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

[Lemuel]

Very important to have with you when a doctor tells you they cannot record etiology when it is in your medical record.   And a good reason to upload your military medical records including both OPTR (outpatient) and IPTR (inpatient) treatment records.

[grayling12]

Thanks Tbird,

My point in this thread is mostly to educate other veterans that this can happen to them as well and very easily. The reason I am going to fight this till I die is, I never once got the courtesy of so much as one warning in all of this. There are no warnings on the myhealthevet site when you IM your providers, it simply says here is a way to communicate with your provider. They should provide examples of this is OK, and that is not OK communication. It's like dangling a carrot in front of patients and if your foolish enough to bite, BAM, permanent flag in your file, one more and you're forced out of VA healthcare, no warnings. When I called the guy that runs the committee that decides to do these flags, he said the permanent note in your file is the warning! The next time you complain to a VHA employee about your VA healthcare, it turns into a permanent flag, and restricted use of VA healthcare or worse. 

I want to advocate for an update to their policy to require a written notice informing you; that you may be using their system inappropriately and maybe give examples of what's appropriate use and what's inappropriate use. Then if you continue to use the system, BAM, permanent note in your file. I would also like someone high up in the VA hierarchy to send me something in writing that explains how they have weaponized punctuation marks. I would also like to know the proper way to use punctuation marks in VA correspondence that doesn't make me seem like a serial killer.

If I can get them to use a little common sense when applying their policy all the better. As I've said before, I know that nothing will come of this, this policy is so broad and arbitrary for a reason; if you question or disagree with us we will smash you, this is the message they are sending.

We all deserve a simple warning before they start forcing us out of VA healthcare, all vets aren't crazed lunatics, some of us simply are uneducated in the complicated workings of the VA.

As a side note, the guy that runs the disruptive behavior committee said we can FOIA the redacted complaints. 

Edited January 23, 2023 by grayling12

[Lemuel]

On 1/17/2023 at 9:56 PM, grayling12 said:

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.

 

When I responded last, I was responding to Tbird without reading the initial post.

The CBOC's are wrong in their setup.  Two-to-three-year contracts.  Some of the contractors are good and others are FHP style.  Make profit by limiting service.  I quit the CBOC near me with community health care because of the reason above.  But instead of complaining directly to the CBOC, I made my complaints to the White House hot line.

I complained about the nurses running interference for the NP so they could work another job, which is what I feel was going on.   Probably making some kick back to their nurse or just wielding their power over them.

Everyone with similar experience should complain.  The VA fixed Cheyenne and Phoenix.  I think the VA can do the same with the CBOC contracts without the changes in contractors so that every 2 to six years you get a new PC and it is the luck of the draw to get a good one.  Plus there is no continuity of care.  Your PC does not know your chronic conditions well enough to provide good care.

[grayling12]

Lemuel,

Thanks for the info. I do plan on fighting until they update their policy or I croak, whichever comes first. Not only did they not give me any kind of a warning, the head of the committee that puts these flags in your file, said the permanent note in my file was my warning, really, this note never comes back out, every time you complain or disagree with them it gets escalated, each escalation puts you one step closer to being forced out of VA healthcare.

I want them to have to give you a written warning first, put a warning on the myhealthevet site warning vets what could happen to them if they use the messenger, and have a way vets can eventually have their flags removed. If this happens then I'd be happy.  

[Rattler]

I was going to close this thread because its going in the wrong direction. We are not hear to bash the VA. We are hear to support each other in the maze of the VA Claim system.

If you have an issue please post it in the corect forum

Having said that RetiredVetFlagged is right Michigan was and is one of the worst in the nation. It is the primary reason that it took 40 years to get my benefits. 

grayling1

Please read the sit Guidelines

https://community.hadit.com/guidelines/

 

RetiredVetFlagged

That is good advice on how to use the FIOA to get the right information.

It sounds like something I would do.

 

 

[grayling12]

Rattler767,

I would like to clarify, I shared my story and experience as a warning to all vets in this country that deal with VA healthcare. I was targeted by the VA for questioning my VA PCP one time in twelve years and was given a permanent note in my record for it. I really don't believe warning fellow veterans to watch their backs when dealing with VA healthcare is bad mouthing the VA, I mean, it was the VA that targeted me for questioning my healthcare. I think it is important for vets to research the consequences of interacting with VA healthcare employees, when these same employees can mark you for life in your records and your treatment even to the point of pushing you out of VA healthcare.

If at any time anyone thinks I'm making any of this up, simply look up the provided sites and do your own research, this is based on facts, these facts should scare anyone that reads the VA's own policies on this subject. Remember, no one told me I had this permanent note in my file, I stumbled on it during a review of my treatment notes, there could be thousands of vets out there with these notes and flags in their files and don't even know it . 

If there are any particular quotes that seem like unfounded bashing, I would appreciate having them pointed out, as anything mentioned on this post is based on my personal first hand experience and researching the VA's own policies on the subject. I am not trying to start an argument, just trying to see if my post is inappropriate instead of informational as intended

Once again this post is meant to help other veterans to not end up in the same situation I am in. I never intended it to be a bashing post or whining session. I included as much info as I could so others can see for themselves how easy it is to get on the wrong side of a VA healthcare employee, be reported for it and then marked for life.

Another point of this post was to seek advice on how to proceed, which appears to be answered by RetiredVetFlagged who seems to be very knowledgeable on this subject.

I did read the community guidelines and don't believe I violated them per se. I understand that the site is here for advice on how to pursue VA claims and claims related issues. My post came about in the first place because I was addressing problems with my VA healthcare that was also affecting my ability to file a claim, this is one reason that I feel it is relevant although not mentioned in the original post.

I did find other very old posts discussing these flags on this site. If this site is not an appropriate place to warn veterans of what to expect when they question their VA healthcare, then does anybody know of a site that is more appropriate? I would like to reach as many veterans as possible. Are there any Facebook pages, forums or other sites where I can get the word out?

Any help or information would be appreciated.