VA Joins White House in Reaching to Military Families

Dear Brenda Hayes,

As I just now read your response as well as your valid points in your commentary that were so right on point! As you are struggling to receive help with your spouse my heart goes out to you and your veteran. As I am the veteran who has been seeking assistance for
years with the VA, although I was not exposed to AO, I however, was exposed to asbestos while in the Navy. As a Toxicologist who wrote an opinion (medical nexus) letter on my behalf stated that in the brief time that myself and other Navy personnel who worked with and handled this asbestos our exposure level was comparable in just daily contact for approximately ten months or so was the equivalent to an individual that had worked a forty hour per week at a job for twenty-five years. Yet despite having two retired Navy veterans providing witness statements, as well as DD214’s and Performance Evaluations that praise my job performance working in the area(s) that the exposure took place, as the VA has stated “Exposure has yet to be established in your claim”. Even utilizing “Junk Science” as one of my doctors said when my VA regional office denied benefits called are one of the countless deny, delay tactics that the VA uses in their unethical bag of tricks to deny, frustrate veterans such as myself and others. In the initial ruling issued the logic used by the medical professional was that since I did not have asbestosis in addition to the cancer that I developed, then this only further substantiates that my asbestos exposure did not occur. Which as one of my doctors said in response was the same as saying that even though a patient develops lung cancer from asbestos exposure, that that his/her exposure never took place unless he/she had asbestosis to boot. The argument is ridiculous, but yet these VA contracted doctors offer these medical opinions and the VA adjudicators as they are not medical professionals are more than happy to follow their lead and render these absurd rulings. In my case I filed a claim in 2005 as four of my doctors said that my cancer was caused by my asbestos exposure while in service. Now unfortunately as of last year I was also diagnosed with Asbestosis which should now only further my claims contention that my cancer was caused from asbestos exposure right? Well wrong, as I recently found out as I had filed a claim for service connection for asbestosis and underwent a C&P examination for this illness. You see the ridiculous is always possible concerning the VA and this was only further re-enforced at this examination. I had mailed in the supportive evidence that my doctors had based there diagnosis on concerning the asbestosis. I know the VA had received this medical evidence as I had a signed receipt from FedEx. Then I had physically carried the mountainous volumes of paperwork that composed my claim file to the Pulmonology department, where I was greeted by a cordial doctor who seated me in an examination room and excused himself for five minutes. When he returned he thanked me for my patience as he said that he needed to review my claim. I asked if he had read all the evidence that I had submitted, to which he replied he sure did. First blatant lie right to my face, I had submitted CAT scan report after CAT scan report from the years 2002 to 2009 along with medical opinion statements from my doctors and experts, witness statements and on and on. No Evelyn Wood speed reading course possible would have allowed for this person nor any other to consume and comprehend the information that was my evidence. The examination continued and as I asked the doctor question after question concerning what he supposedly had just reviewed which he greeted with silence and clear embarrassment as he knew that I had caught him in a lie. This same doctor then asked me to explain my asbestos exposure which I gladly recounted for him with as many details as possible. As I again began to question this doctor the seat got too hot for him and he said that he needed to consult his resident in charge and would be right back. So after another five minutes he returned with two more gentlemen who one of them identified himself as the resident in charge of the Pulmonology department. Now this doctor took over the examination to which he said that he had looked at my last CAT scan that was conducted at the VAMC in 2006 (This is now February 2011) and proclaimed as in a miracle “You have no signs of any asbestos related lung disease!” Halleluiah! Well now I am totally relieved, how wonderful! Then I asked this same doctor if he had read all the other evidence that I had submitted to which he said that he had. So I said first doesn’t common sense say that if this in now 2011 and you are making a medical diagnosis would you not want to utilize the most recent reports, exams, tests as possible? I said if you had a child and were consulting a doctor about your child’s health would you look at something from 2006 or 2009? This was met with silence. I said look the way that asbestosis is diagnosed is that radiographic films from over a period of time usually many months and years between are compared and contrasted. When these are reviewed things such as interstitial lung disease, pleural plaques, pleural fibrosis, pleural thickening and all these other lung abnormalities that are noted are evidence and are indicative of having asbestosis. I said that this is throughout any literature anywhere that you read concerning asbestosis. This or an actual biopsy that can actually identify the actual asbestos particles. I said in reviewing these CAT scan reports is anyone of you an American Board of Radiology Certified “B” Reader? I explained that this is a medical doctor who has been specifically trained to diagnose asbestosis when reading radiographic films such as x-rays or Cat scans, so are anyone of you certified? Once again I was greeted with silence. In fact now this doctor began to try and talk over the top of me as though I was not even there. I said look I have brought with me both the reports and a copy of the actual films that I have submitted that two of you have said to me that you both have already read and reviewed, along with all other evidence that I have submitted to the VA regional office. Would you like to go over with me what my doctors have said as well as comparing and contrasting these reports or films? Again silence and discomfort. I said what you have done is said that you have reviewed all the evidence and have not. Next you have chosen a CAT scan taken from five years ago that does not list any of the symptoms that clearly identify asbestosis and despite what my doctors have diagnosed proclaimed that a miracle has taken place that I do not have the disease that you are supposed to honestly and objectively investigate whether or not has occurred. The resident in charge asked me about the nodules on the exam that he was referring to, he asked me if I had an biopsy? I said that a biopsy had been done as well as a lengthy discussion had been held with the Pathologist who said that although he had only been looking for cancer but that he had noted granulose material had been identified. He further said that the sample had been taken from mid-lung and that it has been his experience that the best location for retrieving samples that may contain asbestos paricles would be from the lung base as this is the area of the lungs that asbestos as well as other particulate matter would collect. The reason is simply the way the lungs function as we do not fully expand our lungs and as such do not expel material and so asbestos fibers begin to collect there first. Having said this the doctors stood up and said that they wanted to schedule me for a Pulmonary Function Test. I said look you and your associates have demonstrated that either the VA regional office is negligent in that either they did not provide all the evidence that I had submitted and you were unable to review this? Or the evidence is there and you have chosen to be negligent and refused to review this evidence? I said either way this has been a farce and that no matter what I said here today had any impact on this examination. I said that you and your staff have determined no matter what I said or did that you were going to make sure that under any circumstances that I did not have asbestosis, period. I said that I will be filing a grievance with the VAMC, the VA regional office as well as anyone else that will listen to me, that is a promise. I said if for the fact that as you have tried to railroad me that I want to prevent any other veterans that appear in this department that they will not be railroaded as I have, this has been absolutely sickening. I said that this has gone against every basic principle that the VA is supposed to stand for concerning veterans that have been injured or develop diseases as a result of serving in the military. Of course I followed up and completed the Pulmonary Function Test which my wife and I then picked up a copy of both the test as well as the C&P examination report. I followed up with my primary care physician who interpreted the report and then said after I explained what had happened that I needed to be re-evaluated and submitted another referral. When we read the C&P report sure enough the doctor said that I did not have asbestosis and that they had based this on the 2006 CAT scan which had been compared with another CAT scan that had been taken two months later in that same year. Wonderful since that was 2006 and now this is 2011. Once again the VA has demonstrated its objectiveness and fairness! Furthermore, the Pulmonary Function test was interpreted and it was stated that I had normal lung capacity. However, regarding the two other critical areas concerning how my lungs are actually performing these could not be interpreted and as was noted by the technician “Due to lack of effort from the patient.” his despite during the entire testing the technician would demonstrate what he wanted and then I would try and repeat what he had shown me, all the while yelling good, good! Why have I relayed this long story with so many details? Simple this is only one example of the corruptness of the VA’s Compensation and Pension examination process. From our point of view this whole process is a conflict of interest right from the very start of it. These VA doctors who are employed by the VA are supposed to be objective, yet this as in other cases does not occur. Their purpose is to find evidence on the VA’s behalf that the veteran does not have any service connected injuries or illnesses. The deck is stacked against the veteran before they even appear for the examination. If the VA was truly getting to the truth of the matter they would contract and have civilian medical doctors conduct these examinations. I know the VA’s issues of logistics and transportation for the veterans and so on, but this does not hold up. As in my case do I now take the medical opinion of a VA Pulmonologist who proclaims that these is no issue? Or do I follow the lead of a medical doctor that is a “B” reader along with an doctor that is a Toxicologist and another that is a Occupational and Environmental Health Scientist as well as the countless Radiologists through the years which have noted time and time again on these radiographic reports in their findings of pleural plagues, fibrosis, pleural effusions, blebs and all the other indicators of asbestosis? Not to mention the physical exertion that happens with even minimal activity? I followed up with the VAMC Patient advocate and was finally informed that I could undergo another evaluation by a different doctor at the VAMC Pulmonologist department, or I can go to another VAMC of my choosing. As a result of my two bouts of cancer from the asbestos exposure and all the secondary health issues from the cancer I will never be able to work again for the remainder of my life and since I was the primary bread winner we now live in poverty. But the VA has burned this bridge with me, so now I must utilize Medicare and seek monitoring and treatment in the civilian sector, which now will cost us even more medical bills. All because doctors that are employed by the VA are not objective. They do not put the patients health first and foremost, they put their paychecks first, while the VA encourages this either formally or informally. I underwent a C&P examination with one doctor who was supposed to be examining me for one issue. He said that the VA only wants him and other C&P doctors to investigate specifically what is on the request for the report when veterans appear in front of him for an examination. However, even in the VA’s own guidelines that if while investigating one injury or illness another is identified then the doctor should make a determination if this disease needs follow up or may be service connected as the veterans health should be the main focus. As he was examining me he encountered another medical issue and said that this was in his opinion clearly service connected and I eventually received compensation. This same doctor said that many of his colleagues turn a blind eye to such things, they are afraid of loosing the easy pay from the VA as most of them are retired and conduct these exams as an easy source of income, no stress, good hours a comfortable job. My personal recommendations for anyone that may read this is to ensure that ensure that you bring a witness, bring a spouse a friend or a family member. Ask questions, do no be afraid to point out things that you know to be true concerning your health. Make sure to take notes afterwards or during of what has occurred, list as many of the specifics as possible. Remember as in my case since now my claim was formally denied that you will be appealing and you can further substantiate your appeal with facts. When I received the Boards decision the evidence that these doctors where supposed to have examined and reviewed were listed as part of the evidence used in determining the Boards decision. File a compliant with your local VAMC as well as your local VA regional office. Unless these doctors are held accountable there never will begin to have positive changes made to ensure that our veterans are evaluated fairly and objectively. In my case irregardless of any VA claim my health comes first and foremost as does any veterans, as I have been told that I have potentially another fatal disease I needed another fair objective medical opinion and I tried to achieve this from my local VA, which didn’t happen. Do not be afraid to get other opinions and have additional examinations from medical doctors.

Madam Undersecretary,

I also am glad you are where you are as I know you do care about Veterans and family members. I am in awe of who and what you represent; not only to all Veterans and family members; but to all women.

Since you wrote this commentary regarding the White House concern for Veterans and family members; I also would like for you to find out what conduit does the White House Program plan to use to find out what is working and/or not for us?

As well, I would appreciate your comments on the following:

Would you please ask the Secretary, when will the Under Secretary of the VA Health Benefits Administration going to show up on the Blog site like Under Secretary for Disability Assistance, Mr. Pamperin? This Undersecretary needs to know what is happening with Veterans and family members under his area of responsibilities? All the Under Secretary’s should be participating!

How do you see the Senate/House Veteran/Family members caucus to be helpful to us?

For All Veterans and Family Members, I would like the Secretary or someone at that level to explain:

Why all VAMC Directors do not have an “open door policy”? Do they work completely independently of D.C.? It does seem there is No Accountability to Veterans and Family members with the VAMC’s.

Why the VAMCs Directors don’t have an email address that these complaints, etc. can be sent directly to them?

Why all VAMC’s do not have an Advocacy Committee made up of Veterans and Family members that meet on a frequent basis with the VAMC Director with concerns, complaints, suggestions from the Veterans and family members they are supposed to be serving?

Importantly, why is there not a Ombudsman at the Secretary’s level to deal with the concerns of Veterans/family members?

Why is it that the Recovery Coordinator Programs, which should be at all VAMC’s (and are NOT), are only highly suggested instead of mandatory?

(I’m trying to get assistance for my husband with a VAMC who does not have a RCP with its accompanying WRAP Program and peer support group) (Most of these RC positions have been up and going for over two years and some are not sharing what they are supposed to be doing as well as making their required 3 or 5 year plan at the local VAMC available. (that’s not transparency)

I’ve been waiting several days for a person from the West Palm VAMC who is over the CBOCs to call me as well as a PA from a VAMC. In my endeavor to assist my Veteran in getting help, I have two kudo’s–Ms. Johnson in the HBA office at West Palm VAMC and the Lead in the Eye Clinic at the WP VAMC.

I am being told that there is no program that can help my husband with his cognitive and memory problems in the VA system; apparently, I can only get help from the VA with this when/if he gets to a nursing home stage or needs daycare!(from the Outside Community)

I have been referred to two Community resources by a CBOC SW: one which was inappropriate as they had NO services for this level; as well as another referral who did not have anything as well!! (I call this the Resource and Referral Merry-Go-Round to nowhere!) Somewhat like the Alaska Multi Million Dollar Bridge to NoWhere!

As well as there not being any programs for Veterans dealing with their SC “first stage” disorders of memory/cognitive issues; there are no support programs, seminars, retreats, etc. for spouses that are dealing with “caretaking” issues of these Service Connected disorders.

I have a Masters in Rehab Counseling and I know there are programs that can be designed and offered for Vets and their family members that are experiencing these SC issues.

VA’s own research states that, more likely than not, the PTSD Vets will experience issues of memory/cognitive (dementias)and/or to include Alzheimers.

Why isn’t the VA speaking about how the Veterans exposed to A/O and the other 50 or so toxins are/will be affected– the Central Nervous System which includes the Brain (symptomatically, neurotoxicity acts like a closed head trauma–TBI’s)?

I’m talking to VAMC Docs and Social Workers, Psychologists, that don’t even know this information–VA’s own research!! What’s wrong with this scenario?

Are you aware that there are A LOT of Vet Centers (including the PTSD CLINIC in Port St. Lucie, FL-outpost clinic of WP VAMC that do not have support or therapy groups for Spouses/Significant others? This is NOT a new issue!

Recently, I asked a Vet Center “therapist” what their VC was doing or planning for outreach for a Spouse/Significant others, such as support groups, etc., he answered, “I don’t have to tell that information!”

Since 1985, as a spouse, I have never seen or experienced any OUTREACH to spouses/family members!

Why is there not an email that “customers” can send their complaints, and suggestions, etc. to the Director of each VAMCs?

As well, an email to CC the Under Secretary of the HBA/and/or the Secretary.

I don’t think “upper management” at the VA (Secretary and/or his Under Secretarys are aware of just how much dysfunction, ineffectiveness, and/or lack of competent services are in the “field”.

As well, why does not IRIS respond in a timely and substantial manner?
Who’s command does IRIS come under? Are they going to do a “guest” commentary?

Also, please post the “new” 800 Hotline at the VA. I had it and misplaced it and why is it not readily available?

I think I posted previously (somewhere on this blog) about my experience in trying to use the VA HOTLINE for homeless issues and the Secretary needs to know how IT is not working well.

In trying to find a homeless Vet help, I did call the 800 Homeless Hotline and was told, “… call the local VAMC homeless program; no response; then call the VAMC Patient Advocate;no response and/or or if that doesn’t work, call your representatives in Congress!

IS this the answer that is supposed to be HELPFUL? (It was a Call Center in a VAMC in NY)

Also, the VA cannot think that the Veterans/Family members will believe they want to “fix” things if they continue to say, “mail it” instead of using 2011 technology!!

The message is clear..”we really don’t want to know”! It’s like the VA continues to send “double messages”. Double messages cancel each other out–so it’s VA business as usual!

You CAN”T Fix it Unless you Know about IT!

Appreciatively,

BH
Vetwife Advocate

P.S. I just got off the phone with another VAMC issue.

Yesterday, I had already spoken to the Eye Clinic at WP VAMC; someone was supposed to get back with me…I tried to get back to the person I spoke to yesterday to see what she had found out and about the canceling of the Walmart optometrist in Stuart, Fl for tomorrow. The operators kept forwarding me to scheduling who refused to put me through to the EC; I asked for the EC extension and they just gave me the Scheduling extension w/o telling me! Ms. Joy,. the scheduling clerk,insisted that they would help me and I did not have to speak with the person I spoke to yesterday! She said she could not forward my call to the Eye Clinic nor give me the extension!!

Not sure how I got to the Eye Clinic yesterday with all the problems I’ve had today. I just got lucky and found an Operator that “can think outside the box” and listened and wanted to assist me; he put me through to the front desk of the EC. I had spoken to Mr. Watson, EC clerk yesterday; he was very nice and very helpful and relayed my concerns to Ms. Robinson ( I also found her to be very good with customer service yesterday and very pleasant) and relayed back to me that she is still awaiting the “answer” from John (I assume the EC manager)?

So, I found out I (the Veteran) had to cancel the apptmt (which was fee based) (so I did immediately) and now await to see when/if he will get the VAMC EC apptmt with a ophthalmologist. (order from his Dr. at the Stuart Clinic–who I can’t say enough about how thorough she has been with him, a Dr. Shipman. My Vet has early cataracts (has had them for years) and, more likely than not from the SSRI’s he been taking for his SC disabilities. (also, know fact/research)

The VA EC at McGuire VAMC in Richmond, Va had no idea of the connection of early cataracts due to SSRI’s and apparently still doesn’t get it that UV/UVB eye protection is completely necessary with this stage or another stage of cataracts! (What is wrong with this picture again?) They refused to give him an order for the appropriately tinted (protected) eyewear or the transitional protected lenses.

Just another walk in the VAMC park!!