Thursday, July 18, 2013

Frustrating Journey - C&P Exams Tomorrow

Many friends know we have to go to Atlanta tomorrow for John's Compensation Exam.  This is nerve wracking for me on several levels. First, last year's exam was incomplete and not at all accurate.  We were told after the fact that the examiner was not "qualified" to conduct TBI/PTSD exams.  She didn't adequately fill out the papers, didn't submit them back to the VA in the allocated time frame, and it was a miserable experience.  The VA only sent about 10 pages of medical records (out of 300+ for the year) for the examiner to review.  They didn't record the actual responses John gave for the complaints and disabilities being evaluated.  It was such a frustrating experience driving all the way to Columbus for three separate days that just before his PTSD evaluation John jumped out of the moving truck on the freeway.  Yes, you just read that right.  I knew he was agitated and had slowed down and pulled over as much as I could before he bounded out of the truck, but it happened.  I eventually coaxed him back into the vehicle and we went for the remainder of the exam.  You better believe I was shaken but guess what....even after that and all the other details of his symptoms and daily life, the examiner reported that John didn't have any significant difficulty on 14 out of the 16 facets listed.  Yet, the VA exam at the VA hospital by two collaborating physicians on the same 16 facets showed EXTREME difficulty in 14 out of the 16 facets measured and some difficulty on the other two. 

So, our financial well being and John's access to more local medical care literally lies in the hands of someone we will see for about 3 hours tomorrow.  Dear Lord, I really pray they accurately record what is real for us.  We're not asking for something he doesn't deserve.  We just want what is needful and appropriate.  Did you know that between the 80% compensation that he presently gets and the 100% that he needs, there is a $1400+ a month difference? Yes. Stark difference. The price of our mortgage and taxes each month, actually.

Even though the VA determined over two years ago that John needed a full time caregiver, and gave me a stipend and health benefits, they have also denied his compensation for Aid and Attendance stating he needs no assistance or care! Yes, they did. Even though his neurologist at the time we applied (Sept. 2011) wrote "Needs Constant Supervision" across the bottom of the application.  So John is frustrated that the VA pays me more when he's the "suffering" one. Right now we can't get close medical care for John.  We have to drive 1.5 hours for emergency care and 3.5 hours for regular care.  Even though the VA allows me ChampVA health care insurance and I can access whatever resources I need close to home because I take care of him.  For me it is great. Yet, it shows how warped the system is because John can't get the same care. 

John's supposedly "expedited" Social Security Disability was denied because the VA hadn't determined him "Unemployable." So now we've waited 12 months on an appeal that hasn't made any progress.  John's Unemployability was denied by the VA based on the fact that they didn't see any barriers to employment.  Yet, he now hasn't worked in 23 months and the Vocational Rehab division has him enrolled in the Independent Living division because they determined him to not be suited for employment or education.  So, they have given him new can openers, jar openers, pens, eating utensils, etc.  so he can be more independent when he looses feeling in his hands.  They gave him a vacuum and a steam mop, a couch cane for assistance getting up, and a pill container that alarms and talks to him.  Still we can't get the home renovations approved.  The housing grant was denied  because John has a brain injury and seizures. Since he hasn't lost a limb or eyesight, they say we are out of luck and have to struggle. (See "We are the VA Backlog" blog)

John fell several times this week again.  He had a multitude of seizures again.  We can't get his oversized wheelchair through the door to our bedroom or our toilet closet or our clothes closet.  This week the most frustrating was when after helping him to the bathroom he had a seizure and fell against the door closing it and blocking my way in.  We were helpless to help him.  With the exception of a few weeks this year, this has been an almost every week struggle.  For a while last year we left several of the doors in our home off.  We took them off the hinges and completely removed them so EMTs could get John out on a couple occasions and John could maneuver easier. 

Now, however after a few bills the VA refuses to pay at our local hospital, John refuses to go there.  A few months ago after a bad fall my grandfather took him to the hospital and because he didn't have insurance they acted like they didn't want to treat him.  They gave him one shot and immediately brought discharge papers, even though it didn't relieve any of his pain.  They refused to call the VA hospital for transfer or treatment, and we wound up driving the 90+ miles to the nearest VA facility as John had to have some relief from the pain after the fall on the tile floor. 

Oh I digress.  If you're still reading my frustrations then "Thanks" or "I'm sorry." I am not sure what is more appropriate.  Today, I needed to vent.  I'm concerned.  I'm scared.  I fear that tomorrow's exams will not be adequate and we'll have to keep fighting for appeals.  The congressman's office requesting expedited case due to hardship didn't work, the Voc Rehab putting in requests for Dental treatment in May and June didn't work, and filing a wounded warrior SSD claim didn't work.  We've been in a backlog of claims since 2008 and I'm tired. I'm tired of fighting it and I can't get a break. 

We took one of the new Disability Benefits Questionnaires to John's Mental Health doctor two weeks ago to his 2 week check up.  My thoughts were that he'd seen her for about 2 years and she could accurately describe his need for total disability.  We go to the appointment to find John had been reassigned to a new doctor.  His doctor wasn't gone but as the VA hired many new MH employees, they redistributed the cases.  Oh my...."Here new Dr. W. Here is this detailed questionnaire for you to fill out" and my heart sunk again because I wanted it done by the doctor that knew John and knew of the severe issues that he was having and knew that they were real. 

Dr. W. did check the box that John has "total social and occupational impairment" and I was happy to see that he did a 97% accurate job, in my opinion.  But it is frightening.  I'm not supposed to be the paranoid one but the whole process is beyond frustrating.  Yes, I have faith....I've had faith....and I am sure I will continue to have faith.  But my faith in the VA system is wavering.  My faith in God to provide for our family is still there but we desperately need this increase in compensation from the VA for my husband's suffering and impairment from his disabilities.

So, if you are still reading....PRAY! Send up a prayer on our behalf that when we get there tomorrow we'd have favor and the records will be in order.  The symptoms and problems will be apparent and recognized and recorded appropriately and justice and mercy and goodness will prevail on behalf of this wounded veteran and his family.

2 comments:

  1. I had no idea things were this complicated, my heart goes out to you and your family. I am so sorry you are having to fight for the benefits that I believe John is due him. I am not sure what I might be able to do to help you guys but know that I am making a run for the U.S. Congress in 2014 and if I win, I promise to do what ever I can for you. In the mean time, I will pray for you and John and your beautiful children.

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    1. Thank you, Dan. It is exhausting. A little progress though...after two months of the Independent Living program the Dublin VA finally acknowledged the Dental referral and we are going to an oral surgeon in Macon today as a pre-op to remove 6 teeth with IV sedation. We were happy with the C&P exams in Atlanta but we just have to wait for the VA to process it and decide the case. Love to you and yours.

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