Saturday, October 20, 2007

Good News for 2 families, shame on the VA

Two stories that I will focus on today one was the Washington Post October 14 article about the Turner family and how the government was failing to care for the husbands TBI and PTSD injuries from the invasion of Iraq.

The other is a story of a Vietnam Veteran diagnosed decades later with cancer caused by exposure to Agent Orange and how the VA Regional Office dealt with this family. It should bring tears to your eyes it did mine, but I should be immune to these stories by now, but I am not. I learned of this one by reading Jim Stricklands regular article in the VA Watchdog

In the Turner's case the Washington Post story got the VA head office off it's proverbial ass, and they got into gear, the job they are supposed to do anyway. But they sent one of the hiearchy into the filed to personally handle the situation. The follow up Washington Post story published today it details how the VA jumped to action.

Turner, 38, and his wife were visited this week by Antonette Zeiss, deputy director for mental health services for the entire VA system. Zeiss spent about 90 minutes inside the Turners' mobile home in Hardy County in rural West Virginia, assessing Turner's needs and treatment program. Zeiss was accompanied by a PTSD counselor from the Martinsburg VA facility.

Acknowledging that not all disabled veterans get their compensation doubled overnight or receive house calls from VA's deputy chief of mental health, Lisette M. Mondello, VA's assistant secretary for public affairs, said yesterday, "It was an opportunity to take one person's experience to see how we are handling it, and translate it to see if there are more things that can be done for other patients."

After the Turners' story appeared in The Post, there was an outpouring of responses from readers. Some sent large donations; others sent small checks and handwritten letters. Evelyn Mitchell, 74, of Riverdale, Md., sent two $25 gift cards with a note that said: "In honor of my late husband, who was a WWII vet -- James J. Mitchell -- a gift for the Turners."

Turner served with the Third Infantry

The former infantry scout acknowledged yesterday that VA's decision will help him, but he expressed concern about others caught in the backlog of claims and appeals. "I just hope they do it for the rest of them," Turner said. "Not just for me, but for all of us."


The other story that got my attention was the story of the Nam Vet and his wife's ordeal with cancer caused by Agent Orange

The letter from his VARO told Don, “A CT scan of your head revealed a mass located in your right frontal lobe, the lower thalamus and upper mid brain. A CT scan of your chest revealed multiple enlarged, enhancing lymph nodes within the mediasteinum, concerning for metastatic disease...you are diagnosed with lung cancer (and brain cancer). Since there is a likelihood of improvement, the assigned evaluation is not considered permanent and is subject to a future review examination. An examination will be scheduled at a future date to evaluate the severity of your service connected brain cancer associated with lung cancer.”

Subsequently, a repeat examination was scheduled for February 2009.

I'm well into the second year of my volunteer activities at the VAWatchdog site, writing as a Veterans Advocate. I've seen some decisions from VBA as well as complaints from Veterans that bordered on the absurd. This award letter now tops the list.

As I read this award letter from the Durham, N.C. VARO, it seemed like it was intentionally written by some mean spirited, sadistic VBA employee and meant to be a cruel joke. This letter could not have been written by a thinking, caring human being.

This man, this Marine had been definitively and precisely diagnosed by VA doctors at a VA Medical Center with lung cancer and brain cancer. The VBA ceded that his cancers were associated with his exposure to Agent Orange while he fought for his country in the jungles of Vietnam.

He wasn't going to heal. There was no “likelihood of improvement”.

When you hear the words, “lung and brain cancer”, your heart sinks because you know that person won't be here long. How was it that the Durham VA Regional Office could get this one so terribly wrong? What criteria or logic could be used in making such a terrible decision?

In May 2007 I got to know Don and Jane. They were shocked to learn that the Durham VBA had assigned his cancers a temporary rating because of that “likelihood of improvement”. They learned that a temporary 100% rating would give them a few dollars each month but nothing else. Most importantly, as Don wasn't able to work, there was no health insurance covering Jane.

A Veteran who is rated as 100% Permanent and Total with “no future exams” scheduled gets CHAMPVA health coverage and other benefits for dependents. A Veteran who has future exams scheduled gets nothing for those dependents. For the most part, that also applies to the Dependents Indemnity Compensation (DIC) benefit for the widow. Without the “no future exams” verbiage, life is tough.

I didn't understand why my friend in Pennsylvania was reaching out to me for help. As I started to investigate and collect facts, it seemed the family was happy with their VSO. I'm not anxious to jump in when a Veteran has a relationship with a VSO. I encouraged them to stay in constant touch with this man and lean on him for some answers.

But that wasn't working. I detected an undercurrent of mistrust that was hard to define. I suggested that a Notice Of Disagreement (NOD) needed to be filed quickly so that the “temporary” status could be soon brought up to the deserved “permanent” classification that Don's conditions clearly were entitled to. But the family waffled and couldn't bring themselves to face the VSO and tell him they wanted some action.

I made recommendations that I believed would have moved things along. I continued to suggest that they should work with their VSO. My suggestions weren't being followed. In my subsequent emails I heard, “I spoke with Don, he's afraid of stepping on (The VSO's) toes, I don't know what the hell to do.” “Don received the 100% rating and it only took 3 months.” “I never get to talk to the docs concerning his condition, they tell me the HIP rules.” “I've decided to give him (VSO) a little more time. He is highly regarded in the area as I've spoken to other vets.”

I was concerned that Don and Jane hadn't been advised that they should be proceeding with details like getting a power of attorney for her. During May 2007 I urged them to seek the assistance from that VSO and get those affairs in order. But it was also in May I discovered that the NOD I'd suggested earlier had never been filed. It seems that the VSO had bluntly told them it wasn't necessary or desirable to do such a thing.

During the month of May, it was also becoming more apparent that Don was getting sicker. He was spending entire days in bed, on the couch and had lost a lot of weight. No further treatments were offered by the VAMC. During a recent CT scan Don had a bad reaction to the x-ray contrast and days later was still fighting the effects.

A call from Jane to the VSO to check on any progress resulted in her message to me, “Apparently he didn't look at his file on Don and mentioned something about how he's sending Don a form he needs to fill out to give permission and ask for physical exam by VA Board doc. So I guess we're still waiting. Not sure how long we wait. Only thing I worry about is that his file was 'lost' by the VA board since they 'lost' it twice before since we began all this.”

Our emails dropped off through most of July. There wasn't much I could do to help. I'd offered my advice but it seemed that the fear of upsetting the VSO was so intimidating that the family was unwilling to listen to me. Then in August I received, “Sorry to bother you, but, you're the only one that I feel has the knowledge of this VA maze. I fear, that due to the VA maze he will not have the P&T rating in time.” Don was in dire straits. There was no word from the Durham Regional Office and no further help coming from the VSO.

Then, the first week of September was this, “Ok, need a little advise. My main decision helper is my 40 yr old son...I truly need help with decisions which will affect my future financially, eg: VA benefits. My son felt that I should have the letter you mentioned stating Don's prognosis so (the doctor) can sign it. Here is his and my main concern. If we do this, the VSO is such an egomaniac (My son was with me when I went to our VSO last week and he was apalled at how the VSO reacted to my getting 'outside help' and threatened to give my case to his superior in Raleigh and be done with me) then who will have help me in future dealings with VA, like DIC, burial, etc. My son said he'd like to talk with you via telephone in regards to that situation.”

Jane wrote again, “The VSO later mentioned if I wanted 'outside help' that I should not deal with him again and said he'd give my case to his superior in Raleigh, he would be done with me. I started crying and he said he would keep the case in his office. My son was with me at that meeting.”

I spoke with the son September 9th, a Sunday. It was our first conversation and I finally heard it all. When he accompanied his mom to a visit with the VSO a week or so before, he'd been shocked at how degrading that experience was. He recalled that their “advocate” had been angry and defensive. At some earlier point, the family had made a call to their Congressman's office and the VSO was extremely upset about that. He was also very unhappy that they had contacted a chaplain of a Veterans Service Organization and berated her for doing that. There wasn't time to bring up my name before they left that office, his mother crying and extremely upset.

It seems that they had been led to believe that without that VSO, they had no access to the VA. He left the impression he worked for the VA, he was the VA and he held the keys to the gate.

I was surprised. In most professions, an outside or second opinion is welcomed. If a surgeon suggests an operation to you, most would encourage you to go ahead and visit another doctor. It makes good business sense to work with others to solve complex problems.

In any case, as the family discussed my conversation that I'd had with the son, the decision was made that I should lead the charge. My advice would be followed and given attention.

I sought the advice and counsel of a friend...my most trusted VA Insider, a long time employee of the Veterans Benefits Administration read my quick email of this terrible situation and told me, “I can't remember a case that is more deserving of Congressional intervention.”

Then Don had his first big seizure. EMS/Fire Rescue took the call and came to his home. He had settled down by then and there was really no need to transport him to any hospital. A seizure in a man with terminal brain cancer isn't going to get much interest from EMS...there's not much to be done.

There had been no progress with getting Don his Permanent and Total (no future exams) benefits. Jane had no health insurance. Don was rapidly showing signs of paralysis and he had not been afforded Special Monthly Compensation (SMC) benefits. His VA medications were far behind, he had no medical care to speak of, there was no VA home health, no hospital bed, no bedside commode...not even a urinal that a dying man could use.

With the family's permission, on September 10th 2007, I contacted the office of Congressman Walter Jones, Don's Representative to our federal government.

I don't like calling a Congressman for help. I much prefer to use the system as it's intended. All too often calling your Congressman only brings about a rubber-stamp inquiry and a form letter telling you your claim is being processed routinely.

I got lucky that morning. A courteous staff quickly connected me to Mr. Jason Lowry. Mr. Lowry is the Military and Veterans Liaison in the office of Congressman Walter Jones. I knew Jason couldn't comment to me...privacy laws prevent that. But he could listen and he listened closely. He promised his help and Congressman Jones' support. We agreed that we needed “the letter”, a letter from a doctor stating clearly that Don would die of his disease.

I had written that letter, Jane had it and it was now time to get it signed. She hand carried it...twice over 2 days...to her local VA outpatient clinic and each time she was turned away. A clerk rudely informed her, “Do you no how many of these we get every day?” and let her know that Don's doctor might get to it in a couple of days, he might not. Her request to speak with the clinic manager was denied. Even though she told the staff the letter needed to get to Congressman Jones' office quickly, that infamous VA attitude was firmly in place.

On the morning Tuesday the 11th, I informed Mr. Lowry of our impasse at the clinic. Don had been taken by ambulance to a local emergency room and returned home. He was largely unconscious and non-responsive.

I had hit a dead end. It was too late in the game and there was no more I could do.

Then, later that day Jane let me know she had gotten a call from the local VA clinic. That all important letter had been transcribed onto VA letterhead and faxed to Congressman Jones. Home health was planning a visit, a hospital bed was being delivered, hospice was notified and appointments were being made.

Within the next 3 days, all of the things that should have happened months before were done. On Friday the 14th of September, Jane received a call to inform her that Don had been declared as Permanent and Total with no future exams scheduled. Her eligibility for CHAMPVA was established. Don was granted Special Monthly Compensation for his paralysis and retroactive benefits were granted.

Home health nurses were there to care for Don as he rested at home in his hospital bed. Pain medicines and counseling came from a hospice. It was all as it should be.

I was traveling Thursday, September 27th 2007. I stopped for a sandwich and as I settled in at a table at the Subway shop, I opened my Blackberry to check emails while I ate.

My first message read, “Don's service will be on Monday October 1st at 11 am at a Funeral Home in Jacksonville, and then off to the Veterans Cemetery in Jacksonville a few minutes from the funeral home.”

Some 12 days after the VBA had acknowledged the seriousness of Don's service connected conditions, he was gone.

The funeral services were as good as that sort of task can be. It was a sunny day with enough of a strong breeze to keep the flags flying. My North Carolina Patriot Guard Rider friends had come and we escorted the procession and stood a flag line in his honor. The USMC, as always taking care of its own, performed a full military honors service for Don.

As usual, Taps, a flag presentation to the widow and a gun salute left me with tears streaming down my face.

I wasn't alone.

The VBA system had turned its back on Don.

When pressed for action, his VSO advocate chose to humiliate Don's wife in front of her son. By then, Jane was a frightened and broken hearted woman who weighed in at barely 100 pounds. I wonder if that VSO would have bullied Jane and reduced her to tears had Don been there healthy, in his camo fatigues smelling of the sweltering Vietnam jungle, locked and loaded.

In spite of the blatantly obvious diagnosis made by VA doctors, the Durham VA Regional Office stubbornly refused to recognize that Don was going to die and he was going to die soon. That Durham RO decision maker never looked up long enough to see the human being that was there...it was just more annoying paper for him to push around.

Even though the system abandoned Don, Don was never alone.

In the end he had steadfast friends in the office of Congressman Walter Jones. I'll never know what calls were made or who made them. I don't need to know. It's enough knowing that at crunch time there are men like Jason Lowry and his boss who we Veterans can depend on. I've never experienced a more responsive, courteous and professional group than at that office. There was little talk and a lot of action.

Don wasn't alone. His family was by his side every minute. Don wasn't alone as the Patriot Guard Riders mobilized to be with him. The USMC...those young Marines of his honor guard...weren't going to allow Don to be alone.

Today Don isn't alone. There will be no man left behind as each Veteran, every one of you who ever donned the uniform, is there standing with Don.

I know this, so did Don.

Fortitudine Vincimus


As to the three paragraph rule for copying, I have permission from Larry Scott of the VA Watchdog to use his websites material freely and widely.

Go for it...you always have my permission........


----------------
Larry Scott
Founder & Editor
VA Watchdog dot Org
www.vawatchdog.org

"It is illogical to put a cap on VA funding when it is
impossible to put a cap on the number of those
wounded and injured in service to their country."



TESTVET@aol.com wrote:
I have a new Blog and have stopped the rants about the experiments I am just now dealing with South Carolina politics and veterans issues http://vets4politics.blogspot.com/ titled Military & Veterans: Politics for the deserving when I find stuff you write is it still okay for me to post it on my blogs on this one and at Daily Kos I use your quotes totally and link them back to VA watchdog and the newspaper articles I quote 3 paragraphs and link back to your site and the newspaper article.

If you object I will stop. I have a nice bunch of regular readers and you have some great commentary on these issues.

Mike


Now to my commentary, why does the VA only REACT to veterans who manage to get front page stories in papers like the Washington Post, New York Times, LA Times, Seattle Times etc.

What about the other 800,000 veterans who have claims on appeal and in some cases have been waiting as long as 10 years for adjudication of their claims?

Why is the Bush administration pushing for a two tier compensation system for veterans, they want the terror war veterans, those discharged since 2001 to be treated differently than all other veterans from wars past? Do not all veterans deserve the same treatment?

Even Senator Bob Dole under testimony to the Senate VA Committee stated "All veterans should be treated the same, it doesn't matter how or where they sustained their injury either in training for combat or in combat they should all be treated the same, the only veterans he stated that should be treated differently are those with self inflicted injuries from drug use or drunk driving, which I agree with and has been law for more than 30 years.

Veterans are veterans, none are better than the rest, all military service is the same, it's all 24/7 for all the years you serve this nation.

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2 comments:

a small quiet voice said...

Sometimes you have to play hardball with these people. Unfortunately, most don't have the resources to battle the system in an effective manner.

We resorted to contacting our senator after getting the runaround from fee services for 2 years. My husband was transported by ambulance to university hospital and the VA was trying to claim that we had authorized his transfer to a private facility. Their point of contention was that HE should have specified that he be taken to a veteran's hospital. (This while he had 6 IVs and was unconscious.) The matter was resolved within a couple of months but ruined our credit because of the subsequent medical bills that went to collections.

Mike (Beetle) Bailey said...

yes, your story is not unique, the fee basis system is a mess and the VA makes it hard for vets and their families to comprehend how to deal with it