Posts Tagged ‘Bureaucrats Gone Wild’

Shoot First… (A Note From Lars)

Saturday, January 24th, 2009

Greetings Friends:

Late to the party, as usual, but this morning I was perusing an article from The Fayetteville (NC) Observer titled: “Changes coming to veterans hospitals?”

In the article some schmuck named Dave Rainey, identified as spokesman for the VA Mid-Atlantic network is quoted as saying: “On one hand, we have a $1.8 billion budget. That’s taxpayer money, and it has to be spent effectively, by making plans in the short term and the long term. That’s the business case for what we plan there in the Salisbury VA.” (Wait… What?)

The VA decided, arbitrarily and capriciously, that they weren’t spending taxpayer money effectively so ordered that shutdown of the ER and surgical service at the Salisbury, NC VA medical center. When the situation came to light, politicians got involved and the VA Secretary ordered the decision be reversed. Here’s how the director of the Salisbury VA characterized it: “The Secretary of Veterans Affairs, The Honorable James B. Peake, MD, has made a decision regarding the proposed (proposed? proposed? those changes weren’t proposed, they were ORDERED.) changes for the Salisbury VA Medical Center. This decision was made after careful deliberation and review of information from veterans and their family members, employees, veterans’ organizations, congressional members, local government officials and concerned citizens.

There will be no changes in the services offered by the Salisbury VA until 2013. The inpatient medical/surgical unit and the emergency department will remain open while Health Care Centers are constructed in Charlotte and Winston-Salem and relationships with community health care partners are developed. Salisbury will also continue to provide outpatient primary care and mental health services, medical and surgical outpatient specialty care and all other related medical services currently available. In addition, programs will be established in Mental Health and Long Term Care. The large number of inpatient beds in these areas will remain open as programs and services are added.

The Health Care Centers in Charlotte and Winston-Salem will essentially provide all clinical services with the exception of inpatient care and emergency department services. Plans for doubling the size of the Hickory clinic remain ongoing, with an estimated completion date of 2010.

The establishment of after-hours primary care clinics at Salisbury, Charlotte, Winston-Salem and Hickory will be implemented as soon as possible. This will involve extended hours Monday through Friday as well as weekend hours. A 24/7 telephone triage call center will be established and a case management program will be implemented for veterans referred through the Salisbury Fee Program.

This plan will improve health care access for our veterans and decrease their travel burden while providing comprehensive health care close to where veterans reside.

Carolyn L. Adams

Q: What can we gleen from this information?

A: The VA shoots first…

Ol’ Lars is pretty broke down friends, and I rely on help from a home health worker to keep me at home instead of in a nursing home. Recently a new coordinator was hired by the VA Mountain Home and he decided that me, and hundreds of Veterans like me, didn’t need twelve hours of care a week, we only needed two. He called me on a Monday and told me that my services would be terminated Wednesday. I called a friend in Washington D.C., and by Friday the Mountain Home director announced that the Secretary of VA had ordered the decision reversed.

While I was on the phone with this new Mountain Home guy I commented on how odd it was that this information would come in a phone call. I said that this kind of information is usually mailed, along with an explanation of how to appeal the decision. He replied: “We didn’t want to incur the expense of a mailing.”

True story friends, Lars wouldn’t lie to you. So I said to him, I said: “I don’t know how much you make, but I know it’s more than 60,000 dollars a year, and it is costing the VA a hundred times as much for you to be making all these phone calls as it would cost to mail a letter.”

But that’s the point I want to make. The way VA makes decisions ultimately results in an enormous INCREASE in what is ultimately spent. For years and years I was telling the VA that there was something seriously wrong with my neck. Despite several doctors recommendations they wouldn’t authorize an MRI because “That’s taxpayer money…”, so they took dozens of x-rays. Because x-rays can’t see soft tissue damage they kept telling me that everything was fine. Finally I wound up in the ER at a civilian (real) hospital and they did an MRI. There were two ruptured disks in my neck that were flattening the spinal cord from opposite directions.

Can you image what kind of pain that caused?

So, I take the MRI report to the VA and say: “Now what?” And the VA says: “We’ll set you up with a civilian neurosurgeon at a civilian hospital that will cost the VA at least 250,000 dollars and because while you are there the anesthesiologist will damage your nose lining causing your lungs to fill up with blood which will require 10 days in the civilian hospital with extensive involvement from the pulmonary department which will wind up costing the VA over 500,000 dollars.” “O, and by the way, the VA will call the hospital daily complaining about how much it is costing the VA and demanding you be transferred back to the VA hospital, which will result in the pulmonary problems not being resolved properly and you will have to go on home oxygen for the rest of your life which will cost the VA well over a million dollars.”

And I say: “Why?”. And the VA says: “Because that’s taxpayer money and we have to spend it effectively.”

Now I’m not the brightest bulb in the box. I have ancestors named Ole. But, I do know that you can be penny wise and pound foolish. Or, for Ole: Øre wise and kroner foolish.

Until next time,

Lars Harfagre

Brazil (Or: A Series Of Unfortunate Events)

Thursday, December 11th, 2008

Ron Paul, on the Department of Veterans Affairs (VA), said: “Any nation willing to ask its men and women to risk their lives serving overseas must also be willing to take care of them when they come home. Veterans deserve dignified care, and we can’t provide that with a VA that is run like the Postal Service or the IRS.” Ron Paul gets it. He is a Veteran, doctor, and humanitarian. But probably most relevant to this discussion is his knowledge of our Federal Government. When he says that the VA is on par with the USPS and IRS that is significant.

Allow us to illustrate. We present a story of fictional Navy Veteran Lars Harfagre (any resemblance to a person living or dead is purely intentional). Lars spent thirteen years in the USN and had Wartime Service in Lebanon, Arabian Gulf, and Somalia.

While watching the CBS Evening News with Dan Rather (he didn’t have cable) one evening he learned that Veterans returning from service in the “Gulf War Theater” were experiencing significant health problems. As he listened to the list of symptoms being rattled off he had an “O shit” moment. He was personally experiencing many of the symptoms that he had just heard listed.

Flash forward to Saturday, December 6th, 2008. Lars is sitting quietly in his room, drooling a little onto his stained pajama top, watching ESPNHD. The only channel that he can watch without crying or throwing something. He is interrupted by Bubba’s Mail Call. He gets a letter from the VA Pension Management Center Milwaukee and assumes, incorrectly, that it is the annual announcement of the new pension rates. What he finds in the envelope is something that will take his figurative breath away.

We now have to go back to April 1997. Lars has been learning about what is being referred to as “Gulf War Syndrome”. He has had a Gulf War Registry Exam at the VA and has been counseled by the Missouri Veterans Commission (MVC) to submit a claim to the VA for service-connected disability benefits because new laws were enacted to provide benefits to Gulf War Veterans with so-called Gulf War Syndrome. Having lineage that runs through Lake Wobegon, Lars was above-average in the ability to use new-fangled World Wide internets to learn about stuff normally relegated to CSPAN. So he looked up the applicable laws and filed his claim in accord with.

When Harfagre filed that claim he listed several symptoms and stated that he believed those symptoms, combined, represented Gulf War Syndrome and he should be granted benefits on the presumption afforded him by law. Going on twelve years later, he now knows that it’s not the law that is important; Rather, it is how the VA interprets the law that is important. VA, contrary to the law, chose to separate the symptoms into several different issues and then began denying them one-by-one.

Stunned and discombobulated, Lars sought help from the MVC, as they were the designated representative on the claim; However, now that the claim transmogrified from something simple to something complex, the MVC expressed regret that there was nothing they could do because they chose to help people with simple claims, low-hanging fruit, that would easily increase the total dollar amount of claims they brought into the state. That way they could claim to really be helping Veterans because they were the representative on a Gazillion dollars worth of claims. Lars learned that this practice is not the sole providence of the MVC. Turns out that a whole lot of groups that purport to be fighting for the Veteran are actually just taking credit for work that they didn’t spend much efforting on.

Lars hired a lawyer in May of 2007 to take over as the representative on his now numerous claims. On August 12th, 2008, the lawyer sent a fax to the Nashville VA Regional Office (that’s where part of the claim was). The fax consisted of a cover sheet and a letter and stated that the original documents and other evidence would be sent by mail. The letter was very clear in what it was referring to. The Nashville VA stamped both faxed documents as “Received” on August 12th.

The news of the past couple of months has been chock full of stories about critical claims documents found in shredder bins at several VA offices all over the country. One could speculate that numerous Veterans have died waiting for benefits that, because their claim was shredded, were never “officially” applied for. It is perfectly reasonable to wonder how many Veterans of the Korean War who are not capable of self-advocacy, and trusted in the system, are being denied benefits that they are entitled to because a VA employee thought it acceptable to shred the claim instead of working it. But I digress.

So, on December 6th, Lars received a letter from the Milwaukee Pension Management Center. In addition to the letter there were three other pieces of paper included. Two of the pieces of paper in the envelope were the cover sheet and letter that the lawyer faxed to the Nashville VA Regional Office. That’s right, the Nashville VA sent, in the mail, two pieces of paper that were supposed to be added to the file that was in Nashville, to Milwaukee. Both pieces of paper were stamped “Received” by the Milwaukee VA on August 27th, 2008.

On August 12th, 2008 his lawyer faxed two pieces of paper to the Nashville VA. At some point after that an employee of the Nashville VA decided that the fax should have gone to Milwaukee. Despite the fact that it was clearly stated in the letter from the lawyer that it was related to an issue that Nashville was responsible for. The Milwaukee VA received the two pieces of paper on August 27th, 2008. Between August 27th and December 2nd, the day that the cover letter from Milwaukee is dated, the two pieces of paper made their way around Milwaukee. For over three months the two pieces of paper worked their way around Milwaukee until a VA employee decided that Lars was the person that should have the papers. Because, as the cover letter states, he does not have any claims pending.

Harfagre is confused about the statement that there are no claims pending. There are numerous claims pending and he is now wondering if the VA shredded all of his claims documents too.

Harfagre tells us that over the course of the nearly twelve years that he has been fighting the VA he has had other Veterans medical records placed in his claim file, and that decisions on his claims were the result of someone else’s information erroneously applied to his claims. Also, he has received other Veterans medical records and appointment information commingled with mail sent to him.

Lars has requested help numerous times from his elected representatives but they routinely tell him the same thing. That is they cannot “make” the VA adhere to the law. All they can do is request information from the VA on the Veteran’s behalf and then pass anything they receive to the Veteran. He has also requested help from the VFW but they have also hesitated to advocate because of the complexity of the case. Even the private lawyer Harfagre hired is struggling to manage the whole case.

And if all of that isn’t enough, he tells us that he has been charged copays for medication that should be copay exempt. He has recently been successful in getting the VA to stop charging the copays but he has been unsuccessful in getting a refund of the several hundred dollars of payments made in error. He states that employees in the business office are unaware of the VA policy that exempts Gulf War Veterans from being charged copays for medications prescribed for symptoms that may be related to Gulf War Illnesses. The VA pharmacy manual clearly states that these medications should not be charged a copay.

When asked what he attributes this myriad dysfunction to, he states: “Transparency, accountability, and training”. He feels that unless VA employees from the Secretary down to the new hire are held accountable, and that all VA employees and representatives who work on claims are thoroughly and properly trained, nothing will change. As far as transparency, Harfagre said that is a huge obstacle to real reform in the VA. He states that instead of transparency, we currently have the VA using their Public Affairs people trying to prevent bad press, and if they do get bad press those Public Affairs people will lie in an attempt to shift blame. What the VA needs, he says, is a Michael Tucker. He is the Army General that went into Walter Reed and said the bureaucracy stops now. He squared away Walter Reed and someone like him needs to go into the VA and say “enough”. When asked about the prospective new VA Secretary, Eric Shinseki, Lars said that his lineage also runs through Missouri and that Shinseki would have to “Show Me”.

And that other piece of paper in the envelope from Milwaukee was a form for Lars to make his “X” on and it has to be witnessed by two people.

Will You Believe Me Now?

Wednesday, April 23rd, 2008

You may have heard about the lawsuit.  Evidence presented includes emails from Ira Katz.  He is the main mental health bureaucrat at the Department of Veterans Affairs (VA).

In this email Katz tells Everett (Call me Ev) Chasen to keep quiet about internal numbers on Veterans suicides.

In this email Katz acknowledges what is being widely reported that there are 120 Veterans per week committing suicide.  In that same email, the Under Secretary for Health at the VA, Michael Kussman, states that 120 Veterans per week committing suicide “Sounds awful but if one is considering 24 million veterans.”

So the Under Secretary for Health at the VA, who is an Army Veteran, believes that 120 Veterans committing suicide per week is OK because there are “24 million”.

Since these emails became public, politicians were quick to jump on the bandwagon and feign righteous indignation.

Message to politicians:  Too Little, Too Late.

These same politicians who are now feigning righteous indignation are the same politicians who have heaped praise on these VA bureaucrats for “Doing the right thing for Veterans”.

We have been telling these politicians for a long time that their praise is misguided.  we have been telling them that there is a culture in the VA bureaucracy of Obfuscate, Deny, Manipulate, Lie, Spin, and apply the full weight of the VA propaganda machine to make sure that the VA “message” is one that disparages critics and buries bad press.

These emails are the absolute best evidence to completely obliterate the rosy facade the VA propaganda machine has built to mislead the public.

Our heartfelt thanks go to CBS News, Armen Keteyian, Pia Malbran, and the rest of the crew that worked so hard on the exhaustive investigation into the epidemic of Veterans suicides.

Our heartfelt thanks also go to all of the good people involved in the lawsuit.  Godspeed.

Please join us in telling Congress that we expect that these VA bureaucrats who have lied to Congress, under oath, will be prosecuted for that felony.

Maybe if one or two dozen of the most heinous of these people are given a perp walk, the rest of the VA bureaucrats will take notice and straighten up their act.