family did not have to see me struggle. I could sleep 16 hours a day in prison and still not have to worry about eating or where I would sleep. I had a Doctor that genuinely tried very hard to figure out my medical problem. Still, of course, it was not ideal, so I have not went back.

Upon my release, from prison I immediately went to the VA for assistance. On Jan 5, 1999 I was awarded 20% compensation for “undiagnosed fatigue”. And denied for bilateral hearing loss, tinnitus, visual disorder, skin rash, right ear disorder, multi-joint arthralgia and headaches. I felt this to be quite low, as did those aware of my situation, for someone that sleeps 12 to 14 hours a day (I did improve over the 16 hours I was sleeping), tires easily, and well, a multitude of other symptoms. Not to mention, that I had not had success in employment since May 1991. But, my major concern was treatment. I just wanted to know what was wrong so it could be fixed. I could not get any answers.

With no answers as to what was wrong with me, and a continued effort to put me on anti-depressants as an answer when I knew I was not depressed, and had already tried that, I came to believe that maybe nothing was wrong with me, despite how I actually felt. I didn’t know what else to do and after all, it was friends and family that pointed out my initial symptoms to begin with. So, I ignored my health and went to work full time, pretending I was the same as everyone else. (Besides, it was a condition of my supervised release)

I struggled to work, going to Private Doctors from time to time, trying to get and be normal. I did not know what else to do. But with the focus still on an assumed GWI, and private physician’s lack of info on this, and no attempt from the VA at answer, my health did not improve. I realized that no matter what I was told, I did have something medically wrong with me. I simply could not keep torturing myself at work. I was miserable. I was not allowed to return to work in Feb. ’03 because I was unable to perform the job duties assigned to me.

At that time it occurred to me that the head injury I had in ’91 was causing my problems. I had mentioned this to different Doctors at different times, along with a dripping or draining sensation I’ve experienced in my right ear (head). (I had been denied service connect compensation for right ear disorder in ’98) So, feeling that the only way I would be properly evaluated for a brain injury was to file a claim and force the VA to look into it, I did just that. I did not know what else to do. I felt that I had mentioned this before and it was not considered to be relevant to my symptoms, yet it had never been looked into.

Around this time I also started counseling at the Pocatello Vet Center. I felt that I should pursue the possibility of emotional issues. I did not know what else to do.

At this time I also knew that I could not work a physical job. I felt that it might be possible that a non-physical job may be appropriate. I did not know what else to do. I inquired and received VA Vocational Rehabilitation and began coursework at ISU Technical School in Electronics.

Aug 19 2003 I was denied service connect for head injury. “There was no evidence of a head injury….” I was very upset about this because no one from the VA contacted me to inquire about when, where, how, why this head injury happened. (It turns out that I put all that in my original claim, but with memory problems I did not know that until recently.) According to my Rating Decision, no one looked for my hospital records. They used my regular service records despite having a full page description from me as to the date of my injury, where I was, (Saudi Desert), witch hospitals I was in, or anything. Much of this I know from hindsight. Unfortunately, at the time, all I knew is that they said they did not have records of a head injury. The local Vet Center Helped me to request a copy of my service medical records as that is all I knew or was advised to do. This request came back stating that the VA already had ALL of my records. I did not know what else to do, and no one else seemed to have any answers so I did nothing.

Well, School did not work. I found out that it was not just physical activity that made me tired. I became very angry at test times because I knew that I knew the material, but I could not remember it. It used to be so easy for me to learn.

The Doctors finally got what they had been diagnosing me for. Not being able to work, and not being smart enough and too tired for school, and supposedly not having anything wrong with me, I did become depressed.

Sept. 2004, I filed to re-evaluate my rating of 20% for undiagnosed fatigue since I could not work due to my fatigue and other symptoms which are denied, and I could not continue Voc Rehab because of these issues, I could not see any other alternative. I also filed for depression secondary to fatigue, because my medical condition and the lack of help I was getting was taking a huge toll on my emotions.

At some point I filed for SSDI.

May 2005, 20% rating remains unchanged. Depression secondary to service connect-Denied. Okay, pay close attention now. “A subsequent psychological examination also diagnosed depression, but linked the condition to a possible cognitive disorder because of a head injury in service”.

Let’s make this clear. I WAS DENIED IN 2003 FOR HEAD INJURY BECAUSE THE VA SAYS I DID NOT HAVE ONE. NOW I AM DENIED FOR DEPRESSION IN 2005 BECAUSE IT IS CAUSED BY A HEAD INJURY I RECEIVED IN SERVICE THAT THE VA SAYS DID NOT HAPPEN. (Later you’ll see my brain’s a little scrambled so maybe you can explain this to me) But, nobody says I don’t have depression, and the two examiners both indicate service connect.

Now to take a step back. During my C&P exam for depression, the examining psychiatrist noticed in my records that I had filed a claim for head injury. He asked me about this, and I explained it along with the symptoms I’ve had over the past 14 years. He told me that he felt that this was the cause of my problems including depression and that it needed to be documented. He said that I needed neuropsychological testing and to see a neurologist. He took me out to the front desk and ordered that these be scheduled. Of course, I was told I would be informed of the dates of these appointments when they where available. This never happened, and I’m not at all surprised. This Psychiatrist has been the only competent person I’ve ever met in the VA. He needs a raise. (Even if he got me denied)

I knew the only chance I had with the VA was to find my own medical records. This was not easy considering the cognitive difficulties I now know I have. I read somewhere that it took a congressional aid around 6 months to find gulf war hospital records. Imagine the VA leaving a retard to do it? Well I did find out how to do it, and gave the information to the local VA assistance so others will benefit.

As soon as I received my head injury records (it took a few weeks longer than it should have. The DOD sent me someone else’s the first time) I re-opened my claim for head injury.

I’m not done yet. Compensation is only one concern. Quite frankly, the VA can put its money up the crack of its well, let’s not say. I would rather be a person again. If money is an issue, I could do better if I could think and work. As far as my life goes, I would rather get out of this house. Maybe depression wouldn’t be such a problem if I could get out and work. As soon as brain injury became a focus, I looked into it.

I was quite confident the VA would screw me on getting any kind of testing. I did not wait to find out. I searched and searched for a knowledgeable brain injury expert locally as I am limited by economics. (I haven’t been able to work for some time) I found no accredited neurologists in the area, but went to one that has helped with my severe migraines caused by head trauma. Now I am on anti-seizure meds which were helping some. (I did have to go to ER a time or two for severe head pain, dizziness, and confusion)

I was diagnosed with post concussion syndrome during one ER visit and referred to a rehab Doc. who referred me for the neuropsych testing needed. This was done and revealed substantial cognitive deficiencies consistent with brain injury. It was explained to me that this is why I did not do well in VOC rehab, and likely why I did not pass my ATC test late in ’91. And that I have moderate depression due to injury. I was told that if psycho-stimulants (witch I am currently trying) do not help speed up my brains processing speed that I will never have the mental capacity to hold a job.

While looking for information on the internet about brain injuries, or Mild Traumatic Brain Injuries MTBI to be precise, I came upon a web page for joint DoD and VA Brain Trauma Centers. At that time I was desperate for answers. (Can’t really say much has changed) I called every # on every website, and did not know what to say or ask but so maybe someone could send me in the right direction. (Now I don’t believe there is a direction if your brain is even slightly damaged. Your just screwed) Well, I called the 800 # for the DoD and VA Brain Trauma Centers because on the website it says that patients can be self referrals. From there I was put through to a National VA coordinator, Gretchen Stevens.

I explained my injury, and my symptoms to the coordinator and that Salt Lake had thus far failed to do any testing or exams to date. I explained that I have been having a very difficult time for 14 years and that I would like to be evaluated by people in one of the brain centers so proper treatment could be suggested. She agreed this was a reasonable request as Salt Lake is not designed for this type of thing and it would take considerable time to accommodate me there. She put me in touch with Stacy Tepper in Minneapolis.

I sent Stacey my head injury records and over several weeks (two months?) I awaited arrangements to go. I was then referred to Palo Alto. At Palo Alto I talked to Myrlyn Elvarado. Once again I faxed a copy of my head injury hospital records. I also faxed a copy of my privately done neuropsych testing results. That was a mistake. Myrlyn called me back the next week and explained that their neuropsych had gone over the results of my private tests and they decided I did not need evaluated because that testing was already done. She also explained that I should continue the treatment I was receiving here as the Rehab program in Palo Alto is full. Well, the neuropsych testing won’t change but what about my physical problems? Keep going to Salt Lake I’m told.

Salt Lake will not see me without a referral from Pocatello Vet Clinic. I went to the Vet Clinic and was told that the psych people handle “mental issues” and not the nurse practitioner. (I’m brain damaged so explain to me. Does Brain INJURY not imply physical damage to the brain? Isn’t a neurologist a person that works with nerves? I.e. Brains.) In ’98 I was denied service connect for right ear disorder. In 2003 I was denied for head injury. If I had a full evaluation of my right ear when I first complained about it, I may already have been fully evaluated for my head injury. I do not know if I mentioned my ear draining problem in ’92. Someone needs to look at it. It has come to my attention that this ear draining thing is possibly a Cranial Spinal Fluid Leak. Meaning fluid may be draining from my brain. I still have not seen anyone, or been assessed by anyone in the VA for my damaged brain.

I have questions.

1. The VA neuropsych went over my private testing, but what was the assessment?

2. I understand that I am stupid, but why am I tired?

3. Keep going to Salt Lake? When has Salt Lake seen me for brain damage?

4. Palo Alto Rehab is full. Continue your treatment at home. What treatment? With the brain injury experts in Pocatello? Who is going to pay for this so called treatment, I CAN”T WORK?

5. I have dementia. Brain Injury. When someone in the VA seen a claim for head injury, did it not occur to anyone that maybe this guy doesn’t think to well and can’t go that extra mile to prove his claim. Why not cut my legs off and tell me there is help at the top of those stairs?

6. Of all the people in the VA, how is it that a mentally challenged Vet could find the very records they could not. Or maybe if testing was done, we’d find VA employees are routinely rapped on top of the head with a sledge hammer upon entrance of the facility.

7. Duty to Assist is an attempt to fool Vets into thinking the VA will help them. And it works. How is a mentally challenged Vet supposed understand that if those thousands of VA employees could not find records, it’s likely the Vet will? Everything says the VA is there to help you. I’m just slow enough to be dumb enough to believe it. At least I was.

8. Why must my wife and I lose our house and everything we own? Did we give up our right to have property when I volunteered to protect everyone else’s? Though we are trying desperately to hang on to our house, if someone cannot help me get the treatment to get me able to work again, or compensation if that is not possible, very soon, we will lose it. This is not acceptable to me and will be a last straw.


1. FATIGUE-generally run down, tires easily, no energy

2. HEADACHE-daily, bad migraines 2, 3 times a week, sometimes severe run to the ER headpain.

3. DIZZINESS-daily, sometimes associated with headache, sometimes no headache

4. VERTIGO- daily, sometimes associated with headache, sometimes no headache

5. TREMOR-constant minor, increases substantially with fatigue

6. MUSCLE ACHES-just aches, does not depend on activity, usually from waist down

7. EAR DRAINING-usually daily but can go several days without noticing. sometimes light, sometimes vigorous, likely CSF leak




11. SENSITIVITY TO SOUND-constant but sometimes the sound of voices can cause severe irritation. This may get me in trouble sometime.






17. TINNITUS-constant high pitch in both ears. One day in September I heard quiet. No ringing. I was in heaven for 45 minutes. I did not realize that I hadn’t had this kind of peace for as long as I can remember.

18. There is more when I can remember them

In ’92 I did not claim that MTBI was causing my problems. In ’98 I did not claim MTBI was causing my problems. At no time did I claim that I was swallowing the fluid from around my brain. Look at the symptoms for MTBI or Post Concussive Syndrome. Then look at my symptoms for the last 14 years. I’m not a doctor; I did not know why I was ill at that time. My symptoms have not changed in 14 years except to get worse. Compare the symptoms of MTBI with the claim I filed in 1997. Every condition listed on that claim with the exception of skin rash, is a symptom of MTBI where the leaking CSF through my right ear is disrupting my sinuses.


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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?

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Guest jangrin


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.


Edited by jangrin

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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.

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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??

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