People have emailed me and even cornered me down at Walt’s in my favorite place- the meat section, of course. It’s like watching meat TV. My best friend in the world, Ray Paul, is the head butcher there. Vets have even tackled me over to the Vaughn Post Office with one or both of these questions and want to know my sentiments. Beats me why. I wouldn’t take my dog to my VA hospital. Three more operations to fix their first fustercluck? I’ve heard of the third time being the charm but VA is waaaay out of that league. When VA doctors talk about their Personal Best, they’re referring to how many medical misadventures they’ve had in one 12-month period.

Speaking of my friend Ray Paul, when he and his wife heard about our predicament, she retired and they sold their house in Salt Lick City. They moved back here to help Cupcake out when I spent that year in the VAMC. In fact, they lived with us for three years and helped out with the horses and the whole shooting match. Now that’s friends. Fact is Ray Paul isn’t even a Vet either. I was supposed to be his Best man in Vegas but I augered in a month before showtime.

Now about RAMP. You all remember I made jokes about this back when but I knew something was going to come to pass.  My daddy once said a fart is nothing more than a turd signaling for Right of Way. Apparently my verbal flatulence was more than a premonition as we see now.

https://asknod.org/2015/04/22/bva-announces-fda-fully-developed-appeals/

Launching RAMP

Since spring NOVA has come and gone, and on account of my dues are paid up, here’s the Powerpoint © presentation for the new Rapid Appeals Modernization Program. Anytime you see a VA acronym and a VA snake oil salesman trying to hawk it, you better move your wallet to your front pocket, son. For my money, no amount of lipstick on this pig is going to get it airborne. We already got the knick-knack, paddywhack with the FDC (Fully Developed Claim) by losing the duty to assist. Here, yet again, we see the same figurative removal of that Miranda warning. The NOVA presentation moves it out of the shadows and into the forefront because it isn’t enunciated.

Section3_AppealsReformPanel

By and large, we’ve come a long way, baby. Comer v. Peake managed to sandwich in a healthy dose of  Barrett v. Nicholson 466 F.3d 1038,1044 (Fed. Cir. 2006) and  Jaquay v. Principi, 304 F.3d 1276, 1282 (Fed. Cir. 2002) all into one donut. My take on RAMP is a beleaguered agency who keeps stepping on their necktie trying to acronym their way to a functional, timely Benefits program.

What, exactly, did USB Allison “Ace” Hickey expect she was going to set loose when she fired up the VBMS engine and 125-day claims service with 98% guaranteed denial rates? The FDC guaranteed one thing. With Vets now having access to the internet and websites that explain “how to” and DIY VA claims, guess what? If you deny a shit ton of claims, you can almost predict an avalanche of appeals soon thereafter. Ruh-oh Rorge. Now what?

Having a rapid appeals program does alleviate the BVA backlog- but for how long? Nobody wants to have a frank discussion at this cocktail party with those 3.5 million 800 lb. Vet gorillas sitting on the sofa. We’ve been busy in Iraq, Africa- and now Syria- making damaged Vets for almost 18 years.  Gee. You figure there might be a “lump in the python” of statistics that skews things a little south on the numbers? I once thought hiring more VA Veterans Law Judges would be the panacea. With 60,000 appeals in cold storage  now and a projected 72,000 by this time next year ad nauseum, 1,000 VLJs might plug the dike for the foreseeable future (2050). Of course, that doesn’t turn off the spigot of appeals. For that, we might have to take a time out on being the World’s policeman.

Several years ago, I was studying a VA stat sheet that showed the numbers of disabled Vets over a 2000-2014 period. The document showed the number of Vets rated from 0% to 100% with the TDIU numbers broken out as well. What struck me is that America started producing severely disabled Vets wholesale  since the turn of the Millenium and strangely enough, the numbers of Vets were static! Yeppers. About 3.2 million somewhere between 0-100% and 3.3 million fourteen years later. Worse, VA had predicted a massive uptick of Vietnam Agent Orange filings as we age out of the system. Quo vadis, Johnny Vet? They must’f hired my ex-wife’s accountant. He could make an elephant disappear up its own derrière.

Enough of those sleight of hand statistics. Let’s discuss VA Medical and this boogyman called privatization. First of all, VA has about 33,000 vacancies-big huge ones. We’re not talking janitors sanitation technicians here. We’re discussing shrinks, general practitioners and specialists in any number of fields. That vacancy rate brain fart is what killed those 45 Phoenix folks who waited too long and died. Yes sir. Vets waited for that promised cutting edge VA medical care until they could not be saved. Vets with PTSD committed suicide because there were’t enough shrinks to listen and prescribe some brain bending medication that might help. VA probably refers to this as the DRM Triage Protocol. That’s a snappy acronym for their Darwinian Reduction Method. If you’re stupid enough to keep waiting for help that will never come, you probably earned your place on the secret waiting list from Hell.

They misspelled Bozo

So let me see if I get this right.  Our good buddies at DAV, VFW, AmVets, and that whole crowd of 146 VSOs are in high dudgeon that we might do away with VA healthcare; that we might privatize it and force you Vets off the reservation. I’ll be an independent thinker here and cast my own troubles as a rare, infrequent medical misadventure that only happens once in a million years. So how do I feel about VFW’s insistence on the status quo that my brothers must die for lack of care simply because they don’t have enough hired help? In a word, speechless. In 1972, when I came home from Vietnam, the VFW told me I couldn’t join because I had not served in a war. Again, speechless. Think how much money I saved on that bitchslap. Now I get solicitations to join almost monthly…

The VA Choice Program was the repair order. It ate $3 billion over the last few years but it saved Vets’ lives. VSOs prefer the secret waiting lists and dying Vets over any scheme for privatization. I want you all to let that sink in. These VSO outfits you folks swear by are demanding you shut up and accept inferior medical care. And you even pay dues to them to advocate against your best interests. 

What I would advocate for is letting VA keep specialty care-polyplegic Vets who need immense physical therapy and prosthetics. Let them focus on PTSD,  burn pit diseases, Agent Orange disabilities and the really big, tough nuts no one else is prepared to tackle. Take the run of the mill folks with an owie on their finger or other small injuries and give them VA choice. Why clog up the scarce resources needed for severely disabled Vets with Flu shots and hemorrhoids? It’s pointless and what’s more-it’s killing a lot of Vets waiting for their shot at a timely appointment. Have regional centers as we do now next door to large medical centers like Portland and the University of Oregon Medical Center and close the rest. Likewise Seattle and the UW School of Medicine. VA does a ton of research on diseases and one of their own even came up with the cure for Hepatitis C. This is where VA should focus their talents and husband their scare resources.

When I was getting ”free” dental care at the American Lake Dental Clinic, my new fillings were falling out faster than they could replace them. During that same time, there was a hellacious VA dentist turnover there. Now why is that? What kind of working conditions would drive a fellow out of a cush 20-year and retire job? Apparently, some funky regulations might be to blame. They probably have the same guy who wrote part 3 of  38 CFR writing the dental regs. On the obverse side, I now have my old dentist back, my fillings stay put and they’re even a matching color as my factory issued ones. He’s 9 miles away (16 minutes) and not 44 with a $6.50 bridge toll. Oddly, now that I get in to see the dentist more frequently, I don’t have as many dental problems. Go figure. If VA Choice works in just this limited sense (dentistry), why can’t we sub out a lot of the nitnoy shit and take a load off them VAMC folks with tired bonus-calloused asses? In sum, how about a hybrid arrangement? DAV and their ilk insist any private encroachment into the sacrosanct area of VA medical care is a bridge too far. I guess if you have friends like that, you sure don’t need me harping about them. Fly at it.

And that’s all I’m gonna say about that.