Dental Insurance for Veterans: Get It Now Through #VADIP

Keep Them Smiling!

Are you a veteran looking for dental insurance? Although Congress has not authorized the VA to pay for dental care unless you are disabled, the VA has negotiated a new "VA Dental Insurance Program" (VADIP) that lets you purchase private dental insurance at a reduced cost.

• Your participation is voluntary.
• Purchasing a dental plan does not affect your eligibility for VA dental services and treatment.
• Coverage begins January 1, 2014.
• You pay a fixed monthly premiums for coverage and any copayments required, depending on the type of plan selected.
• You may participate if you are a veteran or are in the CHAMPVA program.

What Do You Get

• Delta Dental has three options: "Standard" "Enhanced" and "Comprehensive"
• Met Life has two options: "Standard" and "High"
• Each of them lets you add some dependents for a higher premium.

What Does It Cost

See Delta Dental Rate Calculator and Met Life Rate Calculator.
The costs vary depending on: 

• where you live
• the insurance company you pick 
• the plan ("standard" or otherwise) you pick
• the number of non-veteran dependents you include
• Whether you are enrolling as a veteran or under the CHAMPVA program.

Each plan has a monthly premium, plus copayments. These are likely to change every year so you'll want to consult the latest plan documents. Don't be shy about calling both insurance agencies and trying to see if customer service can identify the plan that comes closest to your needs - just be sure your thought about what you need and WRITTEN IT DOWN FOR REFERENCE before you make the call - you don't want to forget something in the middle of the call!

I compared the 2014 monthly premium for  for Veteran only standard option:

• Delta Dental 
• Washington State (ZIP code 98204) $12.90
• West Virginia (ZIP code 26054) $8.90 
• Met Life
• Washington State (ZIP code 98204)  $25.90
• West Virginia (ZIP code 26054) $17.27 

Keep in mind that these are probably not identical plans; the difference in prices might be due to one having different coverage than the other - or it might not.

Your situation will vary so check for yourself!

• Delta Dental Rates
• Met Life Rates

Learn more

• Delta Dental 1-855-370-3303
• Met Life 1-888-310-1681
• VA website http://www.va.gov/healthbenefits/vadip/

Do You Have The Drive?

Typical Volunteer Van

PICTURE YOURSELF driving a fine, late-model vehicle like the one in the picture. You are taking six of your fellow veterans to their VA medical appointments at the American Lake VA hospital in Tacoma (Lakewood) or the VA hospital in Seattle. When you get there, they thank you for the ride and you know that if it weren't for you, they might have missed their appointment and not gotten the care they earned through their service. And the frosting on the cake: the VA provides the vehicle and the gas!\

This can be you! Every day, Volunteer Drivers serving in VA Puget Sound's Volunteer Transportation Network (VTN) make the difference in getting veterans to their medical care. The network of vehicles are garaged all over the Puget Sound area because veterans live everywhere - there's probably thousands in your area. Now you can use your knowledge of your local roads and your driving ability to get them to their medical appoints on time.

If you have one day a month, or more, the VTN needs you! Why not get started? Just call 206-764-2195 (Seattle) or 253-583-1054 (Tacoma/Lakewood) and find out how that driver can be you! 
(Note: this program was started by Disabled American Veterans (DAV) but you do not have to be a member of DAV to participate)

Welcome Michael J. Murphy

Michael J. Murphy

Veterans and Friends of Puget Sound extends a “Welcome to the Seattle Area” to the new Director of the VA Puget Sound Health Care System, Michael J. Murphy. A permanent director for VA Health Care Puget Sound System has been needed for a long time! With the arrival of Director Murphy, it is hoped that some stability and long-range improvements may be on the table.
Murphy comes to us from the Fargo VA Health Care System, where he was the Medical Center Director. Previously he was a Medical Group Commander in United States Air Force from 2000 – 2002. As a Fellow of the American College of Healthcare Executives (FACHE) he is board certified in healthcare management through the American College of Healthcare Executives.

November 1: Webcast - Advocating for Veterans: The Basics on VA Benefits, Discharge Upgrades and Veteran Cultural Competency 2013

There are over 21 million veterans in the U.S.; many of them are not aware of the benefits to which they are entitled. Medical and financial assistance are available to men and women who have served in the military, but some who can qualify are not receiving the benefits that they need. Attorneys can assist veterans with the problems that preclude them from receiving benefits, such as:

• Lack of proper paper trails to “service-connect” their injuries
• Ineligibility for benefits for those given less than fully honorable discharges for behaviors that were related to post traumatic stress disorder or minor disciplinary infractions

Nearly 45% of veterans returning from Iraq and Afghanistan seek compensation from the Department of Veterans Affairs (VA) for service related injuries. A stunning 30% suffer from post-traumatic stress disorder.  Many of those who should receive benefits will be denied. All of them will wait months or years for the VA to issue decisions on their claims. Learn how to navigate the VA claims process and to become an effective advocate for veterans in need. This all day program will provide an overview of VA disability law and military discharge review law. You will gain an understanding of different types of military discharges, why they are important, and how you can help veterans with less than Honorable discharges.
The three morning sessions provide the basics you need to represent veterans before the VA. The morning sessions fulfill the VA’s requirement for qualifying CLE within the first 12 months of your VA accreditation.
The 1:45pm session, Veterans’ Cultural Competency: Combat to Community, will help veterans’ advocates to understand the challenges that veterans face in their transition to a noncombat community.
The 2:45pm to 5:00pm sessions will provide attorneys with the tools that they need to assist veterans in upgrading their discharge status and removing stigmatizing information from their discharge documents.
IMPORTANT!! GET ACCREDITED BY THE VA BEFORE YOU ATTEND THIS TRAINING.

1. Attorneys and other advocates must be accredited to practice before the VA. To obtain accreditation you must complete this form: www.va.gov/vaforms/va/pdf/VA21a.pdf.
2. Accreditation by the VA may take several weeks, so do not delay filing your application. You can speed up the process by emailing the form to OGCAccreditationMailbox@va.gov, and including a copy of your State Bar Certificate of Good Standing
3. Within 12 months of accreditation you are required to complete three hours of qualifying CLE. The morning session of this program satisfies that requirement, but only if you have already received your accreditation from the VA.

Attorneys and other advocates who become accredited will be listed on a national VA list, and are entitled to represent veterans in their claims for benefits, on a pro bono basis, and for attorney’s fees on appeals, where they are available.
Title:
Advocating for Veterans: The Basics on VA Benefits, Discharge Upgrades and Veteran Cultural Competency 2013
When/Where:
November 1, 2013
9:00 AM Pacific
San Francisco, CA
Also Webcast
Speakers:

• Co-Chair(s)
• Theresa Mesa ~ Program Developer, Office of Legal Services, The State Bar of California
• Teresa Panepinto ~ Legal Director, Swords to Plowshares
• Bradford Adams ~ Skadden Fellow, Swords to Plowshares
• Becca von Behren ~ Staff Attorney, Swords to Plowshares
• Michael Blecker ~ Executive Director, Swords to Plowshares
• Amy N. Fairweather ~ Policy Director, Swords to Plowshares
• Starlyn Lara ~ Women Veteran Program Manager, Community Educator and Outreach Program Manager, Swords to Plowshares
• Nicole M Perez ~ Staff Attorney, Legal Aid Foundation of Los Angeles
• John Robert Unruh ~ Staff Attorney and Pro Bono Coordinator, Swords to Plowshares
• Program Attorney: Christina Thompson ~ Program Attorney, Practising Law Institute

Credits:
Alabama, Alaska, Arkansas, California, Colorado, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Minnesota, Mississippi, Missouri, Montana, Nebraska, North Carolina, North Dakota, New Hampshire, New Jersey, New Mexico, Nevada, New York, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Virgin Islands, Washington, West Virginia, Wisconsin, and Wyoming.
By:
Practising Law Institute
Cost:
Free
More Information And Registration

Veterans Field Guide to Government Shutdown

You probably know that federal government expires Monday, September 30, 2013; while Congress could prevent a lapse, prudence requires planning for the possibility of a lapse.
VA's 2-page information sheet, the Veterans Field Guide to Government Shutdown summarizes the services that will be available and those that will be impacted by a lapse in appropriations.

The Veterans Health Administration is forward-funded and so VA will still be able to provide some services. All VA medical facilities and clinics will remain fully operational including inpatient/outpatient care, prescriptions, surgery, dental treatment, extended care, mental health care, nursing home care, special health care services for women Veterans and Vet centers.

Additional services that will be available:

• Military sexual trauma counseling
• Readjustment counseling services
• Veterans Crisis Line
• Insurance processing
• Home loan processing
• My HealtheVet – all services
• Education benefits claims will be processed
• Vocational rehabilitation payments will be processed
• Compensation and pension claims will be processed
• Acquisitions Logistics Center will accept and fill prosthetics supply orders
• Office of Small and Disadvantaged Small Businesses will be open

Payments to be made Oct. 1 include disability and compensation, and education benefits payments.
See more:
http://www.va.gov/opa/docs/Field_Guide_20130927.pdf
And think about calling your Congresscritter!

Operation #Huling: Car Dealers Who Abuse Disabled Veterans Should Reform While They Still Can

Last week, we were told of an elderly disabled veteran who had been taken advantage of by a car dealer.
His wife told us that this veteran is on medication for PTSD that affects his memory and other mental processes. He enjoyed walking along a row of car dealers near his Tacoma home and looking at the vehicles. "It's a guy thing," she explained.
Living on disability, he didn't have the money to buy a new car and didn't have the need either. He was not interested in buying anything and most of the dealers left him alone. Perhaps some of them were smart enough to appreciate having a guy looking over their offerings, since customers tend to go where there are already customers.
However, one afternoon a dealer sent a salesman out to this guy. The veterans remembers saying that he was just looking and not interested in buying, and then there is a gap in his memory. The next thing he remembers, he was in the sales office being congratulated on buying a $22,000 truck.
The veteran walked home and told his wife something odd had happened. She told him he needed to go back and find out what happened; he didn't have anything in writing, such as a contact.
The next day, he was at the dealership at 9AM. They told him he had signed a contract, so he owned the truck. He said he didn't remember that, he was on medication and didn't want a truck he couldn't use anyway. They told it that was tough, they had his signature and a $500 down payment from his debit card.
The wife called them to explain he was on medication and couldn't fairly sign a contract, and they hung up on her. She went to the dealership and spoke to the general manager; he told he that there was nothing he could do; they had sold the vehicle and was preparing it for delivery.
On Saturday, they called the veteran and told him to come and get the truck. He was quite unhappy about the situation; it is difficult to deal with PTSD and car salesmen at the same time. His wife got on the phone and told the dealer to stop harassing her husband.
The wife called Washington State's Attorney General's Office, and also the state department for helping the elderly. She says she was told that this dealership was the source of frequent complaints but there was nothing the state could do if there was a signed contract.
She then contacted a lawyer who forwarded the issue to the listserve of the Legal Assistance to Military Personnel Section of the Washington State Bar Association. This group does not itself perform pro bono services, but its members are generally interested in serving our servicemembers, veterans and their families. Through this listserve, Veterans and Friends of Puget Sound learned of this situation.

• I called the veteran's home and discussed the matter with the wife. She confirmed the report given to the listserve and added some details, and gave us permission to make further inquiries on their behalf.
• I called the dealer asking for more information. I was directed to the general manager's voicemail where I left a detailed message and my phone number. I did this twice. I received no response either time.
• I went to the dealer's website and left an inquiry with my contact information. Again, no response.
• I went to the Facebook page of the dealer's national brand carmaker, and left an inquiry. This seems to have disappeared
• I talked this over with Cyril Miller, VAF's Chairman. We agreed this was outrageous; regardless of the status of the contract, the dealer always has the power to rescind a contract made with a mentally disabled person. If this was an innocent mistake on their part, they could do the right thing quickly and without fanfare, or even earn some praise for doing the right thing. On the other hand, if they continued to try to get this disabled veterans' money, they were the lowest of the low and deserved the fullest shaming for their business practices.
• We started contacting persons who might be interested. Investigative reporters at the first two TV stations expressed great interest and wanted to set up immediate interviews with the wife. Officials at the Washington DVA and the Veterans' Affairs Specialist in the Washington Attorney General's Office likewise expressed interest and implied they would look into this.
• We introduced the story to a number of investigative reporters, at least one of which did an excellent job of interviewing the parties on both sides of the issue. I'm not naming this person because I don't know whether publicity is desired, but I would guess that being interviewed may have motivated the dealership's manager to think about this matter more seriously.
• Throughout this process, we contacted the wife because the veteran preferred to keep his head down. We have to respect his privacy and his wishes; in helping people you don't want to make things worse! We also tried to keep the number of phone calls to the wife to a reasonable number, while still coordinating efforts. Ultimately we agreed to go meet them early next week to plan out a campaign of naming and shaming the the dealership, on the grounds that there are over a million people in Puget Sound country who are either veterans or family or friends of veterans, and none of them would approve of this treatment. If decency won't motivate a company, perhaps financial self-interest will.

On Friday I was pleased to learn that the transaction was going to be cancelled; the veteran was going to get his money back and the dealership would stop harassing him. We don't know yet which step made the difference, or even if it was just a sudden attack of conscience by the car dealership. We may never know. But let us be happy that, this time, things have worked out.
----
UPDATE:
When I followed up with the veteran's wife, she said that the refund for the $500 had not arrived. I called the dealership a couple of times and was assured the check had been mailed. After two weeks and no check, I called to ask when we should show up as a group to collect the check. The manager asked me to wait on hold; after about five minutes, he got back on the line, said that the check had been mailed to a certain address. I told him that was different from the address that the veteran had given me, and asked when we could all come down to get a new check. He said that if the veteran's wife came there the next day at 3 PM, the check would be at the front desk.
I reported this to the wife, who seemed happy to go get the check on her own. The next day, she called us and said that not only was the check at the front desk, the entire building was surrounded with the dealer's vehicles; there were no parking spaces nearby for what the dealer may have feared was a huge media and veteran presence.
There is of course no way of knowing what exactly happened, but we don't have to make any assumptions; the client got the money back and all is well!
----

And next time? I'm thinking of putting together a campaign in the name of the Huling Brothers, a car dealership that was destroyed after it took advantage of a mentally disabled man. As we helped the family in this week's case, we received numerous hints that this sort of thing was pretty common. It might be worthwhile getting an intern to check around, figure out which dealerships (if any) are scummy enough to take advantage of veterans on disability, and publicize them widely --- as well as those dealerships honorable enough to refuse to abuse. If you're interest, contact us. This could be fun! 

Internal reviews rank Puget Sound VA health system low in quality - Seattle Times September 8, 2013

The tip of the iceberg of problems at the VA Puget Sound Healthcare System was revealed to the public in
"Internal reviews rank Puget Sound VA health system low in quality", an article in the Seattle Times September 8, 2013.
In it, reporter Hal Bernton described some of the issues that Veterans and Friends have been talking about all year - safety violations, failure to provide proper equipment to staff, retaliation against employees who insist on quality work, and so on. The article didn't go into a lot of detail and confined itself pretty much to the content of official reviews and a few quotes. but those reviews are damning enough: the hospital, which used to be among the top 10 in the VA system, now gets one star out of five, making it at the bottom!
The official response to these ratings is equally shocking. Rather than frankly admit there's a problem, "I am proud" says one official. 
There is also mention that the hospital got 3 out of 5 stars for "efficiency". That means that the hospital may be delivering one-star care, but it's doing it cheaply!
There is absolutely no reason that this hospital should not be earning five star ratings, but it will not be possible to improve without a frank admission of the problem. You cannot fix what you don't realize is broken.
Read the whole article, then decide for yourself whether this is acceptible.

Washington State Military and Veterans Legal Resource Guide

PRESS RELEASE FROM WASHINGTON STATE ATTORNEY GENERAL

Attorney General Ferguson unveils new resource for veterans, military personnel

September 10, 2013

Washington State Attorney General Bob Ferguson today announced a new “Military and Veterans Legal Resource Guide” to help veterans, military personnel and their families understand their legal rights and protections. ...

The guide is available online and will be distributed throughout the state.

With approximately 640,000 veteran residents, Washington State has the 12th largest veteran population in the United States.  Washington is also home to a number of major military installations, such as Joint Base Lewis–McChord, Fairchild Air Force Base, Naval Base Kitsap, and Naval Air Station Whidbey Island. Between active duty military personnel and members of the National Guard and Reserve, there are about 62,000 service members in Washington. Taken together, veterans and military personnel account for more than 10 percent of Washington’s total population.

Get The Guide Here

Introduction to Veterans' Benefits: Recording

This recording "Introduction to Veterans Benefits" was produced by the Legal Aid Foundation of Los Angeles in 2009.
 In one short hour, it develops a basic understanding of the veterans benefits system, focusing on the two major income-based benefit programs for disabled veterans and their families. It also briefly reviews the Department of Veterans Affairs adjudication process and discuss practical tools for effective advocacy on behalf of VA claimants. It is aimed at lawyers serving veterans, but it can also be useful for veterans and their family members.
  Try it Now!

A New Day at the Seattle VA: A True Story of Excellent Customer Service

Last week a veteran's mother called Veterans and Friends of Puget Sound with a problem. The veteran was at a VA facility in Washington State outside Seattle with a serious medical condition. The mother, who lived out of state, explained that the veteran needed and wanted to be transferred to a facility nearer his family so they could assist with his care. For medical reasons, this had to be done in a hurry and she was flying in to Seattle at the end of the week to escort him.

(I apologize if this story seems a little vague, but we can't use names, for privacy reasons.)

This posed problems. She didn't know how to make arrangements for the facility back in her home state to receive him, get his records, find a bed and so forth. Also, he had lost his photo ID, and we all know that it's almost impossible to fly without it. The need for speed was driving this situation right into major roadblocks.
Time was short. Frankly, it didn't seem likely that this could all be taken care of by the weekend.
VAF contacted the head of Customer Service at the VA Hospital in Seattle. Within a short time, he was talking things over with the mother and making arrangements for the veteran to get into the facility nearest the mother's home.
The ID was a harder problem. Fortunately the veteran was already registered with Puget Sound VA System, so they had photo on file. The Customer Service Manager pushed to get his photo ID reprinted and delivered in time for them to make their flight; he even stayed an hour after his work shift to ensure the ID got into the mother's hands on time.
It all worked!
This weekend we spoke with the mother, who tells us the veteran is now being cared for in the new facility. Mission Accomplished!
This is a good example of what looks like a new day at the Seattle VA. VAF is encouraged by stories like this, in which problems get solved by treating veterans like valued customers. While it's our job to keep looking for issues to work on, we're happy to report that many of them are now being dealt with and we stand in support of this positive trend. If we can all keep working in our various roles, there is no reason why Puget Sound VA Hospital System cannot return to being in the Top 10 VA facility and start competing for the Number 1 spot.

Hoorays For The Valets!

We would like to thank Yonatan Teklai and Kudus Ghebreslasie, part of the team of valets working at Veterans Administration Hospital in Seattle, for their help last week to an elderly veteran.
Why is the valet service so important? Imagine that you have trouble walking and are coming to VAH/Seattle for medical care. When you get to the main entrance, what are you going to do with your car? If you park in the lot, you have a long uphill walk into the building. If you're in a wheelchair, it's a difficult push!
To help out with this problem, valet parking has been available at VAH/Seattle ever since we got funding for it, and apart from an organizational hitch around New Years', it's been working pretty well. We don't have exact numbers, but from the samples we've observed whenever we visit, there must be several hundred veterans being served every business day! That's hundreds of veterans getting the practical help they need at the start of the process, in getting from their cars into the building.
Here's a true story. Last week we were helping a veteran who is unable to maneuver his wheelchair on his own. He got out at the main entrance and the valets parked his car while his wife took him to see the doctor.
When it was time to go home, she was prepared to wheel him to their car, but it can be difficult to take a chair down the hill safely. Also it can be hard to get from a wheelchair into a parked car when there are other cars parked next to it. Finally, the weather here in Seattle is often too wet for the comfort and safety of fragile elderly people to be out in.
No problem. Yonatan and Kudus were right there and went into action. One of them went to get the car, and then they both helped the veteran in and stowed his wheelchair. The veteran and his wife didn't have to fight the hill, the other parked cars or the weather; their departure from VAH/Seattle was just that much safer and that much faster.
We reserve the right to complain when things don't work, but that gives us the responsibility to praise when things do go right. On behalf of the veterans and their families who they have helped, we say to the Valets of the VA: THANKS!

Welcome Dane Olsen

The Seattle VA Hospital has a new Customer Service Manager: Mr. Dane Olsen. He's so new there that he doesn't have a business card to hand out or an official photo for us to post, but he met with two members of Veterans and Friends of Puget Sound last week in the PA's office.
We were duly impressed with his commitment to getting the best possible care to America's veterans who have earned it. We frankly pummeled him with questions, which he calmly received and then responded appropriately to.
Mr. Olsen is an Airborne Veteran of Operation Just Cause, the 1989 invasion of Panama. Apart from his evident fondness for jumping out of a perfectly good airplane to get shot at, he seems like a reasonable guy. If you see him in the halls of the hospital, why not step up, introduce yourself and talk with him a bit?
Veterans and Friends looks forward to working with him!

Why Give Up on MIST Treatment and Crow Boot? Jack Kegley's Story

UPDATDJack Kegley, USMC

UPDATED: 5/18/2013:
Mr. Kegley reports that he is now getting treatment that is satisfactory to him. Thanks for everyone's help!
------------------------------------------
ORIGINAL STORY:

Jack Kegley USMC is a 100% disabled Veteran (Vietnam) currently receiving treatment at the Seattle VA.

With the use of treatment such as MIST therapy, skin grafts, negative pressure therapy and specialized boots to offload the wound, his wound shrunk to the size of a pencil lead and was continuing to heal. Then the VA decided to give up on him. Why?

In 2007 Jack sought treatment of a diabetic ulcer about the size of a quarter, on his right big toe. Elderly diabetics are frequently at risk for injuries of this sort and, if not properly treated, they can grow to the size of a nickel or quarter, and compromise the patient's health generally.  For two years he was treated weekly at the dermatology clinic where a nurse practitioner would debride the foot (that is, scrap off any dead tissue), wrap it in a bandage and send him on his way. This did not result in healing.

Typical "Crow Boot"

In 2009, a new approach was tried: instead of treating Jack as an ulcer with a patient to be managed, he was treated as a patient with an ulcer to be healed.. The more aggressive and holistic approach went after not just the dead tissue of the toe, but the entire patient's nutrition (vitamins and minerals), blood sugar, bio mechanics of walking and so forth. This included the use of a Celleration Corporation “MIST Treatment” (which is also approved at other VA facilities and at Madigan Hospital). Plans were made for a "crow Boot" made to offload the foot even further and perhaps a skin graft to close the wound completely. The ulcer began to shrink and reached the size of a pencil lead.

However toward the end of 2012 that treatment was terminated. The Mist Treatment device was taken away and the previous, ineffectual treatment of scraping the wound was resumed. What does this mean to Jack?

He wrote to the VA several times:

"Let me start this conversation by stating that I am pleased with the level of care that has been provided to me, under most circumstances, by those I have worked with at the VA Seattle and that the following is not reflective of the entire staff and facility.

I am now back at the position I was a year ago with no indications to what type of progress they expect to make, how they expect to offload the weight on my toes (I now have wounds of both large toes) or give me any indication as to the future plans.  They are even talking about taking the scooter away at some point in the future.  I will not tolerate going backwards, I will get out of the VA system and seek private care before I let this return to a point it was a year ago.
Now that they have cancelled the crow boot which was suppose to offload my right foot, and made other changes that do not give me confidence, there are no indications as to when they expect to do anything other than debride the foot.
It has now been 8 weeks since Podiatry took over care of the wound, I am no better than I was when they started, my second toe is healing as expected (but no indication as to why the foot blistered in the first place) and secondary wound has occurred on the side of the original injury.  When I was receiving the Mist treatments, infections were non existent ( I am now under antibiotic care for an additional 6 week to fight a new infection) and an explanation was never given as to why I only received 3 of 27 mist treatments authorized by fee services and why the treatments were cancelled. No plans have been discussed as to future offloading of the wounds or future treatments other than a weekly debridement.  That treatment has now been denied for the future with no explanation to me as to why.
As a Marine I learned the difficult we did right away and that the impossible took a little longer.  I will not stop this type of correspondence until my status returns to a satisfactory state or this issue is resolved.
Sincerely
John M Kegley
USMC"

Lest you think that MIST Technology is some strange, new-age things, see the Bibliography of studies proving its effectiveness. It's not as cheap in the short run as debridement but, on the other hand, it was fixing the problem. The crow boot is not exotic either.
The VA system is not a privilege or a nice-to-have; it is a right that was earned by service to our nation. It is not a place to mess around; it is a place to implement effective treatment. Why was the treatment that was working ended and the treatment that was not working resumed?
Why the change?
Who benefited from stopping the treatment that worked?
So far, Jack has written several times to the VA and not received any response giving him a satisfactory response as to why the Seattle VA Hospital decided it didn't like MIST treatments and the crow boot. What will it take to get these questions answered and effective treatment resumed?

Saluting The Speechless

This week at the VA Hospital on Columbian, I was working with a client. He was there with two family members, I was with another volunteer from Veterans And Friends of Puget Sound, and jointly we were shepherding this elderly veteran through the process of getting the basic exam necessary for medical assistance there.

He was certainly deserving; he was a member of The Greatest Generation and I won't go into the details, for the point of my story was this: he could no longer speak or write. Communication was difficult. It seemed as if he had lost mental function, and it's hard to tell whether he had, for his hearing was not the best either. People around him typically spoke of him in the third person; there seemed little point in speaking to him since he could not respond and it was not clear that he understood anyway.
This changed when one doctor was told that the client was hard of hearing. The doctor started giving directions in a loud voice: "Can you raise your right hand? Can you give me a thumbs' up with your left hand?" and so forth. The client did all that, subject to some restrictions obviously of a physical nature. It became apparent to me that he was mentally alert to a significant extent.
I didn't know what to do about that. I made an effort thereafter to speak loudly into his ear where we were going next, "We need to get a blood draw, is that all right?" But it is hard to keep this in mind, when the responses are minimal. The responses were there, but they were purely physical and difficult to feel as communication.
Then it happened. We were in a waiting area and, as often happens, struck up a minor conversation with another waiting person. When that person left, he looked straight at the client and gave him a salute. The client gave him a relatively sharp salute right back.
This nonverbal message communicated a lot: respect, presence, interaction, normalcy. It is a part of the military culture that was important to him. It was something he could do and feel good doing, and in the process receive the respect he merited.
For the rest of the visit, I made a point of encouraging those present to give him the salute. He always responded. After we loaded him into his vehicle to be taken home, I faced him and did what I have not done since the Boy Scouts: gave my best salute. He returned it with firmness.
There is nothing more to say.

What Does "It's Taken Care Of" Mean To You?

Last week I sat in a meeting with an Associate Director and a Patient's Advocate at the Seattle VA Hospital, and the question came up of necessary medical supplies for a disabled veteran with whom we are working.
"It's been taken care of," said the PA.
Now, in the real world, a problem is taken care of when it is solved. When a patient needs some supplies, it is taken care of when the patient has the supplies.
In fact, in business the problem isn't "taken care of" until the patient has the supplies and has been asked whether the patient is satisfied with the way things went.
That's how you stay in business. You take care of problems by taking care of your customer. They will then take care of you!
How it appears that "take care of" has another meaning: "not take care of".
Today I called the veteran's family and was told that none of the supplies had arrived. This is nearly a week after being told to my face that the matter was taken care of, I learned that not only was the matter not taken care of at that time, but nearly a week later it was still not taken care of ... and the veteran/customer/client had not been given any idea as to when it would actually be taken care of.
If this is what employees at the Veterans Hospital think is meant by "take care of", they need to be tested for their comprehension of the English language.
I will be checking with this veteran's family on a regular basis to see when the matter is truly "taken care of".
I have not named any names here so far. First, the veteran's privacy will be respected absolutely, and until the veteran receives the care earned by fighting for our country, I'm not going to risk the quality of care by even asking to print the name. Second, what has happened so far in this matter is an employee not doing his jobs, but the reason for it is not yet known; is it policy? is it the culture at the institutition? is it a failure of training or leadership? I know for a fact that there are some very, very good employees at that hospital, so until we find out, I won't blame or shame the individual employee, but only report the facts necessary to get the problem solved.

William Booker Welcomed Into the VA System - A Success Story

William Booker Arrives
At Seattle VA Hospital

Today the staff at the Seattle VA Hospital welcomed Mr. William Booker, one of the last of our Tuskegee Airmen, as he went with his family through the process of getting the VA Photo ID needed to access its resources.
Until earlier this month, Mr. Booker was having difficulty gaining access to the VA system. As blogged earlier, when making inquiries as to his eligibility, his wife Dolores had been told that their income exceeded the statutory cut-off. This didn't seem right but what could they do? Rules are rules.
As it turned out, when the Booker family tried again with the help of volunteers from Veterans and Friends of Puget Sound (yes, we are boasting ;-)   we discovered that Mr. Booker's medical expenses should have been subtracted from his pension income in determining whether he met the qualifications. With this small correction, he easily qualified. A couple of weeks ago, the Booker family, our volunteers and the VA Hospital eligibility staff worked together to get the appropriate forms filled out correctly and into the system, all right and tight.
Today (February 27, 2013) Mr. Booker arrived at the Seattle VA Hospital to get his photo ID. The parking lot was very busy, but the valet service made it possible for him to disembark in his wheelchair and enter the facility, while the valets took care of the family van. He, his family and a couple of volunteers went to the eligibility determination station on the first floor, where it didn't take long to get his picture taken.
Next, our little party took the elevator by the entrance to go to the 2nd floor to make an appointment for his initial medical checkup. As you exit the elevator, you pick a number from the machine to establish your place in line; there are four categories of visit so make sure you pick the correct category and push the correct button, so you get the right number.

I 'm not mentioning any staff members' names in this blog post, because I didn't ask them. Yes, the 1st amendment and all that means that I could list what I saw on their nametags, but isn't it best to ask first? especially since they were all being so darn helpful. They know who they are and their efforts were greatly appreciated!

We waited about 10 minutes in the 2nd floor lobby, which didn't seem bad considering that we were category "B" - unscheduled visit. The interview was in an office with a door that closed for patient privacy, and the staff member gave us all the time we needed to answer questions - and you can believe that we had multiple questions! Due to the high volume of demand, there was about a five week delay for the initial checkup, but the staffer explained that if something came up in the meantime, he could go directly to the VA Hospital's ER for help.
Afterwards, our party went to the 1st floor to meet a Patient Advocate, because it can be helpful for family members who may be advocating for the veteran to know who they're talking to, and vice versa. While the family was discussing Mr. Booker's situation with one of the advocates, an Assistant Director stopped on the way by and welcomed them.
On the way out, the guards at the front desk suggested Mr. Booker wait inside the building, where it was warmer, while the valet went to get the van. They, along with everyone else we met today, were quite welcoming and seemed pleased to have met Mr. Booker.
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One lesson to take from this story: when in doubt, apply for benefits. If you or your family member might qualify, get the form and fill it out.  It's o.k. to use a screening checklist to give you ideas as to what to apply for, but do not try to figure out yourself if you qualify; do not let someone else try to figure out if you qualify; let the system figure whether you qualify. Remember that the Bookers could have gotten successfully enrolled into the system, and gotten the help that they had earned, much earlier if only they had known. It looks like they will be taken care of from this point, but there must be other veterans in similar situation who don't know they qualify for VA help that they earned through their service.

Quick Screening Guide

It has been estimated that half of all American veterans are not collecting the benefits that they earned, simply because they have not applied or their application is not completed. Here's a quick "screen" that can help you pick out some benefits for which you or a family member might qualify; remember that the only way to know for sure is to apply; this page is for general guidance only.

I. General Screen for Veteran Eligibility

• Are you a veteran or the dependent spouse, child, adult dependent child, or dependent parent of a veteran?
• If yes, does the veteran receive any cash benefits or health care from the U.S. Department of Veterans Affairs (VA)?
• If yes, advise the veteran to contact VA to inquire if additional benefits may be available.
• If no, does the veteran believe that the veteran has a disability that was incurred or aggravated by active military service?
• If yes, refer the veteran to apply for service-connected compensation and VA health care.

II. Screen for Pension Eligibility

• Do you have a discharge under conditions other than dishonorable?
• Did you serve during a period of war, such as World War II, Korea, Vietnam, or after August 2, 1990?
• Not counting your home, normal personal effects such as furnishings, and motor vehicles used for normal transportation, do you have resources less than $80,000 ?
• Is your income less than (a certain amount, which changes; check with the VA) after subtracting out-of-pocket medical expenses (be sure to count up these expenses since they make a big difference)?
• Are you (either one or both):
• 65 or older
• AND/OR permanently and totally disabled?
• If yes to all of these questions, contact the VA for possible pension eligibility.

III. Screen for Surviving Spouse Eligibility

• Are you the surviving spouse of a veteran?
• If yes, were you married at the time of veteran’s death?
• If no, stop. No VA benefits are payable.
• If yes, have you remarried since the veteran’s death?
• If no, screen for the veteran’s wartime service, character of discharge, and resources as outlined above and substitute current death pension income amounts for the family’s size. Note that the surviving spouse may be eligible for a death pension even if not aged or disabled.
• Refer a survivor who appears to meet the criteria to VA to apply for a death pension.

IV. Screen for Dependency and Indemnity Compensation Eligibility

• Did the veteran die of a service-connected disability or a disability that VA recognizes as presumptively serviceconnected due to service during the Vietnam or Gulf war or due to prisoner-of-war status?
• Is the survivor currently remarried?
• If no, refer the survivor to VA to apply for Dependency and Indemnity Compensation (DIC).
• If yes, were you remarried after December 31, 2003, and after you were at least 57?
• If yes, refer the survivor to VA to apply for DIC benefits.
• If no, DIC benefits are not available while the survivor is married.

The above is from "What Difference Does It Make if  the Client Is a Veteran? None if You  Don’t Ask About Veteran Status".
When screening, don't stop with the above; always check for eligibility with state and local programs as well. A little bit of time can have a huge impact.

Bus Stop At VA Hospital Lacks Rain Shelter

Bus Stop At Seattle VA Hospital
Lacks Any Rain Shelter

The bus stop at Seattle's VA Hospital has no shelter. Let's hope it doesn't rain much up on that hill. Some of those patients are not in the best of health; it is, after all, a hospital!

Who's in charge of bus shelters anyway?

You'll notice that there is a shelter nearby; it's for the valet service, which is an important feature of the place. Disabled veterans who can drive to the place can drop off their cars at the front door and the valet will park for them. This is IMPORTANT because the parking lot is very big and often full; it would be crazy to require veterans with limited mobility to get from the outer edges to the building on their own ... possibly missing ... feet.

If you're going to have a valet service, you need a shelter for the valets. That's just logic; it's rainy here in Seattle, and workers need to be treated well. 

But a shelter for veterans waiting for the bus is important too. Who do we see about that?

How Long Should You Sit In Your Van With A Broken Leg?

Not Really Where
An Elderly Man With A Broken Leg
Should Sit For 45 Minutes

Last Thursday, a veteran with a broken leg drove himself the Seattle VA Hospital. Since he's wheelchair-mobile, driving with a broken leg was not necessarily as difficult as for other people, but still, getting out of your vehicle with a broken leg is not something you want to do on your own.
When he pulled up to the unloading zone of the hospital, most medical facilities would have instructed him to remain where he was, and sent out a some medical professionals to assess his condition before helping him into a wheelchair or onto a gurney, or to have transported him in some other way.
This didn't happen, according to the veteran. The good news is that that valet service was alert and helpful, and promptly sent one of their number to seek help. The bad news is that help was not forthcoming. The veteran waited forty-five minutes until some non-medical personnel decided to assist him into a wheelchair and then into the facility. Presumably the valets were then able to park his vehicle properly.
There are other problems reported with this incident, but let's stop the story right here. The question must be raised: why was no medical personnel sent to assess the patient? If a patient is at the door and unable to enter under this own power, shouldn't this be a sign that a medical professional's attentions are required? What sort of institution leaves an elderly guy with a broken leg at the door?
Is the problem understaffing? If so, what sort of staffing level is required to see that this sort of thing does not happen again.

I have not given the veteran's name because he's still under the VA's care and I have not cleared this story with him. I have spoken with his wife, who confirmed all the facts above and she gave me many more details.

These questions are not directed in hostility against the facility; these are questions that citizens, taxpayers and veterans themselves might ask so that we can figure out what should be done. If the facility cannot advocate for itself for the ways and means to help an elderly man with a broken leg on its doorstep, then it's up to the rest of us to do the advocating - but first, we need answers as to how this happened.

Should Tuskegee Airmen Spend Twilight In Poverty?

William Booker

UPDATE:
Since this post was originally published, Mr. Booker has been enrolled in the VA system with the help of volunteers from Veterans And Friends of Puget Sound. The staff at the hospital were very welcoming and it looks like he and his family will be getting the help he earned. There will be a fuller post on this soon. But for the record, here's the original post:
------------------------------------------------
William Booker served in combat as one of the Tuskegee Airmen. You might have seen the movie, and you probably enjoyed seeing other Airmen at the 2012 Inauguration but won't thing you won't see is the VA helping him stay alive. The rules don't allow it.
In his late 80s and suffering from multiple illnesses, Booker's problem is that his pension, combined with his wife's, exceeds the $40,000 maximum allowed for those seeking VA assistance.
Mr. Booker's medically necessary direct care costs are around $4,000 a month, due to his illnesses. On topic of that are several hundred dollars  in medication, every month. His caretakers have decided, after careful consideration, that he will require a better bed and a reclining wheelchair due to his condition; this will be many thousands of dollars more.
Over Christmas, he was sent to the hospital; his wife hasn't gotten the bill for that yet, but three days and two nights there are not going to come cheap.
You don't need an advanced degree in math to figure out that this adds up to a lot more than $40,000 a year. In other words, if his wife Dolores spent all of their pensions and social security, that would not cover their medical expenses, and it would leave nothing for her to live on.
Some of these expenses are covered by Medicare, but even when they pay 80% for medicines, that still leave a lot for her to come up with.
Dolores says she went to the VA four times to apply for help. "They say he can't get any VA benefits at all" because of the income limit. "I just want some help paying for medication".
There's not necessarily any bad guys in this story; rules are rules and if the rules say that VA can't help you, it won't.
But are we really supposed to pat ourselves on the back for celebrating The Greatest Generation, and then demand that they impoverish themselves at the end of their lives?

Parking Problems At Seattle VA Hospital

It can be quite a hike from your parking spot to the hospital,
assuming that the lot isn't full

Valet parking is an important service at the Seattle VA Hospital for two reasons.
First, many of the veterans seeking care at the hospital have problems walking, but the parking lot is necessarily large. Usually when I go over there, I drive around the lot about ten minutes, finding no open spaces, and end up parking in the neighborhood. That's ok for me because my legs are just fine and I'm never there for treatment, but for others, that's a problem.
Second, there's money in the budget for this. It was put in there in response to community pressure, and there's no financial reason not to do it. There's supposed to be enough money to cover valet parking until the new parking garage is completed, which will take some years but when it's done, should solve the issue for the long run.
However, a problem has arisen. The first day of 2013, the valet parking disappeared, and there was nothing to tell people when, if ever, it was returning. Veterans called the hospital and, receiving no real answer, our congressmen and senators. Soon the valet returned and it seemed like things were on track. However today (January 11) I stopped by there for another reason, and the valets were gone.
To the Hospital's credit, the signage was a little better; it told us the day on which the valet service ended. But it didn't say why it was gone or when it was coming back.

This is a helpful sign,
But knowing when the service would return
Would be more helpful

I emailed the veteran's affair person on the staff our congressman, Jim McDermott, and he quickly replied that the hospital had contacted him and said they were having problems with the contractor. They sent out a second message late this afternoon saying "Services will begin on Wednesday, January 16, first thing in the morning." and they'd let the community know by updating their message on the facebook page. and its twitter feed. This suggests a number of things:

Seen Jan 11,2013

• Contractor problems do happen; that's not strange. But it would be good to figure out exactly what happened so that it doesn't happen again. Where did the contractor selection process go bad?
• The community didn't have a good way of monitoring what was going on; maybe the community need to occasionally check up on the place's status so problems can be addessed more quickly and, failing that, information can be disseminated more rapidly. 

Welcome to Veterans and Friends of Puget Sound

Cyril Miller, US Army Veteran
Founder of
Veterans And Friends of Puget Sound

Veterans and Friends of Puget Sound helps veterans navigate the often confusing network of Veterans Administration and other agencies, to get the best possible service that they have earned.
We are currently focused on the Puget Sound area but have contacts throughout the nation. Our main website is http://vafpugetsound.org/; we've started this blog to keep you up-to-date with current news, of which there is a lot!

• Are you a volunteer interested in common-sense service to those who served? Whether you're a professional, such as a doctor or a lawyer, or an American proud to provide service to a fellow citizen, your assistance is needed! 
• Are you a veteran in need of help figuring out whether you have a service-connected problem, how to prove it, or what to do with the help offered if you get it? 

America is a nation proud to provide those who offered their bodies and minds in dangerous service. Do your part; join us by contacting Veterans and Friends of Puget Sound today at VAFPugetSound@gmail.com.