Health care for veterans – Bob's Story

By Megan Drake

I will start with full disclosure… this article has nothing to do with Philadelphia or dog advocacy. It does have a lot to do with human advocacy… it is about the unacceptable governmental bureaucratic inertia that is alive and well within the United States’ Veterans Administration… and it’s personal – because it is happening to my big brother!

It’s not just the Iraq veterans who are having trouble finding adequate health care within the Veteran Administration system. There are numerous documented cases of the VA being medically negligent in delivering health care to our veteran’s directly causing permanent and irreversible bodily harm the consequences of which are left for the veteran to live with for the remainder of his or her life.

This is Bob’s story: In November, 2006 my brother, then a 56 year old Vietnam era veteran entered the VA Hospital at Palo Alto, California (considered a flagship VA hospital, by the way) for a femoral artery/popliteal artery bypass to his right leg. Due to preexisting conditions, two anesthesiologists strongly suggested spinal anesthesia be used instead of general anesthesia. The Podiatry Department had previously told Bob that the anesthesiologist would not allow general anesthesia. Bob took their advice, he needed the operation.

During the surgical procedure the needle used to administer spinal anesthesia was misplaced causing blood clots to his spinal cord and brain necessitating a seven hour emergency surgery to remove the blood clots from his spine (using the general anesthesia anesthesiologists were certain he wouldn’t survive during the bypass surgery.) He did. The result is permanent nerve damage to his spinal cord with paraplegia. After five days in a coma and on a ventilator, he was assigned to the spinal cord injury ward instead of the traumatic brain injury ward.

That’s bad enough but then during the course of rehabilitation a nurse ran over his foot with a shower chair resulting in a wound that would not heal because of Bob’s pre-existing diabetes. After much advocating going on by the family with VA doctors about their lack of aggressive treatment for the foot wound, including finally getting approval for hyperbaric oxygen treatment (albeit too late to make a difference), eventually amputation of his left leg became unavoidable.

Adding insult to injury, one of the doctors had the audacity to blame Bob for ‘allowing’ his foot to dangle off the shower chair. Ah, excuse me, but if someone is a paraplegic how do they know their foot is dangling off a shower chair? This only served to prove what I knew all along from my many years advocating for veterans as a medical social worker – that logic and common sense are not innate characteristics in VA doctors.

Adding further insult to injury (after having been hospitalized for nine months) is the decision the VA made regarding Bob’s application for VA disability benefits. It took the VA fifteen months to process Bob’s disability claim when we were told the normal time was three to six months. After all, America has that ‘inconvenient truth’ called Iraq going on so that’s not the surprise here. As I’ve stated before, the ability to work in a state of inertia is a pre-requisite for holding a VA job. The VA has over 900,000 benefit claim cases backed up now.

Not only did the review and decision take an inordinate amount of time but he was denied 100% disability in spite of the fact the Social Security Administration awarded him 100% disability within three months of application. The VA increased his disability from 40% to 70%.

Now, if anyone has ever dealt with the Social Security Administration they know just how rare it is for any applicant to be awarded permanent disability by SSA on the first application. You’ve seen all those commercials on television "…if you’ve been denied Social Security Disability… contact our law firm…" It’s actually a sub-specialty in law practice for God’s sake – what does that tell you?

Back to Bob’s story. Wow, the VA approved both a manual and an electric wheelchair for him! Okay, that’s appropriate… but the electric chair remained unused as he was unable to lift open the garage door. You can see the logic in that of course. This forced Bob to purchase another home without 10 steps to get in the front door. Don’t get excited – the VA hasn’t provided any money for the move necessitated by the VA’s incompetency!

Additionally, Bob had to sell his standard shift pick up truck due to his inability to shift the transmission. He purchased a used van with automatic transmission at his expense. He is now working with the VA to trade his electric wheel chair for a lighter weight scooter so that the scooter can be mounted on a lift to provide transportation when he travels out of town.

There’s no accountability in the VA system; employees are not rewarded based on merit, ability or any other measurable criteria that the private sector utilizes. The only thing a VA employee must do to keep their job and get their raises… is to show up!

It has now been over two years since my brother had his left leg amputated. He has been vigilant in attempting to work within the VA system to appeal their denial of 100% disability benefits including at least weekly calls to the Oakland VA office and writing letters to his senators and congressman. The only response politically was for each office to refer the matter to another office for review. In other words ‘pass the buck’ was the game de jour.

Bob applied for an evaluation for Unemployability Allowance based on advice from a representative of The Paralyzed Veterans of America (PVA) organization. He was told this would be quickly approved. After seven months, he was turned down. My brother is a licensed Pharmacy Technician; he responded that he would be happy to go to work in the Monterey VA clinic as long as he could use his wheel chair and a hand grabber to reach medications. The VA never responded to his offer. He’s also a Bail Agent but that line of work has been rendered impossible due to the abject negligence that caused his amputation. Let’s face it, chasing after a fugitive in your wheel chair is not going to end with a successful capture!

A recent article published in QC Politics titled House Appropriators Approve Increases for Veterans’ Programs reports

"Approximately $109 billion of the overall total would go to the Veterans Affairs Department, 15 percent more than the amount appropriated for fiscal 2009 and equal to President Obama’s budget request."

It goes on to quote Subcommittee Chairman Chet Edwards (D-Texas) who stressed the need to hire more veterans claims processors. “Knowing that veterans who have served our nation and answered Uncle Sam’s call when called, they should not have to wait six, eight, 10 and 12 months to get their earned benefits,” he said.

If you are tired by now of my ranting and raving about lack of VA health care – I am too! If there is anyone out there with any ideas or suggestions on how to push the United States Veterans Administration off it’s proverbial backside – I am all ears! Kindly post a comment… every possibility is urgently needed! 

In conclusion, it is my ardent hope when universal healthcare is finally legislated in this country that it is NOT modeled on the VA system for we will surly all die an early and painful death. Oh, wait a minute – I guess that’s the plan after all, is it not? Get rid of the elderly and infirm since they are a burden on the tax payers… Is there anyone out there that can help?