The Graphic Bean is a veteran-owned business that produces creative design solutions for Northern Arizona companies and non-profit organizations. “The reason The Graphic Bean exists is because of my injury. I went through VA rehab and was retrained. I was able to start the Graphic Bean because of my disability,” said owner and lead designer Tim Fox. However, last October, Fox had to step aside from work obligations for several weeks to have reconstructive ankle surgery for his service-connected injury and disability. But the saga of trying to get needed care from the Veterans Administration (VA) had gone on for months prior.
The uncomplicated procedure of picking up the phone to schedule an appointment is not common practice with the VA. Veterans wait weeks or months for notification of needed appointments, according to the recent Interim Report: Review of VHA’s Patient Wait Times, Scheduling Practices, and Alleged Patient Deaths at the Phoenix Health Care System. “You can’t arrange appointments – we’re sent these letters and I have to show up [at the time specified by the letter]. If you can’t rearrange your schedule to make the appointment, you have to start all over again,” said Fox, a United States Air Force veteran.
“This letter dated Jan. 31, 2014 says that I had an appointment on Feb. 13. I probably got it the first week of February,” said Fox, explaining that it is sometimes difficult for businesspeople to rearrange their schedules on such short notice. Project ARCH (Access Received Closer to Home) has made scheduling easier for those who qualify. ARCH, according to the VA website, “intends to improve access for eligible veterans by connecting them to health care services closer to home.” Flagstaff is one of only five pilot sites established across the country.
“Through the ARCH program, I can schedule my appointments like you can with any normal doctor, once I’m referred by a VA doctor. Humana Veteran Service contacts the doctor and sets up the first appointment with a local specialist,” explained Fox. However, even this program has delays in care.
“My surgery was already scheduled [for September with a Flagstaff specialist] when I was told by Humana that I needed a cardiologist release prior to surgery. But Humana declined me going to see a local cardiologist,” reported the 51-year-old. That meant Fox needed to go back into the Prescott VA system. “It took four weeks to see a cardiologist at the VA hospital in Prescott, and get all the approved procedures,” he said. “I lost a day of work driving to Prescott, and the VA paid my mileage to go down there. I don’t know if it saved anybody any money.” His surgery in Flagstaff was delayed until October.
“My surgery went great, the facility was wonderful, and the tending nurses were great. A little more than a month later, they removed the cast to evaluate the ankle to see how it was healing, and took X-rays like they do after surgery. They contacted Humana because they needed to put me in an immobilization brace. Humana declined authorization for the brace because the doctor did not request it prior to surgery,” said the exasperated veteran, who understood that until physicians removed the cast, X-rayed and examined his ankle, they would not know what would be required.
“If they don’t approve the brace, I reinjure the ankle that they just paid to fix! From the veteran’s side, it makes no logical sense. It might make sense for the administration side – but I don’t know how it would,” Fox said.
“So they had to recast the ankle because it was non-weight bearing. There was no reason that I had to wait an additional 48 hours for the brace. Then I had to go to a different facility to get it fitted. That required another trip with a driver. Those are the parts of the administration thing that drives most veterans crazy. It makes absolutely no sense. It is ugly; it is a lot like nailing Jell-O to a tree,” said Fox, who was discharged after nine-and-a-half years of service as a Sargent E-4.
Brian Anderson, 42, recently retired from the Arizona National Guard and had prior service in the Army as a Sergeant First Class (E-7), otherwise known as a platoon leader. In his 23 years of service, he did active duty in Desert Storm with the U.S. Army and was in the Persian Gulf twice and served on the Mexico border with the Arizona National Guard.
Anderson was trying to get a disability rating for his knees, back and hearing, but in 2003, he was denied because he was back on active duty. In 2004, he resubmitted and was again denied disability for his injuries. “Three weeks later, I got a call from the VA. They had found out that I got a Purple Heart and that I was near enough to the explosion that it could have affected my hearing. I ended up getting a rating of 20 percent [disability] for my knees and 10 percent for my hearing.
“The VA contacted me and asked me to come for a physical that included an EKG, blood work, diabetes scanning – everything. They explained the ARCH program to me,” said Anderson, who now works as a field superintendent for Flagstaff construction firms. “I thought it was a great deal. I had three things that were bothering me, tendonitis [tennis elbow] in my arms, headaches and knee pain. I could only do two at a time – my forearms hurt more than my knees, so I picked arms and headaches. I saw specialists in Flagstaff and didn’t have to go to the VA in Prescott.”
“I have not had a bad experience,” said Anderson, who relayed another story. While on a mission with the Arizona National Guard at the Arizona-Mexican border, his disability payments were discontinued because he was on active duty again. “Then seven to eight months ago, I got a call from a guy out of the blue who tells me I could collect on a state order. So I would have never known until they called me and tried to make it right. They called to correct a mistake that was made. The VA has not done me wrong. I’m young enough and healthy enough that I don’t need the VA for extensive medical care.”
Veterans report that it is difficult to know the services or payments to which they are entitled. “There’s no one in charge, there’s no accountability and there’s no booklet that we can see that tells us what our rights are because it’s always changing,” said Ronald Arthur Hunter III of Mountainaire.
Hunter served with the U.S. Marine Corps from 1979 to 1983 and was discharged as a Corporeal. He spent nine months at Marine Corps Base Camp Lejeune in Jacksonville, N.C. According to the VA’s Public Health website, “Veterans and family members who served on active duty or resided at Camp Lejeune for 30 days or more between Jan. 1, 1957 and Dec. 31, 1987 may be eligible for medical care for 15 health conditions” that include Non-Hodgkin’s lymphoma, lung cancer, bladder cancer, leukemia, and neurobehavioral effects.
In 2006, a tumor was removed from between Hunter’s ear and skull. Since then, he suffers from what he calls extreme vertigo: incapacitating fits, convulsions and cold sweats.
“I got into the VA three years ago and since then I’ve hit every roadblock that I possibly could,” said the 52-year-old. His first veterans advocate helped him fill out paperwork for Fort Lejeune claims. Before Hunter could be assessed, his advocate retired and the computer documentation and paperwork asking for a hearing were lost. His second advocate helped him repeat the process of piecing together documentation needed to assess eligibility. “I still don’t know if I am part of that [Lejeune] group or not. I’ve seen a minimum of four specialists and no one has ever told me what’s wrong. They’re still trying to decide if it is an ear thing or a brain thing,” he said.
Hunter also experienced multiple scheduling problems. “I received a letter that said I had an appointment in Kingman. When I tried to schedule a DAV [Disabled American Veterans] driver to take me, he said, ‘We don’t go to Kingman.’ The doctor had to remake the request for an appointment in Prescott or Phoenix. Every time something happens, it is a three-month delay,” said the veteran, whose paperwork slipped through the cracks for eight months one time. “The doctor apologized for that,” he said.
“I know they have the ability to give me back good quality of life because they did before,” said the Marine. Twenty-five years ago, VA surgeons in Oregon performed surgery to relieve the crippling effects of carrying heavy backpacks with undiagnosed spinal bifida, says Hunter. “I’ve had a superior experience with the VA in the past. I think it has gotten worse in the past four years.
“When we signed up, they told us that we would be taken of if we couldn’t take care of ourselves. It is a good attraction for a poor man who is just starting out in life,” said Hunter, shaking his head. FBN
Veterans can find out if they are eligible for ARCH by contacting their care coordinator at their VA Medical Center, http://www.va.gov/health/arch/
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