VA Disruptive Behavior Red Flag

[grayling12]

This is going to be long winded!

I just noticed in my VA treatment notes that my CBOC put a disruptive behavior red flag in my records. I'm pretty sure this stems from me sending 3 emails in the last month, to my PCP mentioning that I think she is making ethical violations and possibly falsifying my treatment records. I have gone to this CBOC for 12 years and have never had a problem till a month ago.

A little back ground. I had been noticing issues with my treatment notes both PCP and Mental Health for a while now. I wanted an appointment to see my PCP to discuss issues with my IBS and also to ask her to stop cutting and pasting my yearly physical notes from one year to the next. I called to make the appointment and the check in lady, who is not a medical professional, required me to go into detail about why I wanted this appointment, I had to tell her about my deep dark private medical issues, just to get passed on to the triage nurse. The triage nurse spent 20 minutes asking me about 40 unrelated questions, he then tells me, now I have to talk to my PCP nurse before I can get an appointment, but it's late Thursday and I'll have to wait till Friday.

Friday comes and I call my PCP nurse around 3pm, she then spent a full 30 minutes telling me that I don't need an appointment and all I need to do is guzzle some Pepto Bismol, and I'll be just fine. She made every effort to stonewall me and prevent medical care. I finally told her, If she was going to refuse me medical treatment then just post that in my treatment notes, she got snotty and said "I'm NOT refusing you treatment", I said " THEN MAKE THE APPOINTMENT". She told me, you have to call the front desk Monday to make the appointment. The front desk was the one that got this merry go round started in the first place. Monday comes along and I get a call from my PCP who's scolding me for not accepting her nurses road blocks, she lied to me and said she was sitting there and heard the whole conversation, so I asked her about some of the things we talked about and she didn't know what to say. I guess if a PA is going to blatantly lie to you, then you should never expect any kind of integrity from her. She agreed to the appointment and I still had to call the front desk lady that I spoke to originally. This makes 5 people over 5 days to make one simple appointment, it's a good thing I wasn't dying.

Her nurse Ratchet kept demanding to know exact details before she would approve the appointment. After the appointment was made I sent an email asking them not to put some of the things I mentioned to nurse Ratchet in my treatment notes. Surprise! They entered my email into my notes with the info I didn't want included. I took this as a slap in the face and decided to follow up the previous email with a new one explaining why the other one was sent in the first place. In this email I spelled out that I felt that my PA was unethical and possibly falsifying my records, I also requested that this email get included into my chart next to the previous one. 

40 minutes later, I get a call on my way to work, telling me that my appointment was double booked and I needed to reschedule, I said I was driving and couldn't do it then. Later on I'm like wait a minute, I just sent them an email calling out my PCP now they want me to change my appointment, I'm like, this is straight retaliation. I sent another email stating that this was retaliation and I was going to fight it straight to Washington DC if I had to. I then followed that one up with an email where I said if they overbooked my slot that was scheduled for 19 days already, then they needed to reschedule the other person instead of me, and pursue disciplinary actions against the employee that made the mistake. This makes a total of 4 emails over 1 month, 1 email don't count as it was only an explanation of my phone call with her nurse. I realized a few days later that the appointment that was changed was for my therapist and not my PA, oops! I sent an email explaining that that there was confusion on my part regarding the appointments and I apologized.

A week after this I went to my mental health appointments with my therapist and my shrink. When I was checking in I asked the check in lady if I had to play the merry go round game every time I made an appointment. She was confused, so I explained what happened, her supervisor heard us talking and said "can I help you", I said "sure you can", I asked her if it was common practice now to run us through the wringer when we try to schedule an appointment. Things were peaceful at this point, She had the gall to say " we have veterans with real problems that may need to be seen ahead of you"! Their theme from the beginning from everyone was that I was trying to cut in front of someone else. I had explained to all of them that I was not having an emergency, I wasn't trying to cut in front of anyone, and I had no problem waiting till next month to get in, I said repeatedly " just plug me into a vacancy". After she put me and my medical problems down and disrespected me to my face, I raised my voice about one octave above baseline, I was louder, but not yelling and screaming. She kept escalating by telling me that there were veterans with worse problems than me, wait, what, how does she know anything about my medical issues? I don't think front desk check in supervisors are trained nurses or Dr.'s, I'm pretty sure they are simply office help.

Now I see this disruptive behavior red flag in my records, one issue out of 12 years and these nut jobs lost there minds. Basically they are saying that the four emails calling out my PCP disrupted their entire operation. This flag is basically because they consider me an annoyance because I am not accepting substandard care, disrespect by their employees and I'm calling them out on possible ethics issues. I am in fact lumped into the same category as lunatics who may be assaulting patients and threatening to kill people, nuisance patients and lunatics get lumped in together, they apparently don't distinguish between the two.

I tried calling this CBOC to see what was up with this flag, I wanted some details, not only were they no help, they kindly hung up on me. I called the Saginaw VA hospital who oversees them, with no luck, apparently they are all trained in how to initiate these flags, but no one has any info regarding them. I tried leaving a message with the patient advocate but they haven't returned my call.

I did some online research, and found some info and policies regarding these flags. Every veteran in this country should be aware of how simple it is to be flagged as a trouble maker by the VA and any of it's employees. Per VA policy, if you so much as complain to a VA employee about how long it took you to get in to see your provider, they can have you flagged for disruptive behavior, If you complain that you are receiving substandard care, flagged, you don't have to raise your voice, you don't need to be upset, just the fact that you are speaking up and advocating for yourself is enough to be flagged. If they think you are bad mouthing them online, Facebook etc., Flagged. Per their policy, in order to be accused of being violent, you don't have to say anything violent or mean, you don't have to do anything aggressive, all they have to say is that they are scared by your mere presence, Flagged as a violent lunatic! I'm sure you think I'm making this up, it can't possibly be that pathetic, sure is, per their policy. These aren't the only things that will get you flagged, If you are in excruciating pain and your PCP decides that you are a dirty little pill popper, Flagged, every VA doctor from now on is only going to see you as a dirty pill popper whether you are or not doesn't matter to them.

Apparently, since they enacted a universal policy department wide, the numbers of psycho, lunatic, violent, nuisance veterans has steadily been climbing. Is the problem that all of these veterans are just trouble makers by nature, or are they just vets that are tired of substandard care by the VA and simply advocating for themselves, and the VA is trying to silence them by labeling them as dangerous nuisances and pushing them out of the VA healthcare system. It seems the VHA wants you to accept substandard care quietly, and if you do speak up, they will put a big target on your back and try to push your face back into the mud where it belongs. This is a warning to all vets using VA healthcare, if you ever try to advocate for yourself, lookout! Review your records often.

Here's some resources, read the OIG report, it is really precious in what they consider to be disruptive behavior, basically anything you say or do to stand up for yourself will get you flagged. If you think you are immune from this, remember the numbers of flagged veterans are climbing fast, so sit down and shut up, and you will be just fine.  

There is more info available on the web, I'm trying to get copies of the current policies as well.

VHA DIRECTIVE 1160.08(1)

https://www.va.gov/oig/pubs/vaoig-11-02585-129.pdf 

Since I am apparently a trouble maker, I am going to fight this as long as I can.

Questions:

1. I'm not getting anywhere dealing with my local CBOC or their parent hospital. They keep just hanging up or giving me extensions that go no where. Do patient advocates have email addresses? Do they actually do anything or are they just there to give you a warm fuzzy feeling then forget about you as soon as you walk out the door?

2. My CBOC doesn't have a patient advocate , are we able to talk to the facility supervisor? Is there someone else at the local CBOC that handles these issues?

3. Is there someone at the main hospital besides a patient advocate that can deal with patient issues?

4. I plan on going to my congressman eventually since I'm pretty sure nothing is going to happen through the VA side of things. Will they expect me to exhaust all efforts through the VA first? 

5. Are there online resources with VA phone numbers and/ or email addresses anyone is aware of?

I realize I am going to be fighting a corrupt bureaucracy and simply can't win over their corruption, but I'm not going down without a fight.

Thanks for any info!

P.S. I do understand that there are a lot of veterans out there that can't afford better healthcare and just accept what they have, so they simply don't question their VA healthcare. I do also believe that there are a lot of us that are simply tired of receiving substandard care. I'm also not trying to rock the boat with any VA employees on this site, I simply don't want to be crapped on anymore, someone has to take a stand against VA tyranny.

 

 

 

 

 

 

Edited January 21, 2023 by grayling12

[grayling12]

RetiredVetFlagged,

To answer your questions:

1. I wasn't informed about the note in my medical record, I found it while reviewing my treatment notes.

2. The note doesn't give any instructions to staff.

3. What is a PATS-R? Update, I looked this up online and know what it is now.

Thanks

Edited January 31, 2023 by grayling12

[RetiredVetFlagged]

 

Grayling12 I believe you, I went through years fighting them to clear my name. I am now cleared but it will take years more before all the bad info and records amended for the ones that can be BUT, the DBC records are one of the only NON amendable VHA record there is so it will always be there to harm me as a “history of”. Sorry I haven’t checked back on this until now. As for why this subject is hard to find info on is because it is actively suppressed in part because of real harm done to healthcare providers even though there is no evidence this does anything but delay the discoveries of errors or wrongdoing harming patients. I can state this as fact as due to disclosures by VHA in my own case that they actively monitor social media such as twitter and linkedin for veterans making specific complaints or allegations about their healthcare providers and will inform them that you are a “threat” to shut down the account. For several years this program was misused against me and now it is fairly well known in the VHA that I was wrongly and improperly flagged. The VHA Police and OIG know my accounts, the VHA police have agreed to contact me to resolve any concerns they have. With that all that said I can answer many questions on this topic due to attorney reviews, conversations with VHA OIG, several tort claims, conversations with two deputy directors at the office of general council, the national DBC program manager and actually going through each process, all of which failed and resulted in everyone from the DOJ to congress being officially told I was not flagged/never was even denying it on several FOIAs but an appeal forced them to disclose I was flagged for years and the instructions themselves stated I was a threat, instructed employees to ignore me and that they were to conceal it from inquiries due to me posting online. It wasn’t until they were embarrassed online with their own FOIA provided documents that I believe they tried to come at me criminally, but I never did anything they claimed so there was no evidence and after years of deadlock resulted in a rapid 180 change in care and access provided.  When they tried to shut me down online, I provided the social media orgs the law that provides for VHA providers to take civil actions against VHA patients, that is their recourse for non threating/non disruptive patient disagreements, not using the disruptive behavior committee to silence the reports of harm or errors by patients. I also provided them with VHA disclosed documents detailing VHA admitted fraudulent actions against me and their own records of their efforts to disclose false information on me and manipulate them into taking actions against me on governments behalf. Let me know if you have any questions I might be able to answer. 

This is a DBC presentation at a BPD event but does a great job as an overview and highlights problems and the doctor/patient views of the impact of the program on getting care. 

 

[RetiredVetFlagged]

On 1/31/2023 at 3:25 AM, grayling12 said:

RetiredVetFlagged,

To answer your questions:

1. I wasn't informed about the note in my medical record, I found it while reviewing my treatment notes.

2. The note doesn't give any instructions to staff.

3. What is a PATS-R? Update, I looked this up online and know what it is now.

Thanks

The note you found is likely the event note for a DB report, it is good it doesn’t have details, VHAs in Ohio and Michigan were putting details on those notes which are clear privacy violations but because the policy and law contradict each other there is no proper due process and no oversight as they us the flag as a basis to lie to congressional inquiries done on veteran constituents behalf leaving us completely unprotected from misuse or errors. For the flag itself by law they are required to provide you a copy but by practice and deliberate noncompliance in the cases where patients still have agency they don’t essentially setting a situation they can use to entrap and accuse you of noncompliance. So to get the flag if there is/was one, they will lie to you about it, you need to FOIA it. Use the number on the report in your record and the date to request from the facility foia officer. Simply write “I request all, reports, notes, correspondence and behavioral patient record flags associated with 0000000 (DBR number & date)” sign it then scan and send to the FOIA officer.

As an example of just how twisted and corrupt the program is check this just released OIG report. A nearly 80 year old was physical harmed and put in pain, when after he reported the ABUSE and reported the employees for harm they continued to be allowed to “treat” him which resulted in physically injuring him then when he tried to protect himself and the Employees were allowed to target the senior they were harming with the disruptive behavior program and VA police.  

https://www.va.gov/oig/publications/report-summary.asp?id=5236

 

[RetiredVetFlagged]

Grayling12 I believe you, I went through years fighting them to clear my name. I am now cleared but it will take years more before all the bad info and records amended for the ones that can be BUT, the DBC records are one of the only NON amendable VHA record there is so it will always be there to harm me as a “history of”. Sorry I haven’t checked back on this until now. As for why this subject is hard to find info on is because it is actively suppressed in part because of real harm done to healthcare providers even though there is no evidence this does anything but delay the discoveries of errors or wrongdoing harming patients. I can state this as fact as due to disclosures by VHA in my own case that they actively monitor social media such as twitter and linkedin for veterans making specific complaints or allegations about their healthcare providers and will inform them that you are a “threat” to shut down the account. For several years this program was misused against me and now it is fairly well known in the VHA that I was wrongly and improperly flagged. The VHA Police and OIG know my accounts, the VHA police have agreed to contact me to resolve any concerns they have. With that all that said I can answer many questions on this topic due to attorney reviews, conversations with VHA OIG, several tort claims, conversations with two deputy directors at the office of general council, the national DBC program manager and actually going through each process, all of which failed and resulted in everyone from the DOJ to congress being officially told I was not flagged/never was even denying it on several FOIAs but an appeal forced them to disclose I was flagged for years and the instructions themselves stated I was a threat, instructed employees to ignore me and that they were to conceal it from inquiries due to me posting online. It wasn’t until they were embarrassed online with their own FOIA provided documents that I believe they tried to come at me criminally, but I never did anything they claimed so there was no evidence and after years of deadlock resulted in a rapid 180 change in care and access provided.  When they tried to shut me down online, I provided the social media orgs the law that provides for VHA providers to take civil actions against VHA patients, that is their recourse for non threating/non disruptive patient disagreements, not using the disruptive behavior committee to silence the reports of harm or errors by patients. I also provided them with VHA disclosed documents detailing VHA admitted fraudulent actions against me and their own records of their efforts to disclose false information on me and manipulate them into taking actions against me on governments behalf. Let me know if you have any questions I might be able to answer. 

This is a VHAs DBC presentation at a VA & Yale BPD event but does a great job as an overview of the VA program and highlights problems and the doctor/patient views of the impact of the program on getting care.