RTFU

It’s Time We Have a Serious Conversation About the VA

By
Updated: May 9, 2014

 

By RU Twisted

This week the American Legion, for the first time in over 50 years, asked for the resignation of the Secretary of Veterans Affairs. Eric Shinseki—a friend to every black beret-sporting soldier in the US Army—as head of the VA is ultimately responsible for its actions and has been called upon to recognize the consequences of the recent deplorable actions by the Department of Veterans Affairs.

In light of these events—specifically a story from Phoenix regarding the Veterans health care system there and its rather shady actions—I feel it is important to open up a dialogue regarding the VA; what they do right, what they do wrong, and what we can do as a community to make it better.

The simple fact is that nearly everyone I know—which means a great many of the people you all know—has a horror story regarding the VA. Injured Vets getting lost in the system; checks not coming through; claims taking years to be processed; claims being processed incorrectly—or sometimes even “lost”; the list goes on.

The recent stories coming out of Phoenix and Fort Collins VA clinics show just how bad this can get. Vets that were part of the Phoenix branch of the VA were apparently put on a “secret list” that was allegedly designed to hide the fact that it was taking over six months to get an appointment with an actual doctor. It is now estimated that at least forty of these Veterans died while waiting for these appointments.

It is easy to read about that and stories like it and become absolutely incensed—to have the blood come to a full boil while screaming obscenities at your computer. I know because I’ve done it more than once.

But that doesn’t change the facts and it doesn’t change the situation. The stories of financial abuse within the VA; of gross negligence on behalf of their upper management; and the countless anecdotes of Veterans who have been neglected just continue. My anger or yours does not stop them.

Nor does that anger allow for some positives to be seen. For example, yours truly made it all the way through his bachelor’s degree without even the slightest snags in GI Bill funding, as have many others. I used a VA home loan with very little difficulty, as have thousands of Veterans before and after me. The Veteran’s Hospital in my own hometown has helped educate numerous resident student physicians on their way to graduation from medical school, opening up their eyes to the Veteran community—seeing things they otherwise never would have.

Simply saying “the VA sucks!” ignores those realities. It fails to acknowledge the benefits for thousands that have helped in the fields of education, home ownership, and medicine just to name a few. We cannot as a community neglect those facts and expect to be taken seriously.

Yet these positives do not exonerate them from the egregious abuses of the Department’s bureaucratic mess. Medical negligence, secret lists, and the shredding of evidence doesn’t get a magical free pass because the VA has held good to their promise on most individual’s GI Bill payments.

Nearly every one of you has a story about the VA. For most of you it probably falls into the category of a disability rating getting rubber-stamped with “denied” despite numerous doctors siding with you—the desk-pushers who review case files apparently having much more medical expertise than the decades of training behind all those physicians who actually examined you.

Sadly, these stories don’t solve anything. We don’t gain a solution by finding out how many Veterans have been left hanging out to dry by the VA—we only get pissed off and want to burn it all to the ground.

And let’s face it—though everyone loves a little conflagration now and then, it just adds to the mess in the long run.

So here I sit, asking the honest question: what do we do? Can we fix it? Is the Veteran community capable of righting these wrongs, or is this an unwinnable fight?

I don’t normally like to write articles that leave with a question unanswered. I much prefer to offer solutions and then get told I’m wrong/stupid/fat/ugly for suggesting it. This topic is, however, a big one that needs a lot of input from the whole community. It deserves to be honestly approached and dissected for the better of each man and woman who served their country.

What say you?

Comments

comments

29 Comments

  1. Jim

    May 9, 2014 at 10:13 am

    The VA is a bureaucracy-organizationally and culturally. “Secret Lists” etc all point to a problem: not enough beds and instead of confronting that issue did what all bureaucracries do and concealed it-not unlike DoD has done in the past. Did Shinseki know about it? Nope probably not-but then just like DoD, if his staff is afraid to give him anything but happy-talk (or is afraid to ask the hard questions to get some ground truth) he’s going to keep going on until something like this bites him in the ass.
    Having said this, I also in fairness have to say I received my disability fairly quickly, had no problems getting a VA homeloan; and when my father died paid out death benefits with zero administrivia.
    Congress’ solution set is usually some form of throwing money at a problem-which Constitutionally makes sense since they control the purse strings. But in this case, it needs DOCTORS and MEDICAL Administrators, plus some finance bubbas to do a bottom up inspection, with the authority to hire/fire and reorganize. A bunch of lawyers and politicians won’t cut it.
    NO I don’t think Congress has the cojones to do this either.
    jim

    • Mr. Twisted

      May 10, 2014 at 11:24 am

      ” But in this case, it needs DOCTORS and MEDICAL Administrators, plus some finance bubbas to do a bottom up inspection, with the authority to hire/fire and reorganize. A bunch of lawyers and politicians won’t cut it.”

      I agree. But how do we make that happen?

  2. Joseph Breton

    May 9, 2014 at 10:37 am

    I’ve been paying back my earned Post 9/11 GI bill now for a couple years because in my last semester of school I was sent to Germany for a medical support mission and tried my hardest to complete my courses from abroad but had to drop the semester. The schools Dean, excused me after receiving my orders and allowed no repercussions with my GPA or missed courses and allowed me to take them again. I provided my orders the excusal letter from the dean and the VA still denied my appeal and extenuating circumstances and wanted all monies paid in full for that year… That made sense.. My tax returns are garnished and a payment goes out every month… Way to be for the Military.

    -SSG Breton
    US Army

  3. CJK

    May 9, 2014 at 10:38 am

    Another thing that is worth examining is the culture in the branches with regard to injuries, going to medical, and seeking treatment. Most of the time, someone going to medical for an injury is just given the “drink more water and take some motrin” spiel, and if they go more than a couple times they are treated like malingerers by their unit. This active discouragement when it comes to seeking medical treatment while on active duty only comes back to bite us in the ass when we get out and apply for our ratings. With little to no documentation, the VA will almost always not grant you a rating.

    My roommate had problems with his knees and started going to medical for them. He was treated like shit for it, given extra duties, random inspections, you name it. He eventually was medically discharged for his knees but they made his life a living hell while he was going through the process. I had knee problems too (still do), but seeing this made me just suck it up because I didn’t want to go through what my roommate was going through.

    While there are malingerers in the military, I’d wager the vast majority of the guys seeking medical treatment have legitimate complaints and injuries. Rather than treating us like shit and making us prove we have a real issue, why don’t the medical guys treat everyone like they are really hurt until THEY can prove otherwise. And stop the harassment at the unit level as well.

    • Clint

      May 9, 2014 at 5:28 pm

      100% agree. I got problems with one knee and finally gave it to get it looked at. Had xrays then pcsed. Finally go get the xrays read cause medic said something was wrong with it. Pa walks in ask whats going on sits down and tells me its just arthritis. Didnt even look at anything. I got pissed some things were said and he looks at my xray. Finds bone spurs in it. Gets touchy feely and comes to the conclusion of a possible meniscus tear. Instead of finding out if it is he just Gives me a bs profile and even more naproxin and says to come back in 30 days if it still hurts. No shit its gonna hurt still its been hurting for 2 years. So I go back and this time he says tendonitis and if its still hurting me in a month he’d reccomend a medboard. So even more things were said I didnt take the profile cause qtf is that gonna do except give me a ticket out without being fixed. It all starts with the Army/navy/air force medical system and it is broke and needs to be fixed.

  4. Erik

    May 9, 2014 at 10:47 am

    MY dealings with the VA have been limited, but I’ve had trouble. A few years ago we bought a house, or tried to with a VA loan. A VA home inspector came out, did the inspection. He denied the loan, due to an unfinished basement which did not meet code. The problem? The home we were trying to buy HAD NO BASEMENT! Nor did it fit the description he applied to it. We tried to get a new assessment, but no luck. Apparently you get one shot. No appeal, no redo, just find another house. I’m still angry about that. I loved that house. The only other experience was with the GI bill, almost 20 years ago. No problems there.

    • Mr. Twisted

      May 10, 2014 at 11:26 am

      It’s interesting, the more people I talk to, the more it seems that the GI Bill portion of the VA runs fairly well. They’re not without their own hiccups, but for the most part it seems to do what it was intended to do.

      So how do we get the medical benefits portion to run the same way?

  5. JoeC

    May 9, 2014 at 11:09 am

    I’m not a vet, so I have no VA horror stories of my own, but I have heard many. What I want to know is why you have to go through so much crap just to get seen. It seems to me that step one would be to have one requirement to be seen by the VA. That requirement should be to show proof of service. If you walk in the door with a military ID or a DD214 you should be done doing paperwork to be seen. Ditching the forms and BS needed to be seen and corresponding personnel that support them should save enough money to fund a lot more space to help the people that need it.

    • John

      May 13, 2014 at 8:40 pm

      The problem is that whenever anything is free, especially health care, there will never be enough to go around. The VA has limited resources and must try to allocate them in the best way possible. They seem to be failing miserably in this task. Yes there are deserving veterans who get turned away by the VA. I think there are even more people who are whining about a bad back or some such thing and want attention or money and go to the VA to get it. We’re about to see this phenomenon play out with everybody in the country as our health care system becomes progressively more socialistic.

  6. LB

    May 9, 2014 at 11:58 am

    I actually work for the VA, VHA specifically. The majority of issues I can tell you are all correctable from the standpoint of the enduser (you–the Veteran) but are challenging to change from within. One challenge is that we are stuck with the GS pay system. Right now I am a GS9, making about $51k/year. On the surface that sounds like a lot, however somebody with the exact same job, same skill set and same level or responsibility at a civillian hospital starts above six figures. The reason for this is that salary is dictated to a legally defined level of responsibility, regardless of market forces on the outside. Which means that in many cases the VAMC in your local area has difficulty hiring admin types, who would rather be paid what their skills are worth. Who wouldn’t? This leads to work overload, mistakes happen trying to catch up, and it becomes increasingly difficult to make excuses–not that we should, because I at least understand that you want it done right the first time. Realistically, this sort of thing can happen at any hospital and I can’t tell you how often I get aggrivated at work because some days it seems like trying to empty water out of a sinking boat with a collander.

    The rest of it honestly, is tied to the VA’s bureacratic nature. If humanity could arrange an $163 Billion organization to assign and manage work in a better way, somebody would have thought of a better way to do it. Couple this with the fact that there is no standardized training. No, seriously. The person who coded and processed your last physical therapy appointment for payment–learned it on the job. The guy you talked to on the phone, asking why noboody paid for your wife’s shingles vaccine–learned it on the job. Attempts at standardizing policy/processes are often met with resistance from the local facilities, who in many cases choose to do it their way because doing it “correctly” would make them look bad.

    Its kind of like the mentality that I could never stand when I was in the AF, you can probably relate: “Hey SSgt B, grab a couple guys to clean the shop up–Command Chief might visit this afternoon.” “It wasn’t clean before?” “Well, yeah it is, I dont want him to see the material we saved from pervious work orders.” “Oh, you mean that stuff we were supposed to turn back in to supply but never did?” “Yeah, get rid of it…quietly”

    • Mr. Twisted

      May 10, 2014 at 11:29 am

      Thank you for commenting. Sadly, this isn’t surprising. The inherent nature of bureaucracy is to, well….suck. Badly. The VA is just a perfect example of that very thing.

  7. Nate

    May 9, 2014 at 12:08 pm

    Brother’s and Sister’s,

    Twisted, you bring up many great points regarding the positive aspects of how the VA has worked. I too have had success using my GI Bill in order to obtain my Bachelors degree. It was quite painless, actually! However, in regards to my health, which is ultimately more important, I have received substandard piss poor treatment.

    After sustaining multiple injuries in Iraq from multiple deployments, it was always my assumption, and many others I assume, that we would be taken care of once we returned. After an RPG impacted against a wall directly behind me and threw me forward about 5 meters causing a severe TBI, broken jaw, and several crushed disks in my neck, my body tapped out. I was medically retired after 12 years active duty as an Infantryman. Again, I did not worry, I thought all would be OK, the VA would take care of my injuries. After I learned how to speak again, I immediately used my Tricare Prime benefits and transferred from the VA in Martinsburg, WV to Johns Hopkins. Why you ask? Not only was my pain not managed, I was left alone in my bed unable to communicate with streams of tears dripping from my face as the wires in my mouth protruded through my face due to improper after care. Simple after care would have prevented this and I will never forget how insignificant I felt. But hey, shit could have been worse!

    After my wounds healed and I was able to advocate for myself once again, the battle with the VA would continue in the form of compensation. My packet was lost twice which prompted me to contact my Congressman. Still, at the end of the day, it took over 2 1/2 years to start payment. Still not receiving payment for my dependents, but driving on.

    My frustration now lies within the Federal Government and their ridiculous spending and handouts, yet they cannot fix their obligation to the folks who have made the ultimate sacrifice for this great nation. In my opinion, Shinseki should have stepped down after a non-profit had to step in a pay survivor benefits to our fallen during the GOV shutdown! A few of them were from Ranger Battalion!

    To predict one’s future behavior, look at their past behaviors…..VA actions during WWI, Vietnam, Gulf War……This is nothing new…I do not know why I expected things to be different.

    Good post RU Twisted,
    Nate

  8. LDB

    May 9, 2014 at 12:37 pm

    I work for the VA–VHA specifically. I can tell you that a lot of the internal issues appear easily correctable to the end user (you–the Veteran) but are much more challenging to tackle from within. For example, we are stuck with the GS pay system. Right now, I am a GS9 making about $51k a year. On the surface this seems like I am paid very well, until you consider that somebody at a civilian hospital with the same job, same skill set, and same level of responsibility has a starting salary above six figures. The reason for this is that like the military, salary is tied to a legally defined level of responsibility—regardless of market forces on the outside. This means that your local VAMC is likely to have difficulty hiring medical/clerical admin types, because they would rather get paid what they are worth (who wouldn’t?). This causes staff to be overburdened, who make mistakes trying to catch up on the workload that management wants eliminated but may not fully understand the situation that created it in the first place. Realistically though, this can happen at any hospital. I can go on and on about how often I get aggravated at work trying to correct some of these things but some days it is like trying to dump water out of a sinking boat with a colander.

    The rest of it, is tied to the VA’s bureaucratic nature. Honestly though, if humanity could come up with a better way to take a $163 billion organization, then arrange it to organize and assign work in a more effective way than a traditional Weber style bureaucracy—it would have already happened. Couple that with the fact that VHA has no standardized training. No, seriously. The person that coded and processed your last physical therapy appointment for payment—learned it on the job. The guy on the phone you talked to about why nobody paid for your wife’s shingles vaccine—learned it on the job. These positions have high turnover and their skill level is unpredictable so if mistakes happen, it only adds to the overall workload. That and when attempts at standardizing policy/processes are made it is only met with resistance from the local facility. Often the reason they don’t want to do it “correctly” is because it will make them look bad on a PowerPoint somewhere so they just do it the way they have been doing it. It’s kind of like the mentality that always bugged me when I was in the AF, you can probably relate:

    “Hey, SSgt B, can you grab a couple guys to clean the shop up. The Command Chief may stop by later.” “The shop isn’t clean now?” “Well, yeah it is…I just don’t want him to see the material we have lying around from old work orders.” “Oh, you mean that stuff we were SUPPOSED to turn back in to supply but don’t want to?” “Yeah…that.”

    • ldb

      May 9, 2014 at 3:36 pm

      –Sorry for the repeat–

  9. leftoftheboom

    May 9, 2014 at 2:56 pm

    My claim was lost. My repeated calls allowed me to hear every possible reason why it was the “system”. I got hung up on and generally ignored.

    The problem with VA, success stories included, is that they are mostly senior former military that were put in place without once ever having to use the system that they administer. Which means that they don’t know the problems of the trenches, don’t have a good baseline for success, and spend too much time covering their ass instead of getting to the bottom of the problem.

    Some shit cannot be fixed by giving everyone a special hat.

    The rest of the problem, VA is a government program. None of the others work, why should it?

    If you don’t think the government knows how much money they save every time a Vet dies, you are dreaming.

    Every time in hear them talk about retirement benefit cuts, what I really here is this: Why didn’t more of you die so we would not have these obligations to pay.

    • leftoftheboom

      May 9, 2014 at 2:58 pm

      misspellings due to rage. *I………..*hear

  10. mike

    May 10, 2014 at 12:31 am

    My va Dr said he couldn’t give me a refural because we have this war to pay for

  11. Mr. Twisted

    May 10, 2014 at 10:52 am

  12. PASMAN

    May 10, 2014 at 2:48 pm

    I sent for a copy of my VA records from the Phoenix VARO. When it arrived, it was in an open box and it included the records of two other veterans and Congressional correspondence from two different members of Congress- all not mine or related to my records. I filed a complaint with my Congress-critter. Due to HIPPA, I wasn’t even sure I could send copies of other veterans medical records to him. I sent him the names and last four. That was nearly a year ago, and nothing has been done. I do get a call from his staffer every 3 or 4 months to “check-in”. I get a feeling they are giving me the “slow-death” treatment. I’ll give them about one more month and I will go to the news with this shit. His staffer did tell me they are looking at how the VA is grabbing parts of Veterans files and “filing” (mixing) them with other Veterans files. He said this trick replaces the “shredding” trick- that way they can look at the “Press” and truthfully say they are no longer shredding files. My problem is that my C&P increase was denied and I think parts of my file were missing since I have parts of other Veterans files mixed into my file. Okay, I’ll say it- the VA SUCKS!

  13. James

    May 10, 2014 at 5:10 pm

    The VA has good and bad facilities. This goes straight to the quality of the administrators. I saw the Saginaw VA hospital go from #3 in the nation to one of the worst, all from one change in leadership. In addition, the “patient advocates” need to be replaced with people who actually are patient advocates. The current ones are simply system advocates, to tell you why you can’t get what you deserve.

  14. Dana King

    May 10, 2014 at 5:41 pm

    Pressure cooking! The players at the top levels need to stop pressure cooking those at the local levels. These days, most of our work enviroments expect the employee to do more with less (I get it)… the problem is that this attitude has become a strong stapple to the “new normal” and frankly, it is being over used and abused. Those in the positions of decision making are tired of fighting the fight because they can’t win the arguement that more resources are needed to fullfill their required duties. The pressure continues to mount. They know this battle, they lose everytime and nothing changes. Along the hands of time, a false solution is created because the pressure becomes too overwhelming. I am not saying this is an excuse for the wrongs committed! I just fully beleive that the practice of pressure cooking requirements / deadlines, without the proper resources, is a dangerous road to travel if it is meant to sustain an operation for an extended period of time. Stop pressure cooking!

  15. Jon Z

    May 10, 2014 at 6:14 pm

    I know a few guys that had issues with the VA after Iraq and Afghanistan but my grandfather is a Korea vet and they take AMAZING care of him and my grandmother when he needs surgery. They pick him up, drive him to the hospital the next state over, put her up in a condo for over night stays, feed her, and drive them home again.

  16. James

    May 10, 2014 at 6:32 pm

    Some VA facilities are better than others. My experiences as a Veteran has been mostly positive and most of the doctors and nurses that have treated me have been very considerate and professional. However, the administrative bureaucracy can be a challenge.

  17. Murphy

    May 13, 2014 at 12:11 am

    So… I work at an office on a college campus. It’s called the Veteran’s Resource Center. Mainly because there were so many other “resource centers” on campus that a bunch of us vets got together and organized.
    We found the space, went to the meetings, and got some funding. We *don’t* work for the VA, and mostly we help vets figure their way through the uses of Chapter 31 or 33 GI Bill. Also, we help the children of vets use the Chapter 35, and reservists and NG use 1606 and 1607 when it was around.
    My, could I go on…
    Why not do these things for VA medical? There are no laws against it, other than that VA personnel are not allowed to help (Because they might help you get benefits when undeserving. At the irony of this, words fail.)
    It takes a few people with phone numbers they find through scout work (like 11D or 19D, say) and advice from those who have been there. I routinely tell people how to physically navigate the Portland VA.(there is no sign telling you where to physically *GO* start the process, for some reason…)
    The VA system is a bit like finding the Wizard of VA, but we can help each other the same way we did when we were in; just find a Spec4 and pay him for.. err… Oh, Yeah!
    Work together.
    And if we do this in other areas as well (Say, politics?), all to the better.

  18. John

    May 13, 2014 at 8:48 pm

    I have a suggestion. It won’t fix every problem, but I think it could help.

    Bring back firing. Once you get hired by the government, you pretty much can’t get fired unless you say you don’t like gay sex. That will get you fired right away, but aside from not liking gay sex, you can be as incompetent as you want and you will not be fired. Didn’t Shinseki already say he wasn’t going to fire anyone before he even investigated?

    • Mr. Twisted

      May 16, 2014 at 6:35 am

      I think that’s actually one of the better options/ideas out there and I wholeheartedly agree. The safety of a government job allows people to act in a way that suffers very little in the way of repercussions. Similar to the relationship of banks to the federal government, when one is under the impression that one “can’t fail,” one has a lot less motivation to ensure they are doing the right thing at all times.

      • John

        May 16, 2014 at 9:14 pm

        Along that thought process, I’m sure there are competent, dedicated people working for the VA. However when you are working your butt off every day to give veterans the best care you can, and the guy to the left and right of you are shamming away on their smartphones, and you start thinking about how they make the same or maybe more than you do just because they’ve been there longer…. How long are you going to be able to keep up that good work ethic? No extra pay for good performance. No chance of getting fired for bad performance.

        I don’t know about you, but that bothered me a bit in the Army. In the civilian world your pay usually reflects very quickly a change in your performance. In the government world, the pay differential between the workers and the shammers is much much slower to change.

  19. Darik Forrest

    May 20, 2014 at 11:15 pm

    I agree with John. A big part of the problem is that many of the people working for VA know that it is almost impossible to get fired. When people are allowed to be incompetent at their jobs with no repercussions there are those will will rise to that level of incompetence.
    I think the only way to improve the system would be with outside auditors or inspectors that examined things with the ability to remove people. Including those at the SES level that continue to pass the blame.
    On a side note I believe GEN Shinseki should be fired. Not asked to retire, but be fired. Did he know what was going on in Phoenix? Probably not, but he is the head of the organization that was doing outright illegal shit.

  20. Anne

    May 21, 2014 at 10:04 pm

    I believe the fix lies in a very systematic approach by coding those with the most immediate need so theclaims are dealt with in a tiered manner (most obvious or pressing medical needs first on down) and adding doctors as trusted agents (just like IG would for an inspection). This will slow down claims short term, but aid in the long term completion of processing.

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