MEMORIAL DAY–2014


downloadA weekend so rich in the history of America’s former military members threatens to be engulfed in a fiasco-the making of which is so shocking as to defy comprehension. A Government Agency specifically designed to give America’s Sons of War succor instead secretly conspires to deprive them of the same. A complicit VA hierarchy goes along with the practice and indeed, threatens job termination to all who would criticize the practice or reveal it to the public-for decades. An outraged House of Representatives-the House of the People-votes overwhelmingly (390-33) to finally give the power to punish or fire these miscreants to its titular head, and the Senate- who provides the “Advice and Consent”- declines to touch it. Worse, the Head of the Veterans Affairs Committee tables it and insists on a “reading” of the bill along with hearings. Gee, where was this level of concern in 2010 when the Affordable Care Act came up for a vote in the Senate? Nobody even wanted to read it before voting. So sure were they in their mandate, they could not be bothered. 

Thus we find ourselves amidst the smoke of our barbecues looking at one another and uttering a resounding “Huh?” Veterans of all wars (and peace) should be making a list and checking it twice for this  November. I have never been one to go political and I studiously attempt to refrain from it now. I merely ask my fellow Veterans to look closely at the the voting records-the whole history of the voting records- of the Representatives and Senators who ask you for your vote this fall. Some congressmen have been ensconced for so long that a large, extended period of study may have to be set aside to analyze them. Measure their response to your and our Veteran needs over the last decades and ask yourself if they have been true to our ideals, needs and belief. It makes no difference what political stripe they profess.

You and I gave up a part of our lives-24 hours a day- for an extended period. Some proffered it for decades as dedicated “lifers”. Regardless of the level of commitment, none of us questioned the morals, the truth or the “why”. We did it because it was required, ordered or in the best interests of our country. None of us would ever consider putting an important job on hold for a three-day weekend-or dissemble for three weeks and schedule a hearing to “make sure all the cows get home”. When malfeasance is afoot, one does not arrange time for the offenders to shred the evidence and have pow wows to get their stories straight.

Politics should never be the flag of Patriots. Our love for America is what drew us to that bridge in Boston, to that beach in Normandy, to that country on the South China Sea, to that Godforsaken land in the southwest asia. For the most part, we did not need to be coerced into showing up. We did not need a mandate from America. A normal sense of decency and what is wholesome is what sent us to Iraq to abolish  Saddam’s rape rooms. The outrage of slaughtering a young girl for smiling at a boy or wishing for an education is what provoked us to set matters aright in Afghanistan. The horror of a Nation when attacked is what brought us together in 2001. I suspect that same dynamic has finally been awoken in the breasts of Americans. But can we sustain it long enough to effect change?

We have a clear case of America’s government employees surreptitiously attempting, by deceit and subterfuge, to allow our former citizen soldiers- our Sons of War- to die by inaction; to suffer permanent medical harm so that the Veterans Administrations’ books will “look good”; to ensure they get their precious bonuses for their inaction and indifference; to say “We don’t know these fellows would or wouldn’t have died so we should be careful not to cast stones in a glass house just yet.” Enough, please.

When you aspire to “be all you can be”, you do not attach codicils to it. You’re all in. As they say in the service, there is no “I” in Team. You are merely a force multiplier by your numbers and your group focus on a goal. Somewhere this metric evaporated when it was rewritten for the Veterans Administration. I won’t go into to the rest of our dysfunctional government process today. Suffice it to say we expect different outcomes from, say, the FCC or the FAA than the Veterans Administration.

The VA-our VA- is a compendium of programs and compensation promised our former servicemen. It is a compact between us and our country that we both signed. Finally, it is a grateful America showering its largesse on its few warriors (7%) who were brave or patriotic enough to want to ensure our greatness forever. They-we, because I certainly count myself as one- held up their end of the bargain. The Veterans Administration has demonstrated time and again that it requires constant supervision and prodding to hold up its end. In recent decades it has required extensive legislation to ensure we are not ignored entirely. which brings us to this sorry weekend of broken promises to those who were promised so much and given short shrift. Is it time for a new VJRA or a VCAA?

In recent weeks and months, I have written extensively about the Independent Living Program or ILP. Some in the VA would say say it is a generous handout and perhaps one that the VA can ill-afford. Perhaps some of those same VA employees hired to oversee it would go so far as to consider it a perk that has outlived its usefulness. Let’s look at it now in light of what is transpiring at VA Medical Centers (VAMCs) and outpatient clinics nationwide.

Much like our promised medical care we “earned” be incurring wounds, injuries and diseases in service, The ILP was also a gift from a Grateful Nation after the Vietnam ‘misunderstanding”. In order to make amends for the horrible way many of us were treated following our long distance defense of America’s ideals, Congress enacted the forerunner of the ILP in 1984. The idea was to give something back to America’s most severely disabled Veterans-those for whom the prospect of employment was unattainable. Rather than let them vegetate on sofas across the country, our legislators opted to gift them avocational pursuits such as photography, woodworking and gardening. These pursuits often encompassed tools or equipment beyond the Veterans’ scarce, financial means. By showing this appreciation to it’s most severely disabled, America’s legislators cemented good will and hope to us where we have normally come to expect none.

America also built a large infrastructure of hospitals and medical clinics to minister to our health needs as well. Their performance over the years was spotty and often imperfect but the occasional war or conflict always brought out the flag wavers and the required level of finance required to keep them afloat. And then one day “professionalism” reared its ugly head. Suddenly, kids were going to college and majoring in ‘professional government career’. Out went altruism and dedication to America and in came “I, Me, Me, Mine.” Gone was the joy of a job well done and in came “I deserve a bonus”.

In 1996, a Republican Congress decided to give the ILP a haircut. They trimmed a little off around the ears and back and reduced the largesse. The VA took this as a signal to continue the barbershop tradition and went so far as to start adding new ‘requirements’ to the program. At one point in 1997, the Office of General Counsel was tasked with giving a thumbs up or down to the whole idea of “avocational pursuits”. Fortunately for us, Congress had not specifically forbidden “hobbies” so it was allowed to continue but it erected the first trip wire to what was going to become the beginning of the end of a valuable asset for the severely disabled. About this time colleges instituted Masters programs in VA Administrative Procedures.

Sgt. John Peck-deserving of more than a can grabber.

Sgt. John Peck-deserving of more than a can grabber.

In 2001, the VA’s Office of General Counsel was enlisted to further tighten the belt on what was increasingly seen to be a wasteful program with no measurable successes. Think for a minute about that. What is success? The fact that a horribly disfigured paraplegic with nothing to live for suddenly found a reason to get up in the morning and photograph flowers? That a wheelchair-bound Veteran was able to go outside and climb on a riding lawnmower and mow his own lawn? That a severely depressed Vet found a reason not to commit suicide because he suddenly had a service dog companion to share his life with? VA doesn’t measure success. They have a mathematical/psychological test that requires demonstrating a ‘necessary and vital” component. You have to prove you need it before their psychologists will even ‘test’ you to see if you will become “more independent in your activities of everyday living”.  How can this be in an avowed ”nonadversarial environment”? Why would any of us, with 100% or more rated disabilities, have to prove by some insane manual requirement that we need a heated greenhouse in order to access the outdoors without doing ourselves medical harm. Does a paraplegic like Sgt. Peck above have to crawl into the VA on what is left of his hands and knees to demonstrate that a wheelchair is necessary and vital to his independence in his activities of everyday living? That is new metric VA is employing both in scheduling appointments and in all their programs. “Means test” doesn’t means much anymore at VA.

Each succeeding year since, ILP rehabilitations-i.e. successful  outcomes of applications of photographic equipment, riding lawnmowers and woodworking shops have declined because America’s Veterans are magically becoming more independent without them , are already independent in spite of missing  parts and pieces of their bodies or they simply have not demonstrated the object of their desire is “necessary and vital” to their independence. And much like the required nexus needed for service connection of an injury, guess who gets to make this assessment? Right. Your ILP Vocational rehabilitation expert.

And likewise, each succeeding year, the VA’s Office of Independent Living Program Services, an arm of the Vocation, Rehabilitation and Education (VR&E) has grown larger. With each passing year, VR&E has also given more bonuses to its workers and begun hiring more and more high-priced psychologists to write lovely denial letters explaining why you are quite independent currently. Incredibly, this transformation has occurred under both administrations (Republican and Democrat) so it is not a political phenomenon. And with each passing year, a program once designed and implemented for severely disabled Veterans now finds all its funding going to high-priced VA personnel tasked with the sole purpose of denying you that which Congress apportioned for you. By now you can see the parallel between ILP and what we are promised medically.

VA has been derailed by a greedy, self-serving hierarchy of souls whose only raison d’etre is money. It’s no longer a job with high ideals. It is focused on doing as little as possible for Veterans at as high a rate of remuneration as can stand the test of approbation. Obviously there is a tipping point like the WWP where good taste is overwhelmed by greed. How bonuses entered into it is immaterial. They must teach that in college too.

I can remember a time when the aura of fairness occasionally gathered around the VA. The Veterans Benefits Administration, that arm tasked with compensation policy, has  been static and has never changed but the Veterans Health Administration (VHA) had always managed to maintain a modicum of respectability. Compassion was the hallmark of their calling. The operable word is “was”. The same metric of “professionalism” began to suffuse the VHA in the early 90s with the beginnings of the VISNs or Veterans Integrated Service Networks. The VHA gave the various VISNs the reins and allowed them to become autonomous and free to shape policy around their own needs and wants. This is perhaps where relinquishing the supervisory role introduced the camel’s nose under the tent. Shinseki can never hope to rope these bozos in and reassert control until they report directly to DC. Likewise, the VA’s ILP program has exactly the same defect. Each VR&E Office is free to arbitrarily deny on its own whim with no structured guidance from DC. We know where this leads. Power corrupts et cetera et cetera.

The VHA, ever since that seminal moment, has been guided by multiple voices with no common policy. Unfortunately, it does not explain how 26 (and counting) different VISNs could all come up with an identical policy to cook the books on VA scheduling and pull the wool over Dr. Robert Pretzel and General “nobody told me” Shinseki’s eyes. I don’t buy it.

I have vociferously defended Ric and his leadership as VA Secretary for numerous reasons but the analogy of President Truman’s well-known plaque stating “The buck stops here” is eerily similar. At what point can you plead ignorance to the machinations of Dr. Pretzel logic? After six years, can it be assumed you are in command of all the King’s horses and all the King’s men? If it can’t be assumed, might it be that it should be assumed? General Shinseki is tasked with an awesome burden of ensuring all his charges are looked after. As a general, he has ostensibly learned the art of delegating authority. Delegation of same is not to be confused with abdication or indifference to a sacred trust. Generals earn their stars for demonstrating leadership. Others follow and obey unswervingly based on this talent. In order for the disconnect we are currently witnessing, either respect has been lost or it never was earned. The obverse of that coin is a gross, systemic indifference to any authority in charge of VA. Donald Duck (or Donald Trump) could be in charge and there would be no different outcome. This is the new wave professionalism of which I speak. It is apparently all-pervasive at the higher levels of the VHA and, I dare say, has festered for centuries in the VBA. General Shinseki is perfectly positioned to effect change-but will he? Will the President allow him to fire all those political appointees? Changing VA Secretaries now would be akin to throwing the baby out with the bathwater. He’s aware of the problem. Let him fix it. If he fails to, then show him the door.

Notwithstanding the fact that there are a large number of dedicated souls working in the VHA, the administrative cohort marches to the beat of a decidedly different drummer. Some of you will say an inordinately large number of Veterans come to work for the VHA. I agree. I also find that many of them are appalled by what they see and report it at their own peril. I get email from them fairly often and read even more of the jobs lost due to their reporting these failings.

vaoigThe malaise infects the VA’s Office of Inspector Gadget as well. They seem no more inclined to mount a meaningful expedition to Phoenix than one to Mt. Everest. Even if they were able to prove mis/malfeasance, they are toothless dogs and can only bark. Being part of the same organization also creates a bow wave that everyone can see coming a mile away. Surprise inspections are not in their vocabulary. Depending on them at this juncture is viewed as “If you like your VA doctor, you get to keep your VA doctor. Getting in to see him might appear to be a problem but we’re working on that so bear with us.”

We were promised much by President Lincoln and succeeding Presidents. We have watched as the rights are bartered away in bits and pieces. We have allowed our congressmen to trade these promises in on newer, better options only to discover they are hollow shells. What appears regular isn’t. VA hospital administrators, kings in their own VISN fiefdoms, have managed to hornswoggle the big boys down at 810 Vermin Ave NW into outrageous $20,000.00 a year bonuses all the while watching Veterans die on their watch. The drive by media were appalled but it strangely subsided. Here we are again at the next logical hiccup and the media are again flabbergasted. How can it be that America is so incredibly gullible or naive?

Memorial Day should be a time of remembrance of great warriors and great deeds. It should be a celebration of all that made us the greatest nation on earth. We should be toasting those who gave their all at sacred places like Dong Ap Bia in the A Shau valley, the beaches of Iwo Jima, or the northern Plain of Jars along Route 7. Instead, we sit in our lawn chairs in the back yards of America and ask ourselves how we could be so complacent as to allow our Veterans to fall through the cracks of the VA medical bureaucracy yet again.

Sadly, this state of affairs has been allowed to propagate due to apathy, avarice and indifference. Let this be a clarion call to renew the compact between America’s citizen warriors and to keep it sacred. Promises were made and gifts were exchanged when we signed up. Time and ‘professional administrators’ cannot be allowed to erode that which was earned by our sacrifices.

The following is what happens when we allow professional administrators to shape our ILP programs. As I said above, gone are the darkrooms, wood shops and feasibility of mowing your own lawn if you are severely disabled. Here’s the new metric.

M28R Part IV, Subchapter C , section 9.05 on what is recommended.

Equipment to Increase Independence in Activities of Daily Living

VA prosthetics and/or Home Improvements and Structural Alterations
(HISA) grant programs are the primary providers for equipment to
increase independence in daily living. However, the VRC may provide
equipment needed to increase activities of daily living as indicated on the
Preliminary Independent Living Assessment if such equipment is not
provided by prosthetics and/or HISA.

Examples of this type of equipment include, but are not limited to the
following:
• Grab bars to increase independence and safety with bathing and
toileting

• Shower chairs

• Raised toilet seats

• Shoe horns

• Grabbers to extend reach and mobility

And:

If the VA physician agrees that the mobility device is needed and
arrangements cannot be made to provide the device through the VHA,
VR&E may provide the device as part of an IILP. However, in no
circumstance, should a tractor, mower, or similar equipment be identified
as a mobility device or as a solution to an independent living need, and
authorized as part of an IILP.

Shit, oh dear. Under no circumstances are we gonna allow Vets to mow their lawns. Let them hire it out if they’re so damn disabled. What the hey? We pay them exorbitant wages to sit around and watch TV for crying out loud. This ILP nonsense has to stop.

 

Happy Memorial Day weekend.

 

 

 

About asknod

VA claims blogger
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4 Responses to MEMORIAL DAY–2014

  1. Randy says:

    I was recently on the phone with the ILP in Denver and his response, concerning my request, was to get the item summarized by my PCP and then “we” could apply for HISA to pay for it. No idea as to why “we” had to go door to door looking for a proven ILP issue when they have a budget. Perhaps it invaded their personal bank account.

    • asknod says:

      Randy, remember you filed before March 31, 2014 so you are under the old rules of M-28, not M28R. We’re going to get that thrown out anyway. It doesn’t comport with the regulations, the statute or the original intent of Congress. Concurrently, VAOPGCPREC-34-97 specifically authorizes “hobbies”. I’m sure VA can say you could entertain yourself with grab bars- perhaps even call it a hobby in the true sense.

      • Randy says:

        My main hobby is to make their lives miserable as much as possible but I do need the requested item in order to sleep better at night and help relieve the swelling of the legs. It took the VA over a year of denial about the DMII until I took them to task and I received the uh-oh letter (CUE). So I will continue to play the game and when the time comes, and it will, I will be the one laughing all of the way to the bank.

  2. John King says:

    I read where if vet can’t get an appointment they will be able to get care at private hospital. Why not just let some of us who want care outside the VA system to get it, regardless? I don’t want to drive 20 miles just for a flu shot from the VA. Let the really sick vets who need to be in hospital and have no other options use the VA hospital. For the rest of us let us use private doctor,s and have the VA pay medicare rate. Medicare for all vets with a drug benefit and dental and vision care. The taxpayers would save a fortune. I hardly use the VA as it is due to access problems. They have refused to do necessary dental and vision care for me. I would not let them trim my toenails. Let me sign off on permanent deferral of VA care for ChampVA. If the VA would just pay my medigap I would be satisfied. I am officially housebound so why can’t I just get Fee Base? The VA has said I live too close to over crowded VA hospital to get Fee Base even though I am HB. Where is the sense in this unless they intend to discourage me from getting care via the VA?

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