Page 1 of 3 123 LastLast
Results 1 to 10 of 28

Thread: Veteran Adviser Vitaglide rejected

  1. #1

    Veteran Adviser Vitaglide rejected

    Thought I would keep you informed on what's going on. On July 8, I saw my doctor, talked to her about the Vitaglide and she thought it would be very beneficial on many different levels for me. Saw a great physical therapist who did my evaluation and she wrote down just about every single reason why I would need this -- she was very detailed.

    Today the PT called me to inform me that I was denied. She told me that the doctor who is head of Preventive Medicine and Rehabilitation (PMR) did not agree with her. I asked her exactly what was the language that he used.

    This is what the chief said,"'Denied because exercise equipment is only issued for cardiac rehab." The physical therapist that evaluated me does not understand why I did not meet the criteria. She honestly did not believe that I would be declined and was surprised and confused that the chief of PMR not only disagreed with her but my VA doctor (neurologist) that I have seen for the last nine years I have lived here.

    Honestly, I am not the least bit surprised. I hate to sound negative but this is all too typical of the VA and the bureaucratic doctors that make these decisions. I have never met this doctor (chief of PMR) but somehow in his wise decision-making, somehow I do not meet criteria for cardiovascular rehabilitation. I guess I will just take a few laps around the old high school track.

    And I really hate to say this but I believe the decision was based more on a personal agenda then what is right for the veteran. The only thing left I was going to ask you is there any appeal process or is this just the way it is?

    I try to avoid dealing with the VA when it comes to my personal health or even dealing with prosthetics but this just seems wrong in so many ways. Even the chief of prosthetics told me during this process that they have specific paperwork for dealing with equipment that is not normally issued.

    Well, if you have any ideas I sure would like to hear them. I would not use my PVA representative because they are too closely aligned to the hospital's final decision. I might get somewhere with my social worker, she's really great. But I don't think she would stand a chance with this doctor who refused it. Probably my best chance for having any real success is contacting my congressman. It is a last resort option, but I really don't think I have any more.

    I have documented everything from the people that I have seen, the dates and conversational notes. I am totally dumbfounded but I have to keep reminding myself this is the VA. So it's kind of hard for me to get upset. Oh, and we are also having a national health-care debate, what irony!

    Thanks for the initial help and listening to my ranting. If only my heart was little weaker then maybe I would be qualified for the equipment! I wonder why they call it Preventative Medicine and Rehabilitation...

    synbat

  2. #2

    This man is the man for Vets.
    Dr. Sniger...Raynham, Ma.



    Specialties Physical Medicine & Rehabilitation
    Gender Male Education Education information, including: Medical School attended, years since graduation, and Residency, are all available in the Detailed Report. Years Since
    Graduation 15 Five-Star Recognition HealthGrades Recognized and Five-Star designations are available in the Detailed Report. State License Information Licensed in Massachusetts What is Physical Medicine & Rehabilitation? Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. A physical medicine physician, also called a physiatrist treats diseases and disorders including neck and back pain, and sports injuries or disorders resulting from trauma, such as [COLOR=blue! important][COLOR=blue! important]spinal [COLOR=blue! important]cord [/COLOR][COLOR=blue! important]injury[/COLOR][/COLOR][/COLOR] or head injury. The physiatrist works with the patient using X-rays, a [COLOR=blue! important][COLOR=blue! important]physical [COLOR=blue! important]exam[/COLOR][/COLOR][/COLOR], laboratory study, pain management and/or physical therapy, to achieve rehabilitation. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation.

    Professional Experience


    Professional Affiliations/Memberships AAPMR
    APS
    Massachusetts Medical Society


    * Indicates physician-provided data.

  3. #3
    Sorry to hear this, Synbat... maybe you don't have enough "points" yet ... ok, bad joke, sorry.

  4. #4
    I forgot to say Dr. Sniger is SCI.

  5. #5
    Hey thanks for the info. But I'm not really for sure how Dr Sniger could help in this situation. But this is far from being over. Yeah, quadvet just a few more points -- that's a good one! A little out there like Catch-22. By the way, just to clarify things when I was talking about the PVA rep, I was referring strictly to the one that I deal with here. It was not meant as a blanket statement.

    synbat

  6. #6
    Go for it, looks legit to me. All the best... let us know what happens. I'm off to the VA now, speaking of...

  7. #7
    1) Was this requested through your home VA, or through your VA SCI Center? If the former, you need to see if you can get it prescribed by a physician at your designated SCI Center. According to VA regulations, the SCI Center prescription should over-ride the decision of a non-SCI center physician or facility, but that may mean you have to get it from the SCI Center's PS&A department as well (on their dime, so to speak).

    2) Have you filed an appeal? You have a right to appeal this decision, and I would STRONGLY encourage you to do so with the assistance and advocacy of your PVA NSO. You can appeal this all the way up to Washington DC if you so choose. You also have the right to appear in person, with the representative of your choice, in front of the Major Medical Equipment board that has the responsibility for review and approval of these requests locally. I used to sit on ours, and it is your right, and often decisions are changed.

    Your PVA NSO is paid to be your representative by the national PVA. They are not paid by the VA. If you don't think your PVA NSO is doing their job, or is siding with the hospital and not acting as your advocate, you can contact Bo Rollins at the PVA headquarters and he will take action.

    The VA DOES purchase and provide exercise equipment (for example, standing frames and gliders, weight machines such as the Uppertoner, even weight sets and pulley systems)! I suspect this PM&R (Physical Medicine and Rehabilitation, not preventive) physician is confusing VA eligilibity with Medicare, and that he has a private practice outside the VA that has gotten him confused.

    (KLD)

  8. #8
    KLD,

    First of all, thank you for all the information. I went through my home VA or VA Healthcare System. Although, they may not be a SCI center, the physician is a neurologist and she's really good. The hospital itself has been totally overhauled and is a really nice facility with a strong budget.

    The last time I dealt with a PVA NSO was about three years ago when the same doctor denied me for a wheelchair that would actually fit. The PVA officer basically threw her hands up in the air and said there wasn't much she could do. I could not believe it! At that point I should have contacted someone higher up in the PVA and reported her at the same time.

    Long story short, I took the matter in my own hands, contacted my congressman and both of my senators and working through a Congressman's liaison officer at the VA the matter was resolved -- I received a wheelchair that fit my lifestyle. I am sorry to say, with few exceptions, this is the VA I have come to know.

    Most likely I will contact the PVA today but I will not rule out my congressman. Resolution seems to be expedited when a politician gets involved.

    Once again I appreciate the information and the suggestions. It can get very frustrating when you jump through all the hoops, and all the i's and t's are dotted but one person in power decides what equipment is effective. I suspect this PM&R physician knows exactly what he is doing. He has said some things in the past that lets say do not reflect well upon his character or a doctor in his field of medicine.

    synbat

  9. #9
    This is why I suggested him....good luck.

    William Sniger, M.D.

    Physical Medicine and Rehabilitation Specialist
    360 Pleasant Street, Raynham, MA 02767
    (508) 822-1293 Fax: (508) 822-1293


    Dr. Sniger is a physician who became paralyzed from a spinal cord injury. He received his B.S. from the University of Massachusetts. He received his medical degree from the University of Massachusetts Medical School and completed a residency in Physical Medicine and Rehabilitation at Boston University. He completed an additional Harvard Medical School fellowship in Spinal Cord Injury Medicine at the Brockton/West Roxbury Veterans Administration Medical Center. He is board-certified in Physical Medicine and Rehabilitation and is one of only 180 physicians in the United States to be board-certified in Spinal Cord Injury Medicine. He is doing Independent Medical Evaluations (IMEs) for disabled veterans. As a specialist in Physical Medicine and Rehabilitation, he is extensively qualified to evaluate any type of disability. He is a member of the Paralyzed Veterans of America and has worked with attorneys who represent veterans.

  10. #10
    Quote Originally Posted by synbat View Post
    Thought I would keep you informed on what's going on. On July 8, I saw my doctor, talked to her about the Vitaglide and she thought it would be very beneficial on many different levels for me. Saw a great physical therapist who did my evaluation and she wrote down just about every single reason why I would need this -- she was very detailed.

    Today the PT called me to inform me that I was denied. She told me that the doctor who is head of Preventive Medicine and Rehabilitation (PMR) did not agree with her. I asked her exactly what was the language that he used.

    This is what the chief said,"'Denied because exercise equipment is only issued for cardiac rehab."
    Synbat,

    Sorry to hear about your being denied, but all is not lost.

    Here's a link to my article explaining the clinical appeals process.

    http://sci.rutgers.edu/forum/showthread.php?t=111445

    Essentially, you should pursue reconsideration by the VAMC Director and, if necessary, VISN Director. Veterans often either don't know about this process or don't want to expend the energy to deal with it, which is why many VA's are also unfamiliar with the clinical appeals process as well (my VA Prosthetics Dept. would often concede rather than deal with the paperwork whenever I'd filed a formal clinical appeal on behalf of clients). But you now know about it, and you have options. As long as your treating physician and therapist support this prescription you have the law, or VA directive in this case, on your side.

    My advice is to start by getting something from the Vitaglide company that helps your case and file a clinical appeal in accordance with my article. The Vitaglide brochure, for starters, says nothing about it being strictly prescribed for cardio conditions. In fact, it's touted as a solution for shoulder pain more than anything else. Cardio is just one of the benefits. That PM&R doc could not be more wrong if that was the sole basis of his denial. Read for yourself http://www.grouprmt.com/vitaglide/brochure.pdf

    Keep up the good fight and keep us posted, Synbat
    Last edited by Veteran Advisor; 08-06-2009 at 12:53 AM.

Similar Threads

  1. Replies: 0
    Last Post: 03-21-2007, 01:28 PM
  2. New Vitaglide comments/questions
    By Jeff B in forum Equipment
    Replies: 34
    Last Post: 02-23-2006, 07:30 PM
  3. Replies: 4
    Last Post: 07-20-2003, 07:57 PM
  4. Deception plagues disabled veteran program
    By Max in forum Ability & Disability News
    Replies: 0
    Last Post: 05-04-2003, 10:51 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •