Ready To Stop Bad Faith Insurance Denials Of Non-VA Emergency Bills?

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Non-VA Emergeny Bill

Do you have an experience you would like to share about Veterans Affairs denying payment of your emergency room bill in a bad faith insurance denial?

We would like to hear from you if you do.

Over the weekend, I discussed stories with a press team about various veterans who were stuck with hefty emergency room bills by VA and its Non-VA Care Department. These stories include my own recent experience with the program and a bizarre denial that lacked any explanation. The news team and I intend to get to the bottom of this issue.

Frankly, my goal is to now force VA to pay millions to cover improperly denied emergency room bills. By getting this story out through my friend AJ Lagoe at KARE 11 News, we stand a great chance at making a national difference.

(email AJ at [email protected])

I think it is time we send VA a message. That message is to start using common sense when adjudicating claims of any type, including claims for Non-VA Care for a medical emergency.

Dear VA,

Your practice of wronging denying claims where the veteran is clearly entitled is fraud or bad faith insurance adjudication. Since VA possibly has government contractors or its own employees applying the wrong standards using the old Allstate “Delay, Deny, Defend” model, this practice could result in a massive class action lawsuit against the government contractor engaging in the fraudulent practice.

Stop encouraging fraud and change the practice of your employees or contractor immediately.

Thanks,

All Of Us

Bad Faith Insurance

Basically, at least in Minnesota, bad faith insurance laws require the insurer adjudicate claims in good faith.

Should an insurer deny a claim, the person who is insured has a cause of action against the insurer if she can prove the following:

  1. There is no reasonable basis for denying the benefits of the insurance policy, and
  2. The insurer was aware of the lack of reasonable basis for denial, or acted in reckless disregard of that fact.

VA has a department called the Chief Business Office where fee-basis claims are processed. Those claims are now called non-VA care claims, and they are generally processed by a government contractor under the umbrella of VA or VA employees directly. Nonetheless, that contractor aka vendor is an insurance company.

Presently, we know Healthnet and Triwest processes some non-VA care claims for the agency (mainly related to Veterans Choice). That said, I want to set out the following involving my own story with the hope that many of you will reach out and share your own story.

Bad faith insurance adjudication is against the law. VA’s government contractors aka vendors can be liable if they get caught engaging in fraud or bad faith insurance adjudication in many states. We do not know who adjudicated my claim, but I will find out.

It is possible Minneapolis VA adjudicated the claim in house, since that is what the letter seems to suggest. It is also possible it contracted out the responsibility and then approved the decision with its logo and stamp on the document. We shall see.

[email protected] @DeptVetAffairs Stop Your Bad Faith Insurance Denials Of Emergency Care! Click to Tweet

Here is my own story.

My Chest Pains Experience

In February, my ex-wife died from burn pit-related pancreatic cancer. She was 36 years old and was survived by her husband and three children.

RELATED: Amie Muller, Latest Burn Pit Victim, Dies

Shortly after her untimely passing, I experienced what I reasonably believed to be symptoms of an evolving heart attack or stroke.

Technically, I experienced an acute potentially life endangering medical emergency: malignant hypertension with cardiovascular and neurovascular symptoms including chest pain, respiratory difficulties, sensorium disturbance and bowel incontinence, to name just a few.

My memory of the emergency is incomplete, but my wife recalls looking up symptoms of heart attack online at 8:30 pm, concluding I was experiencing such symptoms including chest pains, and immediately driving me to the nearest emergency department.

Our driveway is quite steep, and with the ice this winter, would not allow any ambulance or other vehicle without 4-wheel drive up.

As we all know from public service announcements about stroke and heart attack, every minute matters, and anyone experiencing a similar medical condition should immediately seek emergency care. So, we went to the nearest emergency department.

This all seems prudent to me and basically what any layperson would do in a similar situation. Luckily, the medical doctors on hand were able to resolve my malignant hypertension before a stroke or heart attack. But without the emergency care, it is probable that I would have died or suffered permanent injury.

After I returned home, and within the 72-hour window, I notified VA of the emergency for coverage by its Non-VA Care Department. I even wrote about it here to help readers file their claims for coverage.

RELATED: The Next 72 Hours – 3 Things Veterans Must Do Following Non-VA Emergency Care

The next month, I spoke with a senior VA official about the incident at the direction of VA Secretary David Shulkin, MD. They reassured me they would take care of it and that I should send my bill in to them. I was under the false impression this meant VA would pay for the ER bill.

Months later, I heard nothing from them or from Minneapolis VA to process the Non-VA Care claim, but I was sure to forward the bill once I received a copy. Two weeks ago, I heard from Minneapolis VA for the first time. The liaison informed me he had no knowledge of my claim.

So what was VA Central Office (VACO) doing with the information? I am not sure.

Why did they ask me to send the bill to VACO? Again, I was under the impression the matter would be resolved there, as there is more to the story that I will get into in a bit.

This Friday, I received the below denial wherein VA basically asserts a prudent layperson would not have sought emergency care with the medical condition I had at the time:

The above listed claim has been administrative and clinically reviewed to determine if it meets eligibility requirements for payment for service connected emergency unauthorized medical care. We regret to infom1 you that your claim does not meet the requirements of 38 U.S.C. 1728.

In order for VA to reimburse the non-VA provider on your behalf for the service connected services provided, the following eligibility criteria must be met: (1) Treatment was emergent according to the prudent layperson standard; (2) VA facilities were not feasibly available and attempt to use them beforehand would have been hazardous to life or health by prudent layperson standard. Furthermore, the emergency treatment must have been for at least one of the following: (1) An adjudicated service connected disability; (2) A non-service connected disability associated with and aggravating an adjudicated service connected disability; (3) Any disability of a veteran who has a total disability permanent in nature resulting from a service connected disability; (4) Any illness, injury or dental condition of a veteran participating in a rehabilitation program under 38 USC Ch. 31. 

This claim for VA reimbursement has been disapproved for the following reason(s):

Claim Denied – The treatment provided does not meet the Prudent Layperson definition of an emergency. 38 CFR 17.120(b).

If you do not agree with this decision, you have the right to appeal…

I think you get the gist of it. Sorry for your trouble, screw you very much, oh, and thank you for your service.

So what is a prudent layperson?

Why did VA not include an explanation of why the treatment provided did not meet this standard?

How many veterans get stuck with a bill via a vague and ambiguous denial like this?

Prudent Layperson Standard

For this, I turned to review the regulation cited using the Cornell legal database, which states for the relevant regulation concerning emergency care:

(b)In a medical emergency. Emergency treatment not previously authorized including medical services, professional services, ambulance services, ancillary care and medication (including a short course of medication related to and necessary for the treatment of the emergency condition that is provided directly to or prescribed for the patient for use after the emergency condition is stabilized and the patient is discharged) was rendered in a medical emergency of such nature that a prudent layperson would have reasonably expected that delay in seeking immediate medical attention would have been hazardous to life or health. This standard is met by an emergency medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) that a prudent layperson who possesses an average knowledge of health and medicine could reasonably expect the absence of immediate medical attention to result in placing the health of the individual in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part.

Basically, it says VA will pay facilities for care provided to certain veterans when a prudent layperson (whatever that means) would reasonably expect a lack of immediate care could result in putting that veteran’s health in serious jeopardy, impairment of bodily function, or serious dysfunction of any bodily organ or part.

Personally, it seems reasonable to me now to believe my heart my stop due to heart attack or stroke. I assume “heart stopping” or “death” is sufficient to meet the serious dysfunction standard.

So what is the problem? Why is VA confused on my case? Further, why are countless veterans receiving denials who sought emergent medical care for heart attack or stroke symptoms?

Prudent Layperson Fact Sheet From VA

The “prudent layperson” standard originated from Medicare law in the 1980’s and was established as a standard for Medicaid effective October 1997. The standard was then adopted by VA in 2010 per the Federal Register.

Using my cyber-sleuthing techniques (ie Google within 5 seconds), I was able to dig up a VA document that explains the standard, its use in VA adjudications now, and an explanation of medical necessity. This document made me wonder how Minneapolis VA and its Non-VA Care Department could screw up my claim.

I would like to repeat one thing. It took my 5 seconds to find a sheet published by VA that explains how to assess a case and what the prudent layperson means.

Would you be surprised to learn it addresses a case exactly like mine – – and that such cases should be approved – – not denied?

DOWNLOAD: VA Prudent Layperson Fact Sheet (from Puget Sound VAMC)

And, I know, some of you may be saying, “Well, you were not diagnosed with a heart attack, so maybe VA was correct to determine your symptoms did not show a medical emergency requiring emergent care.”

I can see why you would say this, but VA’s own guidance on the subject explains this reasoning is incorrect.

Now, instead, you may be saying, “Many VA executives hate you, Ben, so why would you expect to be treated fairly?” I will get to this in a second.

In bold print, that Prudent Layperson Fact Sheet states, “A determination of a medical emergency focuses on the patient’s presenting symptoms rather than the final diagnosis.”

Prudent Layperson And Medical Necessity

The full section on medical necessity reads:

Any medical condition of recent onset manifesting itself by acute severity of symptoms, including severe pain. A determination of a medical emergency focuses on the patient’s presenting symptoms rather than the final diagnosis.  

Adjudicative decisions are made on a case-by-case basis. However, certain conditions are the leading cause to seek emergency treatment. These conditions include, but are not limited to: loss of consciousness, seizure, no recognition of one side of the body, paralysis, chest pain, shock, gangrene, coughing blood, trouble breathing, and choking.  

Cases that fall into categories that may be chronic or blatantly non-emergent generally do not fall into qualifying for immediate treatment under the prudent layperson standard. Normal follow-up of a medical condition, removal of stitches, or medication refills would generally be considered as non-emergent conditions under the prudent layperson standard.

Notice the explanation includes symptoms I experienced including chest pain and trouble breathing. Again, since I experience chest pain, and this was reported to the emergency department, how come Minneapolis VA denied my claim?

Coincidentally, Case Example A in the document addresses a similar situation as mine, where the veteran presented with a complaint of chest pain:

A patient presents to the emergency department with a complaint of chest pain. The patient is examined and evaluated and discharged with a diagnosis of mild gastric irritation. Retrospective analysis by a Fee Basis Unit may determine that gastro-intestinal upset is not an appropriate use of an emergency department and deny the claim as non-emergent. However, the patient’s initial judgment seeking emergency treatment regarding his/her chest pain, a potentially serious problem, is appropriate. This type of visit clearly falls into the category of what any prudent lay person would consider an appropriate use of an emergency department.

Seems open and shut, right? And, since VACO offered to help resolve the matter, why was my claim denied despite being on point with VA’s own guidance?

Minneapolis VA Has A Beef With Benjamin Krause?

I can only conclude this result has everything to do with an ongoing dispute between me and Minneapolis VA about policy and my work as an investigative journalist and attorney.

In the past, I was threatened by a VA employee. The threat was confirmed by VA OIG and relayed through a contact of mine at Vietnam Veterans of America.

Two years later, a social worker at Minneapolis VA told me I needed to watch my back because of how vindictive VA employees might be while seeking medical care.

A year later, I requested non-VA care on a permanent basis because I do not trust that VA can provide me with appropriate and beneficial health care given the nature of what I do.

Is my concern justified? Minneapolis VA director Patrick Kelly does not think so, but let me know what you think in this context.

My Recent Work At VA

Most recently, I exposed a $1 billion traumatic brain injury (TBI) scandal originating out of Minneapolis VA where the facility was fraudulently selecting unqualified doctors to conduct initial TBI examinations. I worked very closely with KARE 11 News and AJ Lagoe to expose the fraud. AJ and his team executed a nationwide investigation that exposed rampant fraud negatively affecting at least 24,000 veterans dating back to 2007.

AJ and his team won the Peebody Award, IRE Top Investigation Award, and the Golden Padlock (on behalf of VA) for VA being the most secretive agency in 2016. It was a big deal, and former Secretary Bob McDonald issued the largest Equitable Relief package to date allowing affected veterans to come back in for a new assessment and an effective date back to the date of the error where an unqualified doctor was used.

It was the biggest scandal I have exposed through partnership with the press to date.

WATCH: NBC TBI Investigation Report

I also helped fund the three “VA Is Lying: Veterans Are Dying” billboards that surrounded Minneapolis VA in 2015 for one month. Its employees were so distraught that they asked Director Patrick Kelly to do something. My wife and I even helped design the signs.

Director Kelly was forced to write an email to all staff explaining that the “disparaging message about VA” was a form of protected speech, and that he could not do anything about veterans exercising our 1st Amendment Rights.

RELATED: Leaked VA Email Decries ‘VA Is Lying’ Billboards

“Like all Americans, Veterans have the right of free speech and are welcome to exercise that right even when we don’t agree with the message,” wrote Kelly. “If you are asked by your family, friends or neighbors about the billboards, assure them that Minneapolis VA is committed to providing timely, high quality healthcare to our Veterans.”

The email written by Kelly but delivered through his assistant Donna Carpenter, reads:

Team,

I want to update you on a couple issues being covered by the local media and provide a little more context.

First, there is continued coverage of the issue of initial Compensation and Pension TBI examinations for our MPLS area Veterans. As I stated in my 6 August email on this subject, we did use the wrong type of examiner as has been reported. Once we identified the problem, we acted aggressively, and in coordination with the VBA Regional Office, identified all affected Veterans and took appropriate actions to ensure they get the benefits they’re entitled to.

To ensure that we’re on the right track, we’ve reviewed our internal processes and have asked an external reviewer to assist us in making sure we’re not missing anything. One of our distinguished MN Congressmen has called for a nationwide review and we fully support this as a means to make sure we’re doing everything correctly going forward.

Second, advertising billboards in the area of HWY 62 and Cedar Avenue in Minneapolis are displaying a disparaging message about VA. One billboard is located across the street from a VA office building. Similar billboards have appeared near VA Medical Centers in Florida, Georgia and Illinois. Like all Americans, Veterans have the right of free speech and are welcome to exercise that right even when we don’t agree with the message. If you are asked by your family, friends or neighbors about the billboards, assure them that the Minneapolis VA is committed to providing timely, high quality healthcare to our Veterans. Encourage them to visit our VA, talk to Veterans and even volunteer to help us in our sacred mission. Anyone wishing to volunteer here should call 612.725.2050. The billboards have drawn the attention of several news media outlets. As a reminder, in the event that you are contacted by the press for comment about the VA, please refer them to Ralph Heussner, our Public Affairs Officer, at 612.467.3012.

You can all be incredibly proud of the work you’re doing. It’s an honor to serve with you in caring for our Veterans.

Respectfully,

Patrick J. Kelly, FACHE

Director, Minneapolis VA Health Care System

612.467.2101

Now, before the TBI scandal, I also exposed problems with the “as the crow flies” rule concerning the Veterans Choice Program, again through KARE 11 News and AJ Lagoe, highlighting the unfortunate case of Paul Walker, a now deceased veteran desperately seeking cancer treatment.

That coverage made the Daily Show with Jon Stewart just prior to VA changing the “as the crow flies” rule to instead using real maps.

RELATED: Jon Stewart Nails It On Veterans Choice Card

By exposing this scandal, AJ and KARE 11 won an Emmy.

And, as if this was not enough to potentially justify being at least concerned about any VA employee treating me for symtpoms of heart attack, I was just informed VA attorneys complain about me to the Department of Justice for being too zealous in my prosecution of appeals and torts on behalf of my clients.

What good news! But that news does not make me feel any safer receiving invastive, emergency health care from any VA facility anywhere.

Needless to say, I have been busy as an attorney and reporter and exposing numerous scandals through collaboration with AJ and his team. Lucky for us, VA seems never to shy away from providing topics worth exposing and we are happy to oblige.

Request For Non-VA Care

Minneapolis VA denied my request using the expired Clinical Appeals policy originally published in 2006 that literally states it expired October 31, 2011.

I informed VA that they were using an expired policy and that they should be using an updated policy for my request, which they later refused to accommodate.

When I requested a hearing, the same personal hearing any veteran is guaranteed after a denial of benefits, my hearing request was refused… approximately 5-6 times.

Instead, Minneapolis VA repeatedly restated in its repeated denials that I was in fact entitled to a hearing, but the agency failed to ever schedule the hearing despite my requests.

Finally, after one year of back and forth, VA certified my Form 9 appeal to the Board of Veterans Appeals, which effectively kicked the can up the road for five years. By the time it gets remanded, it will be someone else’s problem. And, perhaps the individuals I would have subpoenaed would no longer work at VA.

Enter VACO And Why They Reached Out

So, last March VACO reached out to discuss the matter after I filed a notice of my intent to file a writ of mandamus with the Secretary.

This matter is obviously somewhat complicated because no “prudent layperson” would likely seek health care directly from a VA medical doctor given this history.

But that was not even relevant here since everyone knows you need to rush to the nearest emergency department to seek emergency care when experiencing symptoms of heart attack including chest pain.

It is now going to make the press, thanks to Minneapolis VA, yet again. But we need your support and stories to make the impact necessary.

No doubt thousands of veterans are wrongly denied each month by Non-VA Care, which is really just the new term for the Chief Business Office based in Denver.

I would like to expose this. So, please post your stories below and reach out to AJ Lagoe, at [email protected]. Please send your denial letter as a PDF to him as well.

Together, let’s send VA a message.

“When you screw with us, we will expose you by name in the press.”

[email protected] @DeptVetAffairs Stop Your Bad Faith Insurance Denials Of Emergency Care! Click to Tweet

My $6,000 wrongly denied ER bill will turn into millions worth of denials being overturned once we get this scandal fully exposed.

These denials are due to bad faith insurance adjudication by Minneapolis VA or on behalf of Minneapolis VA. Either way, this broader matter of veterans being screwed by a fraud scheme or bad faith insurance adjudication will be exposed.

Disgruntled Veteran
Disgruntled Veteran

Following.

Angela
Angela
Benjamin, I guess it never ends. Americans with including veterans are stuck to no end. Congress, the Senate, and the VA just do not get it or have any insight at all. The situations with the American citizens with including the veterans all lead directly back to the Congress and the Senate even the VA with their Socialistic agenda. Benjamin, people are stuck due to being stepped on, slammed, and discriminated against due to disabilities or whatever the circumstances happen… Read more »
Angela
Angela
Adding to my comments. I am speaking about the VA healthcare. The system does not allow for enough dependability, flexibility, and accountability for one to be able to try to hold a job or even be in school. Benjamin, the professors and the companies will not wait on the VA. Benjamin, the misuse of time in the VA conflicts with a veteran’s outside schedule. When I went to the VA, I never knew if I would get out of there… Read more »
eric mckenney
eric mckenney

Just to show how bad emergency room care is, I was seen at a VA CBOC and they decided to send me to a local emergency room, Not only did they deny the payment at the ER, they also denied payment to the ambulance they insisted I take to the Hospital. If the VA PCP is unable to determine if an Emergency Room visit is required, who must approve it.

James Gallegos
Get a copy of your cboc visit, that has to show your visit and it should show that they refered you to the E R. Send that back to the people who denied it. DoD you call the nurse hotline number within 72 hours. What was the reason for denial. When did this happen. It was posted where the VA was given money to pay for emergency room visits for non service connected conditions. The VA was caught not using… Read more »
Don Howard
Don Howard

HUNDREDS IF NOT THOUSANDS IN SOUTHEAST MICH

Crazy elf
Crazy elf
I’ve always been afraid to use the non-VA emergency room! Mainly because I don’t want to be stuck with the Bill! My health is deteriorating, because I’m NOT receiving proper medical care by a PCP I believe hasn’t passed the proper medical exams in America! She went to a medical school in Poland. When I asked her “Where did you go to medical school?” She answered; “Atlanta!” If she’s truly a medical doctor, why wasn’t she being truthful? This comes… Read more »
Richard Rust
Richard Rust
Crazy isn’t it ..lol Have had Issues since Dec 2015 when I started mentioning things since then I’m now on 3rd PCP who last Visit when asked about TBI by Me ; She responded that doesn’t even know what that is . Problem was being told TBI – I didn’t have it .. but was Diagnosed with it in 1983 How could it change ? and recently learned that I now have CTE but still no TBI well that’s what… Read more »
Lem
Lem

All it takes for a TBI is a bell ringer. Walking into a door or a low hanging limb. Plenty of places on a ship to ring your bell. It is not so much the strength of the blow by where and from which direction it landed.

And not remembering is part of some TBIs.

JOHN COKOS
JOHN COKOS

I had just the opposite experience at my local hospital emergency room visit in southern nj for a breathing problem. This was close to 10 years ago. VA paid the Emergency bill from the hospital with no problems. They were the good old days…

Lem
Lem
Not exactly but. I called for an “urgent care problem.” Turned out to be a yeast infection. To save the VA money, I went to the local walk in clinic rather than the ER. I was over 150 miles from my assigned VA and over 80 miles from the nearest VA. There was a VA clinic 30 miles away that had refused to see me for chest pain because I wasn’t assigned to it. I was without a driver and… Read more »
ANutterVet
ANutterVet
@Lem – – – Glad that you gotten some control with the yeast issue. We talked about Candida months ago. Here are some medical conditions that are misdiagnosed, mistreated even when antifungals are used, and controversial. They conditions are; [1] Candida albicans – Yeast Infection [2] Microbial Dysbiosis – overload of bad microbes that have taken over good micro organisms in your digestive tract. [3] Leaky Gut Syndrome – where there is an opening of the lining of the digestive… Read more »
Richard Rust
Richard Rust

don’t expect any repeat experience ?
Same thing that happened in California
has now happened to Me in Fl.
“.. 25 Years later “

cj
cj
@Ben, same standard of proof should apply to emergency care, as well as fear of loss of life. Just because an officer of the law, didn’t lose his/her, life​, doesn’t mean they couldn’t have. Just because you didn’t lose your life, doesn’t mean you couldn’t have. Should I stop making sense? I agree, wrongful and intentional, denial of benefits, with malice. We have no money for you GI Joe, we have apps to buy, and useless kiosks to purchase, and… Read more »
cj
cj

Ohhhhhh shit! You didn’t get the memo.

Had to make another comment, cause I forgot to check the notify me button. What a wing ding I is.

cj
cj

Ben, fire at will.

░░░░░░███████ ]▄▄▄▄▄▄▄▄▃==========O>——-(+)V.A.B.S.
▂▄▅████BEN███▅▄▃▂
I███████████████████]
..◥⊙▲⊙▲⊙▲⊙▲⊙▲⊙▲⊙◤–

Ex va
Ex va

@cj, i like that tank, it looks realistic.

Candace Delis
Candace Delis

My father is dead because of his fear of an uncovered emergency room bill. Ben, you know the story. I received threats from VA employees and harassment and extremely harsh criticism from people in my community – telling me if I had taken him to the ER he would still be alive. And they are probably correct. But he was afraid, and like a fool, he trusted the VA to care for him.

cj
cj

@Candice Delis: Candice, sorry for your loss. Sad your father was made to feel as he did. You won’t find any veterans here, that will lay blame at your feet. We all know how corrupt, and criminal the VA is. Always sad to hear of another veteran, who’s time was cut short, especially when the VA is involved.

ANutterVet
ANutterVet
@Candice Delis – – – I’m so sorry for the loss of your father. When I lost mine, it was crushing to say the least. Especially since I found both of my parents dead. Not at the same time, and in different geographical locations. All that I can say, is that you’re welcome to post your thoughts, findings, humor, anger, or what ever on Ben’s blog. There are many good Veterans on Ben’s blog that help out each other if… Read more »
Disgruntled Veteran
Disgruntled Veteran

@Candice Delis – – – I am sorry for your loss. The VA kills many good veterans, including your father. I hope you find something of value in the postings of those here. All of them are survivors of VA Veteran Care Terrorism. Welcome Aboard.

91Veteran
91Veteran
Good for you Ben. Your actions can only help many other vets being bent over by the VA repeatedly. My comment may be long, so please bear with me. I don’t know what pisses me off more, worthless VA bureaucrats, crooked insurance companies, or crooked insurance companies working as contractors for the VA. Are those contractors getting a bonus? Say a percentage of every dollar they prevent being paid out? That seems that way to me in dealing with my… Read more »
namnibor
namnibor

🙂

James Gallegos

Ben have you been Red Flagged as of today.

VA terminology is what ever they say they want to say. Green is black don’t believe me ask a VA employee…

They may correct me and say it’s in between…

Its the same thing going on with the disruptive reporting and confirmed by the OIG.

VA can not define what constitutes disruptive behavior and they use what ever is handy at the time…

The VA is dangerous. !

Edward Sieczka
Edward Sieczka

I live in the Philippines and they will NOT pay for my chiropractic therapy, because the Philippine government does not recognize chiropractic therapy. WHAT? What does the Philippine government have to do with the VA. I filed a complaint with my Congressman to no avail.

ANutterVet
ANutterVet
@Edward Sieczka – – – You’re right what does the Philippine Government have to do with the VA. You’d think that as long as the Chiropractic Provider is a licensed practitioner and will accept payment from the VA, what is the problem? Wow! This is interesting. At one time when living in Hawaii, I was offered a position to teach in Guam. At first I was attracted to it, but then after finding out that the climate is a lot… Read more »
91Veteran
91Veteran
Edward, you should ask the VA to put in writing that they will not pay for your care because some foreign government does not recognize a procedure. Tell them you need it in writing in order to take the next step of appealing their decision. I bet once you ask them to put it in writing that their story changes. Why should veterans of the US military be held hostage to the backwards thinking of some other country? Think of… Read more »
Underwater basket weaver specialist
Underwater basket weaver specialist
I had an incident where a va executive was snooping thru my veteran medical records. I was a va employee and interviewing for a va job at the exact time the va executive accessed my medical records. In the real world, that would be a slam dunk case on my part. Well the director did everything in his power to cover for the executive. Long story short, I got va approved treatment in the private sector. However even though I… Read more »
ANutterVet
ANutterVet
@Underwater basket weaver specialist – – – You may still be able to file a complaint under HIPAA Act. Both the Executive and Director are involved according to what’s in you post. Maybe you can find the Director to hold him accountable [ignored word for the VA], depending how long ago the incident happened, and if you have any direct proof that documents the incident. UBWS, sorry these sneaker RAT BASTARDS put you through this illegal shit. Next time if… Read more »
cj
cj

Meanwhile, Tommy ” The Butthurt Snowflake” Distefano, just left a butthurt comment against Ben, under (VA awards 19mil) must suck to be Tommy. How’s it feel Tommy? To go through life so jelous of someone you could never be?

Poor Tommy, does it hurt and have a temperature? You lost snowflake, deal with it, better yet, you ball-less wonder, go drink some draino, cleaning the swamp can start right in your own home.

Tommy Distefano
Tommy Distefano
Are you stupider in real life than you are online. When have I ever mentioned any like for Clinton or any mainstream Cuck politician? Jealous over what? Read what I wrote; Israel is in control. Our government needs to be completely and totally overhauled and not by some draft dodging, Israel loving ,bankrupt business man. I would support David Duke for office…you see where I am going? I am saying trump fooled us all. You calling me a snowflake but… Read more »
James Gallegos

I have to ask again what is white, what nationality.

Are you an albino. ! ..

Answer please. !

ANutterVet
ANutterVet
@Tommy Distefano, @cj, @Disgruntled Veteran, @Ex va, @Namnibor, @91Veteran – – – Let me put a clear sharp bead on this. Tommy, I’m glad that you moved on. Your fantastic, yes, your better than others that see things differently, or may have other beliefs because of what they know. They read and interpret the VA policies, and know their BENEFICIAL rights. Do you know what BENEFICIAL means Tommy? Let me tell you. A Veteran that is seeking Compensation or Pension… Read more »
James Gallegos

LoL

Lem
Lem

Not to mention those benefits are guaranteed in Sec 4(d) of the 14th Amendment. And to listen to Trump in the campaign, now guaranteed by POTUS? Where is it?

Disgruntled Veteran
Disgruntled Veteran
@Tommy DiStefano – – – I agree with you that our government needs to be completely and totally overhauled. Washington D.C. has no effective, guiding moral principles for leading this country. The whole damn government is corrupt beyond belief. That is the ONLY thing you and I agree on. My skin is “white” on the outside. I was raised in a family that included Mexicans, Chinese, Japanese, Argentineans, Chileans, Africans, Americans of African descent, Scots, Irish, Germans, Native people and… Read more »
cj
cj
@Tommy Distefano: Try again shit for brains, I receive zero from the government, that’s $00.00. Read your post again you illiterate piece of cow dung. You slammed every single veteran on this blog, and you don’t know Jack shit about me. Yes, that’s right, you did. Now who’s the all assuming asswipe? You will also notice, I mainly comment late at night, although I will make this one exception, because most days, I am too busy working my fucking ass… Read more »
cj
cj

One more thing Tommy, your name would suggest your part Italian, the likes of Duke would like you better at the end of a rope, be very careful who you align yourself with. Duke would love to use you for his dirty work, then turn on you, and strike like the snake he is.

Dennis
Dennis

I wish you the very best of luck on this Ben but I realize that you’re up against a formidable foe with the VA. I fought my battles with that agency to where I just wanted to give up numerous times. They dragged me through the mud, told lies,etc.etc. I have no love for those people. It just ticks me off that other vets have to put up with their crap also.

ANutterVet
ANutterVet
Off Topic – Important for All – @Namnibor, @James Gallegos, – – – Nam thank you so very much for posting the information about the drug epidemic that our Country has been facing in the last 15-20 years, compared to what the Main Stream Media [MSM] stating that the problem started about 10 years ago. The public has been mislead about the increase of the misuse of pain medications, when it started, and by whom. The American public has been… Read more »
Underwater basket weaver specialist
Underwater basket weaver specialist
@Anutter Thanks for the encouragement. I did file with hhs a few years ago and quickly found out the va is the largest hippa violator in the nation and is not held accountable. Most of the corrective action taken is repeated from previous incidents involving the va. After 5 years of bitching I finally got vaco proof from the the privacy office that the executive did violate federal law. I’m now strongly considering contacting dept of justice and ask for… Read more »
ANutterVet
ANutterVet

@Underwater basket weaver specialist – – – Good, and I want to encourage you further to go ahead and file with the DOJ. As long as it is feasible, and it doesn’t add additional stress to cause more health problems. Don’t forget to keep all paper trails, and GOOD LUCK. Keep us all updated. – – – Thanks. Nutter.

91Veteran
91Veteran
You can make the request at DOJ, but will they do anything? Or will they allow the VA to claim some BS excuse to avoid accountability? I believe HHS has a procedure for filing a HIPAA complaint. I am not sure of the success. I recall reading some time ago that the VA has a separate system to report HIPAA violations. Ben may have written a column on it, but I know I read about it somewhere…possibly a USA Today… Read more »
Robert Little
Hi , I am on 60 percent service connected disability thru the V A , should be 100 percent but I’m just a pea on. I’ve been on Social Security Disability 100 percent for years . The V A said so what ,we don’t except what the Social Security does or the way there process works because there federal and were V A . YEP YOU READ IT RIGHT, LETS SEE NOW , If social security is federal and the… Read more »
Rob D
I cut my thumb bad, down to the bone, cut a tendon. Called the VA explained it and they said take an ambulance to the ER as it was bleeding bad. I asked can someone authorize it and she said no, but she would enter in the records that she directed me to go there, but that it wouldn’t guarantee payment, although “it should”. I made the 100 mile round trip with a tee shirt wrapped around my hand, then… Read more »
Nick
Nick
I was not denied… yet. I fell 12 ft. off a ladder last June. I went to the local ER because the local VA urgent care was closed. My fiancé drove me there, as I didn’t want to incur an ambulance bill. So I am in a tremendous amount of pain, told the nurse I had fallen 12 ft. off a ladder and I was in extreme pain and bleeding. After 15 minutes of them laughing and having a good… Read more »
ANutterVet
ANutterVet
Off Topic – Please read and comment about this post by @Tommy Distefano on May 22, 2017 at 2:42 pm. I posted Tommy’s wonderful welfare notice because Ben published a new article, and many of us switched over to today’s new story. Please post your thoughts about Tommy’s negative comments towards Ben and the rest of us. Thanks. – – – Nutter. It looks like everything will get better now that Big Daddy is in the White House. Nice that… Read more »
91Veteran
91Veteran

My thoughts? I think someone is a little bitter or jealous that Ben made the system work.

In addition to being angry at having a little pecker.

Ex va
Ex va

@91Veteran, ROFL!!!! Too true!!!! LMAO!!!!

cj
cj

@91Veteran: Lmaooooooooooooooooooooooooooooo spot on!!!!

Angela
Angela
In response to Tommy, he is in left field. As far as big daddy, the allegations are conspiracies. Tommy needs to consider the fact that our country is in an unrest and declining state due to Democrat policies and Liberals. As far as draining the swamp, it is not a lost cause. The battle will never be over until the return of the Lord Jesus Christ. Meanwhile, President Trump will try to restore this world and this country to an… Read more »
wilken jones,jr

I wilken jones,jr ,they (va) refuse to pay a hospital bill ($6,000.00 +) at Opelousas General Hospital,Opelousas,la. dated back to 2010. please tell me what must I do? Tell me by email.

ANutterVet
ANutterVet

@Wilken jones, jr – – – You should send Ben an email. This can be done on this site. – – – Thanks, Nutter.

Ex va
Ex va
@Ben Krause, you were experiencing heart attack symptoms you sought help at an e.r. This is not your fault or financial responsibility, it is the va responsibility. I thank God you went to get help for your life. I feel like this question should not even be asked or decided it should be paid by the va period. This whole thing may stop someone from getting life saving care because they are worried about an expensive bill. That is a… Read more »
cj
cj

@Ex va: Ex, you around tonight? I lost you lastnight, what happened? lol

Ex va
Ex va

@cj, i don’t know computer problems, we had a storm come thru.

cj
cj

@Ex va: That’s okay Ex, can’t control Mother nature. That Tommy is a special kind of fucked up.

How are you tonight?

Ex va
Ex va

@cj, ROFL!!! Tommy is special alright. Dipshit! LOL!!!

Everyday or night getting some kind of small rain or storm. We are still getting inches of rain. Losing my regular wi-if and the 4g isn’t working right either for some reason.

cj
cj

@Ex va: Finally got a break from the rain up here. Got my onions and potatoes planted, and the remote plot all prepped. Tomorrow I will finally get the tomatoes all planted. 16 different varieties, and 80 plants.

Ex va
Ex va

@cj, i hope you wil have some help during harvest time. That is a lot of varieties. You are going to make a lot of people happy this summer with all the fresh vegetables.

cj
cj

@Ex va: I enjoy growing different stuff, and veterans love eating all those tomatoes. It is an honor to grow for them.

Ex va
Ex va

@cj, that is a lot of tomatoes. Are you going to have them grow in cages or poles??

cj
cj
@Ex va: Neither, think of a clothes line over each row stretched between two posts, then a string hanging down over each plant, to train it to climb. The rows are raised, so they heat up easier, and stay well drained of rain. I put a mixture of purple cow compost, lime, and epsom salt in the hole before the plant goes in. The purple cow feeds the plant, the epsom salt has magnesium in it that helps with calcium… Read more »
Ex va
Ex va

@cj, that is a good idea, you will not get diseases from the soil with them climbing on the rope. Raised rows are good. I think it is blight that comes from the soil that hurts plants. Do you ever use oyster shells for calcium? I did when i grew tomatoes. It helped a lot.

cj
cj

@Ex va: You mean like crushed oyster shells? Where do you get something like that?

Ex va
Ex va

@cj, feed store usually sells them. We would give them to chickens for calcium for egg production. You can get a whole bag cheap and it is good for the garden. Somewhere they sell chicken feed and animal feed.

cj
cj

@Ex va: Is it powdered oyster shells? We have lots of feed stores out this way.

Ex va
Ex va

@cj, yes crushed oyster shells is what i was talking about. Till in soil.

Ex va
Ex va

@cj, they are crushed to about 1/4 to 1/2 inch. They were thin, wafer pieces of oyster shells. I tilled in garden they would slowly dissolve over time. Plants like them.

cj
cj

@Ex va: Thanks Ex, I will see if they carry it at the feed store, they have all kinds of stuff for gardens. I wish I could find micro nutrients, like rock dust.

Ex va
Ex va

@cj, Ben, has been going thru some bad stuff lately. Hate to hear about that.

It sounds like you been super busy. Doctors changed my meds again. Have to see another one tomorrow. Have you been feeling better?

cj
cj

@Ex va: The VA is good at wasting money, just not on veterans, or their er bills. I really believe if there were no veterans left on Earth, the VA would still exist, still complain that they need more doctors, etc. and still hand out bonuses. They would also still be on a worldly quest, to hire incompetent union line towing hacks.

Ex va
Ex va

@cj, you are correct. They have millions to blow on contractors probably with some kickbacks or favors. Now when it comes to paying bills for direct Veteran care they want to delay payment or not pay at all although they are legally responsible for the bill. BS!!!!

cj
cj

@Ex va: Not feeling better, just don’t let it get me down. Can barely move my fingers, I think arthritis is getting real bad. Need an xray, then maybe think about joint replacement. I sure hope your doctors can find something that works for you pain, you need a damn break.

Ex va
Ex va
@cj, i didn’t know your fingers were bad. Sorry to hear this. They can do joint replacement in New Mexico i believe i research it a while back. It is like knee replacement, they can make deformed fingers look normal. I am trying to ignore the pain. This ra is thru my body. Pain is just a symptom wish i could get in some kinda of remission. They increased some of my meds. You are right you need to get… Read more »
cj
cj

@Ex va: New Mexico? whachu talkin about Willis?

Ex va
Ex va

@cj, lol! I googled it finger joint replacements and they are suppose to be one of the best in the country. I will have to look it up again.

cj
cj

@Ex va: You scared my for a second, I thought you were sending me to some unfamiliar VA facility, hell, I might of come back with the wrong joint replaced and have robot kids from now on.

Ex va
Ex va

@cj, i wouldn’t send anyone to a va facility. Not even my dogs or someone else’s dog for that matter.

cj
cj

@Ex va: LOL, I told my VA pcp, “I wouldn’t make an appointment for roadkill, in this place”

cj
cj

I think he thought I was talking about some kind of sandwich.

Ex va
Ex va

@cj, ROFL!!! Maybe that is what he is use to eatin’. He has two brothers named Darrell and Darrell. LOL!

cj
cj

@Ex va: LOL I remember them.

Ex va
Ex va

@cj, “fitzhand.com” i believe it is the one with state of art finger joint surgeries.

cj
cj

@Ex va: OMG, they are called Fitzhand? I certainly hope that is the case lol.

cj
cj

@Ex va: I wonder if Tommy wants to go short bus racing.

Ex va
Ex va

@cj, yeah, that is probably all he knows. LOL!!!!

cj
cj

┈┈┈┈┈┈┈┈┈┈┈?????????????
┈┈╱▔▔▔▔▔╲┈┈┈??????????
┈╱┈┈╱▔╲╲╲▏┈┈┈?????┈
╱┈┈╱━╱▔▔▔▔▔╲━╮┈┈
▏┈▕┃▕╱▔╲╱▔╲▕╮┃┈┈
▏┈▕╰━▏▊▕▕▋▕▕━╯┈┈
╲┈┈╲╱▔╭╮▔▔┳╲╲┈┈┈
┈╲┈┈▏╭━━━━╯▕▕┈┈┈
┈┈╲┈╲▂▂▂▂▂▂╱╱┈┈┈
┈┈┈┈▏┊┈┈┈┈┊┈┈┈╲┈
┈┈┈┈▏┊┈┈┈┈┊▕╲┈┈╲
┈╱▔╲▏┊┈┈┈┈┊▕╱▔╲▕
┈▏┈┈┈╰┈┈┈┈╯┈┈┈▕▕
┈╲┈┈┈╲┈┈┈┈╱┈┈┈╱┈╲
┈┈╲┈┈▕▔▔▔▔▏┈┈╱╲╲╲▏
┈╱▔┈┈▕┈┈┈┈▏┈┈▔╲▔▔
┈╲▂▂▂╱┈┈┈┈╲▂▂▂╱┈
…..Tommy

Ex va
Ex va

@cj, looks like a tommy LOL!!!

cj
cj

@Disgruntled Veteran: DV, I tell you what I don’t get. I put in a FOIA request for my C file. It will be almost a year when they finally get it to me. I called Mr. Peck, and he printed it out, and sent it to me in just days. Exactly what the fuck is up with the VA, and its inability to follow the law? Unbelievable!!!!

Ex va
Ex va

@cj, that shows you the difference of an va employee that actually works and the other one who doesn’t do their job whatsoever.

cj
cj

@Ex va: Mr. Peck works for the county, to assist veterans, the VA hates him, so he must be doing a good job lol.

Ex va
Ex va

@cj, LOL!! Those bastards would hate him because he is doing his job. I hate those afge piggies who want to do nothing all day and complain about someone who is doing their job.

Disgruntled Veteran
Disgruntled Veteran
@cj – – – Easy Answer. People like Little Cox and Shithead Shulkin have deemed the AFGE/VA conglomerate to be above the law. Just like General Michael Flynn. The military has changed since the days us older guys were in. Not the same sense of honor, duty, and discipline exists anymore. In my day, the best CO I ever served with (Adm. Henry Howard “Hammerin’ Hank” Mauz jr.) would have thrown Mickey Flynn overboard for pulling this “lawyering up” bullshit.… Read more »
cj
cj

@Disgruntled Veteran: Makes sense them thinking they are above the law, and apparently they are. I haven’t been keeping up with what is going on in DC. Can’t stand the constant drama, while the country goes to hell in a hand bag. priorities are all out of whack.

Disgruntled Veteran
Disgruntled Veteran

@cj – – – Priorities all out of whack is precisely what is wrong with this country. It is the thing that is going to cause the obliteration of the nation within the next ten years. People cannot look ahead to the future and plan today for it. When tomorrow arrives, it will be such a shock to these fools. Then they will say we need a plan. Too little, too late.

cj
cj

@Disgruntled Veteran: So true, I hope I am still around to contribute to the battle, I would rather die fighting for our freedom, then from some kinda cancer. They say a great General will rise from the Midwest to defeat the government. I have seen speculations it would be a farmer from Iowa.

Disgruntled Veteran
Disgruntled Veteran

@cj – – – Could be true. Farmers have been known to become great generals.

cj
cj
@Disgruntled Veteran; It wouldn’t surprise me, of all the people I have run into, farmers hold veterans in great regard. I was looking to rent a plot of land to grow some food for veterans in need, and when a local farmer found out what I wanted to grow for, he would take no money, because it was to feed veterans. These hard working families are some of the most patriotic segment of our society. That has been my experience… Read more »
Disgruntled Veteran
Disgruntled Veteran

@cj – – – I disagree not at all. Most farmers are really patriotic, not PR Firm patriotic. When I was on the mainland, before I got stuck over here – – – some of the best experiences of my life were had with farmers and ranchers.

What my granny would have termed “salt of the earth” people. Always kindly, Always generous, Always willing to help.

The way America OUGHT to be.

cj
cj

@Disgruntled Veteran: True again. Really down to earth people, and very hard working. Nothing but respect for our farmers. Even though I once got shot in the ass with a load of rock salt. Us teens new ahead of time, it could happen lol.

Disgruntled Veteran
Disgruntled Veteran

@cj – – – My “Seat of Wisdom” was no stranger to the “Salt of Education” when I was a teenager back in the ’60’s. Uncle Jim Benson had an old L. C. Smith shotgun . . .

cj
cj

@Disgrunteld Veteran: LOL It sure was common place back then, I look at those days as my character building days hahaha.

Disgruntled Veteran
Disgruntled Veteran

@cj – – – LOTS of Missouri Boys know about that subject. Never took more than once. Twice if you were real SSSLLLOOOOOOOOOWW . . .

cj
cj

@Disgruntled Veteran: you know that is true. I remember when pops found out, he took me to the farmer, and asked him to put me to work for the rest of the week. I learned real quick, and the farmer was more than pleased to teach. LoL

Disgruntled Veteran
Disgruntled Veteran

@cj – – – I sure wish Mama would call. Her condition is quite serious. Tried to call the hospital desk. Bounced from one robot voice to the other. Such bullshit. They need human beings to talk to other human beings 24?7 at major hospitals.

Left voicemail on mama’s phone a few hours ago. She had phone turned off. If no contact by midnight, I am taking a 7 mile hike along the freeway . . .

cj
cj

@Disgruntled Veteran: Oh that would be stressful not know what is going on DV. And the phone being turned off. yikes. Nobody there that can give you a ride? I would, but my flotation tires are shot.

Disgruntled Veteran
Disgruntled Veteran

@cj – – – Got an Old Marine Solution to the problem – – – Two Feet. Left – Right – Left. It will get done. Called the Nurses station for her floor. Bounced to a robot.

cj
cj

@Disgruntled Veteran: I hear you, sometimes it’s the only way. Godspeed. and goodnight…………..I really mean it this time.

Ex va
Ex va
@Disgruntled Veteran, so sorry to hear of your dear one on having troubles. It is so sad. I hope they find the answer quick and she goes back to her normal state. My meds are being increased and i need to go to sleep if i can. It is making me dizzy right now and tired. Lol. God Bless you and your wife and i pray for healing and a spiritual lifting. God Bless yours and a goodnight. I hope… Read more »
Disgruntled Veteran
Disgruntled Veteran

@Ex va – – – Missed this one. So Sorry. Thank You. No sleep for me tonight, I ‘m afraid. Not much different than any other. Out the door at midnight. 7 miles to the hospital. Should be there by 02:15. Hopefully, just a breakdown in comms, and nothing more serious than that. I have this bad feeling though.

We shall see . . .

Ex va
Ex va

@cj, i don’t think DC wants to work. They are all being looked at and being criticized because of their lack of work. They are getting fired.

cj
cj

@Ex va: What do you mean? The VA? or the politicians?

Ex va
Ex va

@cj, I believe it is the government in DC the workers, the politicians. It has been a struggle everyone is unhappy and it is like nothing is getting done. I think they need to just go ahead and shut down the government until they can actually get things done. Everything is taking longer to get done. IRS slow this year. It feels like everyone is just dragging their feet.

cj
cj

@Ex va: Agreed, DC is only concerned with party politics, and could care less about the nation, non stop bickering, endless bs, from both sides. Except when it come to voting themselves another pay raise, or better retirement, or better health care, or more power, then they magically all get along. Time to start erecting public gallows poles.

Disgruntled Veteran
Disgruntled Veteran

@Ex va – – – I REALLY LIKE the idea of Public Gallows . . .

cj
cj
I think when this witch hunt is over with Trump and the Rooskies, Every single democrat that wasted the taxpayers money on this made up bs, and have put the country into turmoil because they lost the election. Should all be held accountable, first impeached, then stripped of all retirement, and then hung for treason, for making the United States look like crap in the eyes of the world. Instead of doing what they are being payed to do. I… Read more »
Disgruntled Veteran
Disgruntled Veteran
@cj – – – If that is how it turns out, then I would agree with you. No matter which side is wrong and wasteful, they should be stripped of power and benefits. I am completely non-partisan with my politics. I see corruption, wastefulness, and lying on both sides. Every few years, we see the “vote ’em all out” e-mails circulating the internet. If only the American Public actually had the discipline and integrity to do it. Just once. It… Read more »
cj
cj

@Disgruntled Veteran: I feel the same way, I don’t care what side of the isle they are on, if they are dirty? fry them. Okay……..lets build public electric chairs as well. lol

Disgruntled Veteran
Disgruntled Veteran

@cj – – – or we could just put the VA in charge of lethal injections across the US. I see how humane it is for the prisoners that they use it on. Sheer torture. Ought to be humane enough to use on our politicos . . .

Ex va
Ex va

@Disgruntled Veteran, LOL!! Me too!!! Cj has some good ideas. Rofl!!!!

Ex va
Ex va

@Disgruntled Veteran, you are right farmers are salt of the earth people. My grandmother was like that too. Americans are good people and we are generous and i think that is a strength. We care. It is the government boobs that waste our tax dollars.

Ex va
Ex va

@cj, so sick of the politics…

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