PDA

View Full Version : Demeaning VA procedure


NHsciGuy
07-18-2011, 08:00 AM
Okay, so my VA has a policy that any time you request a major medical device...(leg braces, orthotics, wheelchairs, gym equipt., etc) you have to attend a committee hearing

SCI-Nurse
07-18-2011, 09:33 AM
I suspect the person on the telemedicine visit was someone from a VA SCI Center, correct? Since you do not live where there is a SCI Center, they are seeking that consultation. Major Medical Committee is under Prosthetics, and in some facilities they require all major purchases to go through such a review. It is up to each individual VAMC to determine how this is done. At my VA, we review the records and letters of medical justifications from the provider and/or therapists, but we do not require the veteran to appear unless they are appealing a previous decision.

Most of the items you mentioned really should be obtained during your annual, which should be done at a VA SCI Center (by regulation), not at a CBOC or spoke clinic. In addition, I would encourage you to file a complaint about the process being used through the hospitals Patient Advocate program, and ask your PVA NSO to also get involved in helping you get a process in place that is more respectful and that you find less demeaning.

(KLD)

skippy13
07-18-2011, 06:46 PM
Here in Oregon they summarily deny just about everything. It is why I go through Medicare for most of the stuff i need and don't want the hassle I get with the VA. I got my new tilite through medicare even though the VA will do the same thing only because I didn't want to deal with the red tape.

They are good about regular every day medical needs, but prosthetics here are a biotch to deal with. They just send out a denial letter without an examination or study even though your doctor recommended whatever it is they then deny. Except for my oxygen therapy, they have denied everything that my doc requested. I don't like asking for something and then end up having to beg.

Oldtimer
07-18-2011, 08:10 PM
It is and always was some kind of political game our goverment likes to play. At one point in your life you signed your life away to uncle Sam, no questions asked. Now these same people are trying to make you believe the things you need are coming out of their own personal pockets. Like everything else, it's who you know to bypass all the bull crap! Don't let them get under your skin, you earned it.

NHsciGuy
07-19-2011, 07:42 AM
Like everything else, it's who you know to bypass all the bull crap! Don't let them get under your skin, you earned it.

That's exactly it!!!

NHsciGuy
07-19-2011, 07:49 AM
I am seen at a SCI clinic for my annual. I was referred there by the SCI team at my local VA. Im assuming there are 3 different levels?

SCI-Nurse
07-19-2011, 09:33 AM
Annuals are supposed to be done ONLY at VA SCI Centers. A SCI spoke clinic is supposed to ONLY provide day to day care needed (for example, med renewals, and treatment of a UTI). You should demand you be sent to your SCI Center (West Roxbury) for your annual. Please contact your PVA NSO to review this entitlement, and talk about the Prosthetics issues as well. You also have the right to ask that your PVA NSO attend any of these in-person required reviews with you.

(KLD)