Weekly QB: VA Hiring Bad Doctors, Voc Rehab…

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Hi there. This week we continue to look at doctors hired by the VA to provide care for veterans. I reported the doctor identified by insiders to be connected to the VA OIG report in Marion, IL to the Pennsylvania medical board. The VA should have done this after it confirmed suspicions, that in fact veterans did die because of the actions of one doctor who had not practiced in a number of years.

The rest of this weekly QB focuses on Voc Rehab and a little issue about health insurance. Some vets are getting blowback from their regional offices claiming Voc Rehab does not pay the fees. So, to dispel any and all myths, I posted emails between Director Ruth Fanning and me that confirm that Voc Rehab does pay insurance.

Last, and unrelated to veterans issues, I have been deeply disturbed about rumors that tanks will be rolling down streets in St. Louis. Aside from the movie Red Dawn, I never thought I’d see the day of military armorment being deployed stateside. Here is a quick report from St. Louis:

Late last week and through the weekend, citizens of St. Louis, Mo., were told not to be alarmed should they see military tanks roll by their home. Even with this warning, though, some wondered why the U.S. Army was taking the vehicles off the base and to the streets in the first place.

According to KSDK-TV, Army specialists from Fort Meade came into town for a training exercise for members of the 354 NP company. As the reporter states, this “drivers’ ed.” for tanks will take place on city streets and the highway.

Source: https://www.theblaze.com/stories/makes-very-little-sense-why-are-army-tanks-rolling-down-residential-roads-for-training-in-st-louis/

Without further delay or rants from me, here are some issues for this Monday.

Suspension doesn’t stop VA doctor from practicing medicine on veterans

Yet another Department of Veterans Affairs doctor licensed through Pennsylvania has been accused of malpractice. Though, this doctor committed malpractice BEFORE being hired by the VA while on suspension.

VA Doctor Frank Zimba, a 57-year-old Texas native, was suspended in Oklahoma in 2010. The reason for the suspension was that he operated on the wrong part of a patient’s spine. Despite the suspension, the VA hired Zimba to work in Albuquerque.

Because of a federal law, Zimba is allowed to practice in any state while working with the VA so long as he is licensed in at least one state. Zimba is licensed in 4 states: Oklahoma, New York, Michigan and Pennsylvania.

According to records, several years before the Oklahoma mishap, Zimba operated on the wrong side of two other patients’ spines. He failed to discloses the mishap to two of the three patients affected by the error.

While Zimba is not competent by Oklahoma standards for citizens, he is competent for veterans, judging from the actions of the VA to ignore his priors.

Here is why the VA is allowed to get away with hiring substandard medical practicioners. The VA explains that its current system is designed to protect the practicioner and the patient, according to a VA spokesperson. The in-house system used by the VA requires the supervisor to investigate. Substantiated claims get reported to the facility ledership.

The VA states that it is only required to report to the state board whenever an action “so significantly faled to meet generally accepted standards of clinical practice… as to raise reasonable concern for the safety of patients.” Examples rising to this standard are patient neglect, medication errors, and abuse of patients.

However, states like New Mexico have never received such a report, despite numerous instances of malpractice settlements nationwide.

At the Marion IL VA Medical Center, another unnamed physicial, referred to as Physician A in an investigation, was linked to the deaths of 5 veterans from October 2011 to March 2012. It took the probing of a US Senator to inspire the VA to investigate the matter.

Accordign to insiders, the doctor in question there is believed to have not worked regularly as an active doctor for over 10 years prior to being hired by the VA. It was further asserted that this same doctor was placed in charge of the ICU where those same veterans died.

The VA is using questionable methods to fill the deman for qualified doctors. Unfortunately, it is not choosing from the cream of the crop. Instead, VA recruiters appear to be selecting doctors with questionable pasts to work on veterans, to the shame of our nation.

Source: https://www.stripes.com/news/us/suspension-doesn-t-stop-va-doctor-from-practicing-1.181223

 

 

Three reasons to hire veterans, a better list

Higher than average unemployment for veterans in Michigan was sited as the reason Detroit was selected for this year’s Veteran Business Expo and simultaneous veteran hiring fair. Analysts believe the Expo will result in an economiic boost to the local economy.

VA commentators have been putting together an expasinve campaing to increase opportunities for veterans through the events in Detroit.

W. Scott Gould, Deputy Secretary of the VA came up with some reasons to hire veterans. Approximately 260 employers agree with Gould, since they are coming to Detroit looking to fill 25,000 job openings will also be in attendance for a corresponding veteran employment fair.

In an article titled, “A lot of good reasons to hire vets,” Gould talks about over a dozen reasons why it is good to hire veterans. Unfortunately for readers, he only talks about the tax incentives for corporations.

While these are a good start, there are other reasons to hire veterans. So, I came up with a few of my own. First, veterans are highly trained and easily trainable for new positions. Second, veterans increase the level of diversity in the workplace after having served all throughout the world. Third, veterans have a statistically higher level of dedication to the employer than traditional civilian employees (Field Tested, 2011).

Sources: Detroit Free Press

High veterans’ jobless rate leads to state and federal initiativesDetroit Free Press  The large numbers of unemployed veterans in Michigan and nearby states led the U.S. Department of Veterans Affairs to select Detroit as the site for its job fair.

Guest commentary: A lot of good reasons to hire vetsDetroit Free Press  The Department of Veterans Affairs is hoping to change that with a free Veterans … In 2011, some lucky viewers watched the fireworks from the U.S. Coast Guard …

 

 

Vocational Rehabilitation: Confusion over insurance fees

Below is the email chain between Director Ruth Fanning and me about health insurance. There was a lot of confusion in VA regional offices as to whether Voc Rehab would pay health insurance fees or require veterans to waive the insurance.

To get to the bottom of the issue, I decided to publish the below email chain. This way, veterans running into problems can at least show the emails to their Vocational Rehab counselors to get insurance coverage.

In March 2012, I met with Director Fanning to talk about the issue. At that meeting, she agreed to develop a policy letter stating Voc Rehab will pay health insurance fees when required by the college or university.

This email chain is the result of that meeting, wherein Director Fanning reaffirms her decision when I requested that my regional office in Minneapolis pay for insurance. Prior to this point, the Minneapolis office required that veterans waive the coverage.

Instead, veterans were required to place their Social Security number on the waiver form where a student was supposed to place their private insurance number. The old position was that VA care is the same as health insurance, but legally these are not the same kinds of arrangements.

This practice was borderline fraudulent since a Social Security number is not an insurance number. VA medical care is not the same as health insurance. For the record, both Director Fanning and my Voc Rehab counselor were amazing through this process.

VA has yet to release the formal policy letter. The date of this writing is June 24, 2012.

On Apr 26, 2012, at 8:52 AM, Fanning, Ruth (SES), VBAVACO wrote:

Mr. Krause,

I wanted to follow up with you to let you know we did ensure the office you are working with understands that this fee/insurance is payable if it is a standard fee for all students and that VA medical coverage is not medical insurance.  We are preparing clarification to send out to the field to ensure everyone is completely clear about this issue and I will be glad to share that information with you, if you are interested.

I am still working with Steve Westerfeld regarding your guide but in the meantime, we are working on a series of articles that can be posted on VA’s site that address VR&E issues.

I hope that you are doing well and that your school is progressing.  Will you be attending the Detroit event?

Best, 
Ruth

R. A. Fanning 
Director, VR&E Service 
VetSuccess.gov 
202-461-9600

Hire Veterans!

On Apr 20, 2012, at 12:52 PM, Turcotte, Sherrie, VBASTPL wrote:

Hi Ben,

I believe we have all of the information we need in order to proceed.  We have the clarification that this is indeed an expense that our agency should pay.     Since the advisory has been requested, we’ll just wait for it to come in as well,  so that we have this resource to utilize in our office.   However, in the meantime, we’ll proceed in the manner in which Director Fanning has indicated.

I hope you have a great weekend!  I haven’t been out since this morning – but it looks like it is shaping up to be a nice day out there.

Take care!

Sherrie

From: Ben Krause [mailto:[email protected]]

Sent: Thursday, April 19, 2012 3:25 PM

To: Turcotte, Sherrie, VBASTPL

Subject: Fwd: April 18 Correspondence Denied: Ft. Snelling requests Advisory on “Insurance”

Hi Sherrie,

I just got this reply back from the Director. It now looks very clear that “insurance” is included within “fees.” Do you guys still need the advisory opinion to proceed?

Benjamin Krause

Begin forwarded message:

From: “Fanning, Ruth (SES), VBAVACO” <[email protected]>

Date: April 19, 2012 3:14:40 PM CDT

To: “Ben Krause” <[email protected]>

Cc: “Westerfeld, Steve, VBAVACO” <[email protected]>, “Cocker, Margarita, VBAVACO” <[email protected]>

Subject: RE: April 18 Correspondence Denied: Ft. Snelling requests Advisory on “Insurance”

Ben,

I apologize for the confusion resulting from the email you received from the local office and we will work with the office to resolve this issue.  Required student health fees are synonymous with school health insurance.  The guidance is not ambiguous but obviously individuals may interpret it as such and we will ensure field offices are provided proper guidance that resolves that issue. We want your counselor to have confidence that she is doing the right thing, I appreciate your bringing this to our attention and appreciate your patience in the interim,

Best and continued thanks for your service,

Ruth Fanning

R. A. Fanning 
Director, VR&E Service 
VetSuccess.gov 
202-461-9600

Hire Veterans

From: Ben Krause [mailto:[email protected]]

Sent: Thursday, April 19, 2012 3:58 PM

To: Westerfeld, Steve, VBAVACO; Fanning, Ruth (SES), VBAVACO

Subject: April 18 Correspondence Denied: Ft. Snelling requests Advisory on “Insurance”

Director Fanning and Mr. Westerfeld,

I have bad news. Ft. Snelling says insurance is a no go without policy clarification.

I forwarded your responses to my Regional Office. Director Fanning stated that she believed her email was a clear answer to my question. My question was, “Will Voc Rehab pay health insurance when it is required for all students at a college or university?”

The Ft. Snelling Regional Office does not agree with Director Fanning’s email on clarity. The RO here believes that they do not yet have authority to pay health insurance fees. I can see why this is confusing since neither response from VA yesterday included the word “insurance.” Specifically, they need to know if “insurance” is covered under “fees.”

I assume any response or opinion should include the word “insurance” in it, for clarity and include an affirmative statement:

“Yes, Voc Rehab will cover health insurance fees when insurance is required for all students at a particular university or college.”

Thank you,

Benjamin Krause

Begin forwarded message:

From: “Turcotte, Sherrie, VBASTPL” <[email protected]>

Date: April 19, 2012 2:31:31 PM CDT

To: <[email protected]>

Subject: RE: Request – resume

You’re welcome.  We just want to make sure that we’re doing what Director Fanning wants us to do,  and that we’re on the correct page.

From: Ben Krause [mailto:[email protected]]

Sent: Thursday, April 19, 2012 2:24 PM

To: Turcotte, Sherrie, VBASTPL

Subject: Re: Request – resume

Thank your for the heads up. I guess her response was not as clear as she believed. I suspected this would be the issue. I will respond to her email as well.

Thanks,

Benjamin Krause

On Apr 19, 2012, at 2:01 PM, Turcotte, Sherrie, VBASTPL wrote:

Hi Ben,

I ran this by my supervisor,  and my understanding  is that we are still waiting for the advisory.   There seems to be some confusion regarding  the terms “fees” and “insurance” and we want to make sure the information that we give you is correct.

Thank you for your patience – I know this has been a rather long process.

Take care!

Sherrie

On Apr 18, 2012, at 7:37 AM, Westerfeld, Steve, VBAVACO wrote:

As requested by the Director, VR&E Service for forwarding to you:

The attached letter from VR&E Service and the Directive from the Veterans Health Administration (VHA) indicate that Veterans participating in a VA vocational rehabilitation program under Chapter 31 are eligible for necessary medical services, including dental treatment, at a VA medical facility.  It is VR&E’s responsibility to make the referral to VHA describing the medical issue or concern.  It is then VHA’s responsibility to make the determination of what services, if any, may be necessary for the Veteran to continue in and complete the rehabilitation program.  VHA must provide any necessary care at a VA facility or through their Fee Basis funding.  Also, VA can pay for student health fees for Chapter 31 participants in certain circumstances.  VA Acquisition Regulations govern the procurement of medical services, including health care fees, outside VA facilities:

VAAR 831.7001-4 Medical services and hospital care.

(a) VA may pay the customary student health fee when payment of the fee is required for similarly circumstanced nonveterans

From the VR&E manual:

Medical Services Under Non-VA Health Care Contracts. The VA may pay student health care fees as a part of established school costs.

<VRE Letter 28-10-15.DOC>

On Mar 19, 2012, at 2:56 PM, Turcotte, Sherrie, VBASTPL wrote:

Hi Ben,

My understanding is that there is a policy in place to require the waiver.  However, I will double check on this and let you know what I find out.

Sherrie

From: Ben Krause [mailto:[email protected]]

Sent: Monday, March 19, 2012 2:49 PM

To: Turcotte, Sherrie, VBASTPL

Subject: Re: DC Trip – Director Fanning Meeting

It was very productive.

So there is currently a policy in place to require the waiver or is it an RO specific policy?

Many moons ago, Callie Overturn told me the following:

“If you do not sign the waiver, our finance department will not sign off on any bills/invoices that you may receive.”

 

On Mar 19, 2012, at 2:09 PM, Turcotte, Sherrie, VBASTPL wrote:

It sounds like a very productive visit!  I look forward to getting the written policy change so we can start implementing it.  It will make life much easier for many veterans!

From: Ben Krause [mailto:[email protected]]

Sent: Monday, March 19, 2012 1:50 PM

To: Turcotte, Sherrie, VBASTPL

Subject: DC Trip – Director Fanning Meeting

Hi Sherrie,

I wanted to follow up with you after our meeting to let you know of a major position Director Fanning took on required health insurance fees.

I met with her and Steve Westerfeld, Communications Director for VBA. Great meeting.

Director Fanning resolved that moving forward, when health insurance is required, that VR&E will pay the fee rather than to require that veterans apply for the waiver. While most universities have given VA a pass until this point, the fact is, given the ambiguity with health care between VHA and VBA, that VHA care is just not the same as insurance. Period. Claiming that it does so violates the intent of the insurance requirement, which is to ensure all students have the ability to receive care while not being concerned about payment for the care.

I just emailed her to confirm the process for facilitating the switch over. As you know, UMN does require its full time students to have insurance. Please contact me or Director Fanning with questions.

I did include the list of offices we met with while in DC at the bottom of this email, in case you were curious. The trip was a great success for veterans!

Best regards,

Benjamin Krause

 

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14 Comments

  1. I have been in the VA medical System since 1968. The doctors I trusted and the PA’s that I have seen need to be fired and put in some sort of jail or prison. Piss poor doctors at Martinez, California. A Dr. Richardson caused me to lose my job and told me to my face “You have no right’s” other’s either lost or destroyed my medical records and other important papers like Jeff Jewel who wiggled his way into being a team leader for a Sacramento Vet Center. Denver Mills let WWII veterans insult and degrade Vietnam Veterans and enjoying it as he himself would bully and pick on certain veterans that came into “his” vet center for help! I am finding out that my NSO only cares about boondoggles and admires these pieces of $&#@! I am going to list the con artist that call themselves doctors. I can’t call them doctors because that would just be insulting to the good one’s. Neurologists at Martinez, California VA Medical Clinic, Michael Remlier, Rana, Kimberly Hardgrave, Richardson, Robertson. Psychologist Soilman, Primary Care Ken Winters, J.J. Jackson and a host of other people like Rubin Soto, Denver Mills, Jeff Jewel, and all the other fly by night incompetents working at the VA Northern California Health Care System. I was wounded in the head and have shrapnel in my body and the last I heard on my claim is that they can’t see where I had a TBI…My head wound got me actually retired from the military and I do even have medical records from when I was wounded in Vietnam. Those don’t really mean anything so it seems, because the people handling our claims cannot read much less type. We as veterans are being screwed both men and women by the no not’s that enjoy the carnage that is piling up and now they have numb illiterate hires from out in front of your favorite home improvement store settling our over due claim’s. The Veterans Administration suck’s, the leadership suck’s and promises made to every veteran are not being met! Support all veteran’s and pay up VA the United States Veteran did his and her job…do yours! @$#%%#@ $#%$#@&!

  2. Dr linda bortguno at the viera fl va clinic,told me i had diabetes and five days to live if i didnt take insulin. I dont have diabetes,and she didnt have any test results. I reported this to senator nelson, but no investigation followed. She still kills veterans. So does dr ricardo pena.

  3. Its like we are ginney pigs at times never see the smae dr twice I a heart transplant and they dont know what to do with me so im out in the cold The only dr I have is My heart DR and i trust her but the rest cab just go away

  4. I went to the viera fl va clinic,after i had a stroke. I saw dr ricardo pena. He put me on the necessary meds. Then one month later i tried to get the meds refilled,and the pharmacist told me i couldnt get any more because i didnt go to the va hospital and have the stroke there. I was denied physical therapy. Before this i had a strep infection on my left buttock. I saw dr ricardo pena. He didnt know what a bacterial culture was,and asked me what kind of anti biotics i thought i needed. Its been four years and im still fighting this infection. The skin has stopped necrotising. But i cant get rid of the infection. Hitler would be proud of drs bortguno and pena. The way they kill veterans under the guise of health care would make DR. MENGELGA PROUD. YOU KNOW,THE NAZI DR THAT TORTURED HIS VICTIMS. these two asshats should be brought up on charges for attempted murder,and jailed. Then deported back to whatever third world cesspool they crawled out of. But unfortunatly, these are the kinds of drs the DOD hires. If they couldnt kill us in battle,the VA doctors will. I contacted sen nelson, but i couldnt give him any medical records because the viera va clinic in viera fl,destroyed 14 years worth of medical records.
    #### the va and #### these two drs. And the staff, with the exception of the veterans that work there, are just as bad. FTVA!!!!!

    • This has been on my mind a whole lot regarding Dr. Pena. Just curious is he bald rather round faced I know now he’d be older if it is one I worked with. You see we had a Doctor with the same name in the Acute Care Clinic in Orlando and not only did HE NOT KNOW WHAT HE WAS DOING, IF HE NEEDED A FEMALE STANDBY HE WOULD ASK YOU FOR THE DIAGNOSIS! He also use to swat my backside and hands on me and I told my Chief Petty Officer “if you do not tell him to stop I will write up his ass myself!” He left ORLANDO and was on a rather large ship, misdiagnosed a patient and the independent duty corpsman knew more than he did. It was reported to the Captain and that Captain ripped into him good and kicked him off the ship. If it is the same one, why would the VA take anyone like this without looking to their military past? Let me know I am curious, if it is the same guy, I would get some Political Help and report it to them! Just keeping it real!

  5. I wish i would have come up with the idea of killing the undesirables under the guise of free health care like the veterans administration did. Im jealouse! A. Hitler.

  6. To Denise. Dr ricardo pena was in the Marines. He very well could be the same incompetent quack that works at Viera. He wasnt good enough to work at a clinic. Dr linda bortguno couldnt make it past the 90 day probation period at places she applied to before the dod hired her. To kill veterans.

  7. Dr linda bortguno was made the chief medical officer. I wonder how many dead veterans she had to step over to get that job?

  8. Update- dr linda bortguno is now in psyciatry at the va clinic in orlando fl. Not only is she not qualified to be an internal medicine dr, but they have her working in psyc. I guess if she cant kill veterans with insulin,she’ll drive them to siucide!

  9. Dr. Julie Stansfield did not like any questions. Changed VA’s because we moved. Wife and I are old. I was doing well on current meds BUT new doctor always want to “tweek” meds. She scheduled numerous tests, but not the one requested (and supported by symptoms and lab work). I c/o feeling of foreign body in my throat and a WBC count of 13.8 in a 77y/o service connected vet. When I went to private doctor, he was livid…said the feeling of a foreign body in the throat “is always an emergency”. It turns out I had a massive fungal infection in esophagus and bronchi (I am service connected for lung problems).

    Dr. Stansfield was concerned with a pulse rate in the 80’s and changed meds to reduce it. She also reduced my meds for high blood pressure. So with a pulse of 50 something and a BP of 170 something over 90+, my opinion is that she wanted me stroked out so I couldn’t question her directions or dead and out of her hair all together.

    Now I am being threatened with a withdrawal of my VA meds unless I tell her all that the private cardiologist has done. It is enough for me that a private primary care doctor, gastroenterologist and cardiologist know what each other are doing. I expect a major increase in my meds in the near future.

    With no malice of forethought; Do you know Julie?

  10. why havent drs linda bortguno and ricardo pena from the va clinic in viera fl been investigated yet for attempted murder? or is this websight a sham? please leave a comment above if you know why.

Comments are closed.