Wednesday, April 19, 2017

The Pain of the VA: Another Red Tape Diaries Entry

I promised a friend of mine I would write this story as soon as I had time. What you are about to read actually happened. I wish I was creative enough to make this all up, but sadly I am not. You are about to read why in this house we use the sayings "Good enough for the VA" and "Nothing from the VA shocks me anymore" quite frequently.

All veterans have to be seen at the VA at least once a year. Makes total sense right?! We want to make sure our vets are cared for so yes once a year is the least we can do. This is our once a year story.

Chaz began at the Murfreesboro VA in January 2013. Every year he went in for his annual exam, he was met by a different PCM, which is sad because we really liked #1. Finally in 2016 we were told this PCM would stay, but required Chaz to basically start all over again with the VA. The PCM insisted he complete a new patient exam. No we were not happy with this, but we thought well ok, maybe this new person is just wanting to make sure they know all about Chaz and his case. Once again we grossly misjudged the VA.

Chaz's appointment occurred at a time where I had to stay home to make sure kids got where they needed to be so I missed out on meeting this person. I was totally fine with them ordering blood work and etc for Chaz. Chaz requested the same requests with this PCM that he made with the other two PCMs. He wanted Physical Therapy so he could start walking again. He wanted ortho to look at his arm because his arm fusion was temporary and we are going on four years since an ortho doc has looked at it. And he wanted infectious disease because he has a long history of infectious disease and wanted to make sure he was on their radar.

We waited a year. Heard nothing from this PCM. Chaz called, sent messages, and got nothing. Chaz went to make his annual VA appointment for January and they said the earliest he could be seen was March 31. Finally I said enough we are using your Medicare to get you actual care. I could not take it anymore. I wanted someone to actually care about my husband. We found a great doctor here in our community and currently we have gotten more done with Chaz's care in three weeks then we did in four years at the VA. 

As we approached March 31, we had to reschedule his appointment and it was moved to April 7. Which is not too bad in VA time. But by the time of this visit, Chaz had been to PT and had an ortho and infectious disease appointment on the books.

At his very first PT session, Chaz's prosthetic leg fell off and he fell really hard. He hurt quite a bit and a lovely bruise that covered almost all of his leg's amputation site began to appear. Chaz has not taken any prescribed pain meds in years. He does have celebrex for his back, but that would not help him with the pain he had in his leg. Since this incident occurred just before his VA appointment we decided he would just ask his PCM for a pain med that was a little stronger than Motrin and Tylenol.  The one thing the VA is excellent about is prescribing meds.

Chaz went to the appointment, showed the PCM his leg and told the PCM the story and his request. I kid you not the PCM said, "Well you don't look like you are in pain, so no I will not prescribe anything for you," but did order an x-ray for him. The PCM told him if the pain continued then he should come back to the VA or visit the ER. Then the PCM informed him that based on his blood work the PCM decided he now has fatty liver disease. The PCM let Chaz know that they did not approve of him going through Medicare and reminded him he still had to be seen by his PCM at the VA. Lovely, huh?!

Again not kidding, the blood work that was referenced for the fatty liver diagnosis was taken in January 2016. We have three potential paths here with this PCM. #1-This PCM saw the blood work in January 2016, determined the fatty liver disease issue, and chose to not do anything about it. #2-The PCM reviewed blood work in front of Chaz at his appointment and just then made the determination. #3-The PCM was angry that Chaz called them out on their lack of caring and lashed out at him for taking care of himself by now going through Medicare. All proposed paths are 100% inappropriate.

Now you ask what is the PCM doing for the new diagnosis? Well they ordered an ultrasound for mid- May, five weeks from his visit. And Chaz was told to diet and exercise. Did she refer him to PT (which we had previously asked for) or a nutritionist? Nope, just ordered the ultrasound for five weeks later and said for him to cut back on high fat foods.

Sounds like a super serious issue, yes?! We want our veterans to be cared for, yes?! Liver diseases can freaking kill you.

And now you ask who gets to deal with the aftermath of this VA visit? Easy answer, I do. Chaz was livid. I got to be the one who calmed him down. I was the one who assured him that that PCM is a moron and no he should not feel bad for asking for pain meds. I was the one who helped him feel even better about using his Medicare. I was the one that suggested he call the local doctor and tell them what happened. (FYI the local doc had a script for Chaz in less than 30 minutes.) I was the one who cleaned up the PCM's collateral damage.

You want to know why we lose 22 veterans a day to suicide....it's stories like this. We have PCM who looked a double amputee who has a ton of pain issues he struggles with daily and said, "You don't look like you need it," and made him feel like he was a junkie. My girlfriend with vast medical knowledge said it perfectly the other day, "I know Chaz is coping with pain everyday that would cause people to end their lives." There are zero pain med scripts on file for Chaz at the VA. Was that consulted?! Nope, the PCM made their determination by simply looking at him. The PCM did not put their hands on him, they just looked. Then the PCM spun up my hubby with this new random diagnosis based on 14 month old blood work, but offered no true assistance to remedy the diagnosis.

We are so blessed in this house. Chaz was "injured enough" that we can now get real care with people who really care about Chaz. There are so many veterans who are not Medicare eligible and cannot afford other insurance. The VA is their only option and this is the care they are receiving. If you want to be outraged, please go ahead, but know this one veteran will be fully cared for because he is mine. Please be outraged that PCMs like this are "caring" for our veterans everyday and this "care" is exactly why we are losing them to suicide!

Sunday, January 22, 2017

Year 6- A Dream Becomes Reality

Six years ago today I sat at my desk in our home in Clarksville, TN. I was up and working away on a tax return when all the calls that turned our lives upside down begin. Six years ago I pushed my dreams way off to the side and committed to helping my family heal.

2016 was a year filled with severe highs and lows. We had our hearts broken a few times, but they are healing. With more time behind us, the heart aches will become just memories.

I left my job with Yellow Ribbon Fund in February 2016. It was a very hard decision to make. Once again, I had to put our family first due to reasons beyond my control. I miss my job and the staff at YRF more than words can say, but it was a decision that had to be made. I will forever be thankful for my years with YRF.

April 2016 Cutie #2 picked up sixteen chickens from 4-H. She has overalls and boots covered in glitter, so she has this farming thing down! We also added two ducks. We had to give three chickens back to 4-H as part of their program, the neighbor's dog ate two, and our Champ "played with one." We currently have ten and we collect eight to ten eggs a day. We love having our feathered ladies here. It was a great addition to our lives.

Summer 2016, I received a call from the Dole Foundation asking if we would fly to California and film some PSAs with Tom Hanks. The hope was this project would help the nation recognize the service and sacrifice of families like ours. Anytime Chaz and I can help military families, we will be there. So off we flew.

Let me go ahead and answer the two questions I always get asked now. Yes, Tom Hanks is amazing. Yes, he is the guy you imagine he would be. We had a blast in California making the PSAs. Here's the link for them.

Cutie #1 and I left CA on that Wednesday and were in NYC that Friday morning for a school sponsored trip. She and I had a blast adding "seeing both coasts in a week" to our life. Cutie #1 also joined the Sister Cities group here in our county. We hosted a student from Japan for a week in our home. It was a great experience for our entire family.

Summer quickly ended and we sent our girls to two different schools for the first time ever. Cutie #1 is in high school (insane to even think about it). She is cheering for her high school and loving it. Cutie #2 is in middle school, but luckily her school is K-8 so she didn't have to switch schools. She is taking dance and is even in pre-pointe. I think we can say we have them officially settled.

Right when we got the girls back into school, I got another call from the Dole Foundation asking me to be on the Today Show with Tom Hanks and then pop down to DC and share our PSAs at the Capitol. Here's the link for that adventure. And here's another link for the Today Show. That day was beyond amazing!

But something pretty great happened in California in Summer 2016. While we were filming the PSAs, Tom Hanks leaned over to me and said something about how I have all this education and knowledge, but because of Chaz's needs I am limited to what I can do. Of course I smiled and said something like yeah pretty much. He asked what can be done about that? I said do the best you can with what you have.

Once we got back home, Chaz and I had a serious conversation. Our original plans were always to let him put in his 20 years, then I would get my turn to develop my career. Well the bomb took care of the 20 years, but deep down I still wanted my dream. My dream (which Chaz always referred to as "The Sugar Momma Plan") was to have an actual brick and mortar building where I can provide financial services (tax prep, financial counseling, all of the things I am licensed to do). Chaz said it was time to get serious about that dream of mine. He and I made lots of plans while the girls were in school and then last week this happened.
I cannot have normal 9-5 hours. I really cannot have any "normal" hours. I have to work by appointment only. But I AM DOING IT!!!! The dream has come true. We have a building!! I have a logo!! It's not much, but it is a start and one huge step forward in our dream!

This all happened because Tom Hanks and the Dole Foundation. No, no one bought the building or anything like that. Chaz and I did it all with saving and planning. The Dole Foundation simply chose us to represent them in the PSA. That connected us to Tom Hanks. He simply inspired us to get back to the dream we chatted about so many years ago. We are so thankful for the PSA experience, because his words were the kick we needed to get serious.

Now everyone asks all the time, "What is Chaz doing?" Chaz is just enjoying life. As many know, he is very limited on what he can actually do physically. He helps out where and when he can. Most importantly he is focused on being an incredibly kick ass father to our cuties. He is still not (and may never be) in a place where he can get a job. We have always taken one day at a time. In 2017, he will continue doing what he is doing, enjoying a life that could have been cut short. And together we are making some pretty great things happen.

Today it occurred to me that Year 6 looks like it will be the year the new normal is finally just our normal. How awesome is that?!



Wednesday, April 27, 2016

Bathrooms and Education

The biggest story I am seeing right now is about who uses the public bathrooms.

Let me tell you what I worry about when I go into a public restroom. I worry about the bathroom being clean and if there's toilet paper available when I need it. That's it.

What do I worry about when our children use a public bathroom...the exact same thing. Why?! Because I don't let them go alone. I am right there with them. And guess what....I have always worried about them being in public bathrooms. Why?! Because there are people out there who will hurt our kids.

Our girls are 10 and 13, and I still do not let them go to a public bathroom alone. Call me overprotective, I do not care. They are mine and I will protect them. When we travel, I stick to Starbucks and a few gas stations chains because I know the cleanliness level I will be dealing with. I even use my Starbucks app to find the bathroom sometimes. For safety reasons, I also prefer the large open single bathrooms rather than the big ones with several stalls. This is mainly because I can have eyes on my girls the entire time and I control who is in the bathroom with them.

Want to know what a much larger issue is....the state of our education systems! I am still waiting on the equal level of outrage.....looks like I'll be waiting a while.

Our children are being taught to test to take the test to take the test to (wait for it) take the test. And now in Tennessee our wise leaders have now cancelled the test. They dumped over one million tax dollars into a testing system that show us what exactly?! I am not sure, but I know our teachers were going to be held "accountable" for their students' performance. But wait, we'll never know what that means and what our children were going to learn from this massive "investment" because (wait for it) they cancelled the testing.

So teachers, students, administration and staff, you spent the entire year preparing....whoops, sorry about that. Teachers, you poured so much time and effort into planning and teaching for these exams rather than teaching like you always wanted to, whoops, the state just said, "My bad."

Kids, y'all have tested to test to test to test. You are now so full of anxiety you cry to your parents and some of you are even seeking treatment for the unnecessary stress of it all. Some of you don't even want to go to school because of all of this testing. Turns out our state was just pushing you to see how you would cope. I hope you survived their test without needing a prescription. 


I can only speak for the state of Tennessee because that is the system our girls are in, but I know this issue is not exclusive to our state. Kids everywhere are developing anxiety and other stress related medical conditions thanks to the insane amount of testing they have to go through. We are setting the kids up for failure, but we are not outraged about it.

Our teachers are NOT being listened to at all. Let me assure teachers do not teach for the money, the fame, or the summers off. They teach because they were called to teach. The teachers I have been privileged to receive my education from and those who are teaching our children are amazing and they are deserve our respect. Our state just basically showed us they are oblivious to the needs of our children and educators. To me, the state told the teachers that this year they did not care about them teaching, they wanted test results. To me, this entire school year was a waste of time and who knows what damage it will have on our kids.

Apparently the state didn't think to test drive the (one million dollar plus) testing system because it crashed upon going live and then they ordered the kids to paper tests. Apparently they didn't think that through either because they couldn't get the tests out to the schools and the schools that received the tests received incomplete tests and/or the tests were assembled in the wrong order.

What a disaster, disaster, disaster we have on our hands. Time has been wasted and our educators and children are the victims. Our communities will suffer for it in the long run. And what has the state said you ask, the word "whoops" about sums it up.

They used our tax dollars on this system that was supposed to do something for our children. I am still looking for exactly what it was supposed to do. The only thing I have seen is stress, stress and more stress in our girls. As a parent, I am horrified at what our state has done to our education system this year. I feel that the Governor should clean house. I propose that he put actual educators in there to fix this mess ASAP! I would hope real educators wouldn't burn a million dollars on something as ludicrous as this debacle.

Here's the thing with the bathrooms. You have the right to boycott the establishments, make sure and do your business at home only, and various other options. You can end that issue with your individual actions.

Our schools are an entirely separate issue. These kids are our future leaders, doctors, teachers, and citizens and they are being screwed!! Where is the outrage over our children being put on an assembly line and experimented on? Where is the outrage over our teachers spending an entire freaking school year teaching a test because that is what the state said to do?!

When you get out into the real world you do not spend a year preparing to take a test to take a test to take a test year after year after year like what our school systems are forced to make our children do. Life is full of tests, but amazingly bubble sheets don't randomly appear.

We are setting these kids up for failure in life, but making sure the right person uses the right bathroom appears to be a higher priority. I guess I shouldn't confess I have used a few bathrooms marked for men, because I could not hold it any longer. I am so glad laws dictating against that didn't exist then, because I would have totally have went to jail a few times in my past. ;)

Monday, February 22, 2016

Red Tape Diary #5: New Patient

Chaz has been seen at the Murfreesboro VA for over three years now. Once a year we go in for his yearly check in. He called last week to make his appointment to find out his PCM (Primary Care Manager) left the VA in December.

Were we notified? No.
Was he reassigned to a new PCM? No

We only happened to find out because we were being compliant by calling in for a yearly appointment. When Chaz attempted to make his appointment, he was informed that he has to now go through a "New Patient Exam." I probably laughed more than a person should. I looked at him and said something to the effect of you are a new patient when you go to a new practice not when the practice forgets about you and doesn't know how to transfer files.

Here's my problem with all of this. Chaz was a "new patient" in January 2013 when he had his first exam at the VA. He has been reassigned to new providers in the past and never was required to start again as a "new patient." Actually this will be his third PCM since we entered the VA. With this one, they only see "new patients" on certain days and only at 10am and 1pm on those days. Chaz can't be seen until the end of March.

What happens if he needs medical care prior to that date? He should go to the VA's urgent care or ER and get in line there.

And now I am done....Our 100 % permanently and totally disabled wounded are required to also take Medicare and have Tricare for Life so they can see civilian providers. That will be happening this week. We will seek a civilian PCM to care for him. Someone that he can build a relationship of care and trust with. We may have to shop around, but when Chaz becomes a "new patient" it will actually be warranted. We would love to use Chaz's free health care at the VA, but we'll just use the Medicare we have to pay for. After all they say you get what you pay for.

Murfreesboro VA we tried. We worked with you. We gave you the benefit of the doubt, but now we are out of patience with you. The red tape is exhausting. And now you just pushed the starting line back again. How many more times are you going to make our wounded restart their journey to healing? How many more times do they have to rehash events and injuries with new PCMs and attempt to develop a relationship only for you to make them start all over again? Don't worry I'll be there at the "new patient" appointment with him so I can meet the newest person who will probably only stick around for a year, maybe 18 months if we're lucky. I am sure this person will be as nice as the last, but we will just be in check the box mode, because we know they'll leave too.

We have actually liked our providers there, but we feel it's pointless to continue going there where the faces are just going to change. We need continuity of care. We do not get that with the VA. No we get whoever can see him when he's there. Keeping up with all of names is exhausting. This is where I am thankful for all the paperwork I keep because how else could we keep up with all the names?!

I keep reading and hearing that the VA wants to be the veteran's choice for service. Well if you want to achieve that goal you seriously need to get to work. Our families have trust issues and you are not helping by putting us on a carousel of care, where we get whoever stops the ride. We need the spinning to stop. We need people we can trust. We need care. VA you need to do better!

Saturday, January 23, 2016

Caregivers and Income Tax Filing

I have had numerous requests to blog about this topic so here we go.....

Let me state my qualifications on this topic.
The topic of income tax in the wounded world is often very confusing. Many do not understand a few key concepts that can make you income tax filing a bit easier or even eliminate the need for you to file. I fully acknowledge that you need a translator to understand the IRS at times. Let me help with a bit of the translation. (Please take note I have linked sites to many items listed.)

Let's start with income itself. We have two categories: earned and unearned.
  • Earned income simply means you have actually worked a job of some sort and received payment from working. You will receive a W2 or 1099 MISC from this income. If you are running your own business, you will need a detailed log of your income and expenses in order to report them. 
  • Unearned income simply means the income came to you through passive means, meaning you did not work to receive it. The most common type of unearned income I see comes from interest earned from savings accounts and/or social security.
In the caregiver world here are the sources of income that primarily concern us.
These sources of income are non-taxable and are unearned income. Social Security Income only becomes taxable when your earned income exceeds the limits set by the Social Security Administration. However even if your SSI is taxable it is still unearned income and will not be considered for tax credits.

Now let me post a few questions that are frequently asked.

What if my child(ren) receive Social Security?
Here's a great link that will go into further detail, but usually the child's social security income is not reported on an income tax return.

How do I receive Child Tax Credit and/or Additional Child Tax Credit?
You must first have earned income to be eligible for the credit. If you have earned income, then the credit will be calculated based on that income and the amount of qualifying child(ren) you have. Unearned Income will not qualify you for this credit.

How do I receive Earned Income Tax Credit?
Like Child Tax Credit you must have earned income to be eligible for the credit. If you have earned income, the credit will be calculated based on that income and the amount of qualifying child(ren) you have. Unearned Income will not qualify you for this credit.

How does the Affordable Care Act impact us?
Everyone must either have health care coverage or meet the requirements for an exemption. If you do not have coverage or meet the exemption then you are assessed a penalty on your income tax return. If you have only unearned income, then you will meet the requirements for an exemption. If you have Tricare, Champ VA, or other health care coverage, you will receive your 1095 form from your company for you to show your tax professional and to keep in your records.

Do we need to file a tax return?!
Visit this IRS link to find out or contact a professional.

Please remember every income tax filing situation is fact dependent. It is always best to consult a professional with any additional questions. Here are a few links to help you find a professional.
Best wishes on your tax filing! May the odds be ever in your favor!
Jessica Allen, AFC

Friday, January 22, 2016

5 Years Ago.....

Five years ago the morning of January 22nd was so normal when it started.

Five years ago I was just another Army wife trying to get through another deployment on her own.

Five years ago our girls were 5 and 8.

Five years ago my husband was just another soldier on a routine patrol. 

Five years ago our journey began....

I have learned so much in the past five years. I have learned about myself, my character, my ethics, my heart, and my strength. I have learned that God sure knew what he was doing went he put my husband on my path. I have learned that our children are absolutely amazing. I have learned about the art of medicine. I have learned that love can really conquer all. I have learned normal doesn't really exist. And I have learned healing from the wounds of war doesn't get better, it just gets different.

I am very proud of our family's journey. We have been through a lot. We have seen a lot. And we have been blessed more than I can say. 

Everyone's journey is different. I know some have not approved of decisions we have made along the way. Maybe they were right, maybe they were wrong. One thing is for sure we made the decisions that we felt were best for the four of us.

Our journey isn't about one person; it is about our family healing together. Sure my husband was the one who stepped on the bomb and has the most visible injuries. However, others so quickly forget the wounds in the heart and mind that they cannot see. And they seldom look beyond the chair or the prosthetic legs.

When I saw my husband for the first time, I immediately noticed his legs were missing and all of the machines he was attached to. Do you know what I remember the most about that moment? The look he gave me when I walked into the room. He needed someone who loved him to tell him it was all going to be ok. That was my job on that day and it is still my job each and everyday that he or the girls need it.

This journey is never easy. As soon as one fire is put out, two more pop up. Dealing with the mounds of paperwork and drama is absolutely exhausting. I often wonder how I am not an alcoholic by now. However every January 22nd I am reminded that no matter what fire comes our way, I can remember all we have overcome since that day in 2011. These memories show me that together we can overcome anything that comes our way!

Friday, January 1, 2016

I Don't Know How You Do It?!

My title is a sentence that is said to me so often I have lost count. I thought I would give the cliff notes version of my daily schedule.
  1. I get up at 4:30am Monday to Friday. On weekends I am up in the 5am hour. Why?! Because I need a good 30 minutes with my own brain before I add in any other brains into my day. 
  2. The first thing I do is consume my vitamin drink then I follow it with one half of a lemon squeezed into 2 cups of warm water. I get my breakfast ready (usually a poached egg with one piece of toast and a cup of chai) and make my way to my desk.
  3. One weekdays I am working by 5am. Why?! Because no one answers their emails that early. I get so much done between 5-6. I even amaze myself sometimes.
  4. Kids get first wake up call at 6. They have to be at school by 730. First call is at 6, then serious wake up call is 630. We have learned that rather than rushing and panicking (which still happens sometimes) we do the multiple calls to get them moving. At some point hubby is up and moving so then this is where the me going in a gazillion directions kicks in. 
  5. Once the girls are up and moving and/or at or off to school (we take turns driving them) I look at the board to see what we are doing for dinner. I live by the crockpot. My mother says our home is where crockpots go to die. I have to admit she is correct. I kill at least one crockpot per year. 
  6. Then I am back to work. I spend my days bouncing between work, hubby's needs, cleaning and whatever else gets tossed in. It is really crazy, but I do find time to take a lunch break with my hubby as many times during the week as possible.
  7. Kids are back home in the 3pm hour. It's homework, extra curricular activities, and chill/snack time. I try my hardest to have all of my work completed by 3. Sometimes I succeed and sometimes I fail. My ultimate goal is to give the girls as much of my time as possible since they have been gone all day.
  8. Dinner is served in the 5-6pm hour. 
  9. Then it's reading, baths, snacks and bed.On school nights everyone here is in bed by 8. I am usually the first one out, but 8 is our shut down and be quiet time.

Do I think everyone needs to be up at 430am? No, this is just what works for me and our home. While the first 4 hours of our day Monday-Friday are basically the same, no day is ever the same around here. We tend to stick to this format, but life happens and sometimes our format gets tossed right out the window. When we are on vaca, I usually stick pretty close to the up in the 5am hour, but everything else is up in the air. I am a creature of habit and function best on a schedule, but I do love vaca!!

As you can see I carpe that diem, then sleep, and repeat. There are 24 hours in each day, I am highly selective on which ones I chose to use as pause time. You are correct to assume I received excellent marks in school for time management. Ha!!