Saturday, November 17, 2018

The VA Caregiver Program: Another Red Tape Diary Entry

When the Army called to inform me that my husband might not make it, I couldn't help but think how could I be a 32-year-old widow. When my next call told me my husband was stable but had lost both legs, I was overjoyed. I before did not care any longer what was wrong with him I was only happy he was coming home. I never thought about any issues that would lie ahead, I solely focused on the joy of our family remaining together.

Weeks after my husband was injured my friend, who had become a young widow years before, called to give me her sympathies with an explanation. She said that her husband may be gone, but she has closure. She said I would never be able to heal and have closure because the VA would put nothing but red tape and ignorance in my path. I remember thinking surely not, our service members have been through so much, how can that be? It's crazy how seven years later I realize that call revealed so much truth.

The VA Caregiver Program was created pretty much while we were beginning our wounded journey. Some pretty amazing people, who I have had the honor to befriend over the years, fought so all of our wounded, injured, and ill families could have help. This group knew all of our struggles were permanent. They fought for us to have some much-needed assistance. Assistance that they didn't have with their journey. Help that they knew would make a big difference in the lives of the wounded, injured, and ill.

The beginning of our Caregiver Program journey was simple. Before we left Walter Reed in 2013, we met with the VA, and they explained the program to us. They said Chaz would always be in the program because he would always need a caregiver. They explained his level of need could change, but the program was designed for guys like him. They described a program designed to help me help him. I remember thinking that was fabulous.

Fast forward through the years....we have had a ton of coordinators, but luckily only two fabulous home health nurses. These two ladies understand our life and have been very supportive. We did have to switch nurses when we moved, but it was a smooth transition. I have only positive words to say about our two nurses. We always look forward to their visits.

Now the coordinator position, that's a different story. I had not had any contact with any coordinator since before our move in 2015. Then magically I received a letter telling me they need to review our case with our coordinator. I had zero problems with this because you should review cases. Things do change. Some people do have improvements. I fully cooperated with the review and even had our civilian records from Chaz's PCM and from PT faxed over before our review phone call.

Then the call started. I was asked to submit my veteran's MEB/PEB file. For those who are not tracking, that is a DOD file that lists all of your servicemember's service-connected related issues so a disability percentage can be determined.  I immediately asked why is the VA asking for a DOD file? She said it was for their review. I countered with that document is five years old, you should only need the last 6-12 months of medical files. She then asked if I could "just fax it over." I told her no I would not because she did not need it, she has the VA file explaining my veteran's injuries, and that my veteran's file is like a 100 pages long and the VA only takes 20 pages per fax transmission. She then informed me she found it in her system. However, in my husband's file, it was marked "item not found contact IRM," which is records management.

Next, I was asked, "What is your veteran's relationship to the children in your home?" I replied with "biological father." I was then told that was not what she was asking, so me being me I said, "Well why don't you just tell me what you want." She then told me the VA needed to know if we had special needs children in our home. I quickly responded with the VA has no need to know that. The interview went on, and some of the questions were spot on, and some were beyond what the VA should be asking.

At one point I was asked if I worked and I said yes, I work when I can. The interviewer said she needed more clarification. I informed her that I work when my veteran is having good days and doesn't need my help. I put him before my work. I went on to tell her I was very fortunate to have clients who understand and support our family.

About a month later, we received a letter letting us know that the CET team, Clinical Evaluation Team, determined Chaz has improved and we were being lowered from Tier 3 to Tier 1. I called and asked for the specific documentation showing where he improved. I was told they compared Chaz's 2018 records to his DOD Med board from 2013. They rescored him according to the new records. I laughed because I knew the lady was clueless. So I set out to write our appeal.

I went through Chaz's records to find out exactly who made the determination. There I found a name, I found her online, and she is with Women's Health at the VA. I am still curious as to why a person specializing in women's health is evaluating the functionality of any veteran. Then I found all five names on the CET. Only one of them has seen Chaz in person, and that was his new PCM we saw in April who didn't like that we use Medicare for Chaz's care. The other four could not pick us out of a lineup. The more I dug, the angrier I got. I realized that the CET simply copied and pasted the notes from Women's Health to support the reduction in Tier level. And worst of all, the home health nurses notes were not acknowledged at all.

We met with Chaz's civilian PCM, who is a fellow veteran. He was outraged and wrote a quite powerful letter. We even sat down and used the VA's scoring chart to rescore Chaz. Together the three of us determined we were definitely a Tier 2 and we could argue for the Tier 3. And if anything at all changes with Chaz's health we were definitely a 3. I then went back through the VA's files and wrote my own letter. Our appeal was 32 pages long. I had more than one VA employee and a few friends tell me it was solid and we should be all good.

The VA response to the appeal was that we spend three days at the VA completing a psych eval and OT assessment. Psych was absolutely fabulous. That team was caring and listened, and the doctor even said it was ridiculous for us to be there because we were doing so well, and that Chaz needed a caregiver for physical needs, not mental. We all agreed that now we have a baseline for Chaz. If something starts happening to his memory or brain function, we now have an evaluation to refer back to for comparison.

OT was a different story. OT was rude when we arrived early. Then when we began, she pointed out that we were there for a "caregiver assessment." Joking, I said yeah we are here to prove he needs help. She scoffed, countered, and informed me that the VA caregiver program was full of fraud and that a double above the knee amputee can live 100% independently for the rest of their life without any help. She told me the legislation that was written was a disaster, and many people who were on the caregiver program had no right to be there in the first place. She then told me I could not be involved in the assessment, even though the VA said I was required to be there, she said I had to sit at least two feet away. I found a chair and sat down and obsevered. She did not read the chart prior to the visit and then didn't understand why Chaz's right arm wouldn't extend. So he went over all of that. Then she had him transfer from his chair to the PT mat and even jumped behind his chair, like I do daily, and made comments about his safety. In her report, she rated him as independent and supported the VA's original finding of Tier 1.

After reading her report, we thought well the VA will come back and say, yup you're a 1. We got the call yesterday...they dropped us entirely from the program. The woman who called Chaz even cried because she was so upset for us. She said the appeals board determined that Chaz was completely independent and has no need for a caregiver. This is effective immediately.

Once I stopped shaking from rage, I posted the decision on Facebook to our friends and fired off a few emails. My poor phone took a beating yesterday. But you know what....we have some AMAZING friends. I had to giggle at many of the comments. My college and our Army friends crafted a few amazing facebook posts. We honestly feel so loved and supported.

It was the Army who gave me the title caregiver. I embraced it, but never let it be my sole identity. Being dropped from the VA Caregiver Program doesn't change my veteran's needs. It won't change the fact that I have to carry legs around for him, load and unload them from our van, and help him put them on at home. It won't change that I have to help him shave, button shirts, and assist with other personal grooming issues. It won't change that at home I have to hold his chair to help him transfer. It won't change that I have to help him in and out of our truck. It won't change that I have to help him sit up in the bed. Or carry his coffee for him, so he doesn't get burned. Or scratch places because his arm won't allow him to reach. Or pick him up off the floor when he falls...I could seriously go on for a very long time. I think you get the idea.

A friend said to me yesterday, "If Chaz doesn't need a caregiver, then who does?" Sure, he doesn't need someone 24/7, but he needs help. Every single day I help him with things that go beyond "spousal duties." Yes, I love my spouse, and I did promise in sickness and in health, but when the VA has a clearly defined clinical benefit we qualify for, we should not have to fight this fight.

This is not a Nashville VA problem, nor a TN problem. Here is a quick list of our friends going through the same thing.
  • KY-Double amputee with missing fingers and other injuries, Tier 3 to completely dropped. He was told his wounds don't qualify him for a caregiver. 
  • TN-Double amputee was told he graduated from needing help. 
  • KY-Triple amputee lowered from 3 to 1
  • NC-Severe brain injury was told what his wife did was her "spousal duties."
  • MI-Severe brain injury, the VA has him listed for aid and attendance, Caregiver Program stated it was not in the veteran's "best interest to have a caregiver."
  • CA-Double amputee dropped citing injuries were not consistent with the veteran needing continuous assistance
  • TX-Single amputee was dropped. Veteran was told the spouse was "fulfilling her spousal duties and did not qualify as a caregiver."
Remember this is just the short list. There are caregivers all over our country being kicked out of the caregiver program at a rapid pace. While it's true that the fight for the wounded never ends, this is one fight we should not have to ever fight. If we can prove the veteran needs assistance with clear and precise medical documentation, why is it even being questioned? If you don't have enough common sense to realize a person missing body parts will require some degree of help for the rest of their life, then please come to hang with us for a little bit.

We ask you please consider communicating with your elected representatives and let them know you want to help our veterans and their caregivers.
  • To contact your Congressman, click here.
  • To contact your Senator, click here
  • To contact the House Veterans Affairs Committee, click here.
  • To contact the Senate Veterans Affairs Committee, click here.  
Together we can fix this for all of our veterans and their caregivers.

Friday, October 13, 2017

The Little Guide I Wrote

For years I have begged for a financial guide for families like ours. I wanted a guide written in simple language. I wanted something that could walk someone from Day 0 to Day-WTF to Day-I can finally breathe and back again. I wanted a guide that I wished someone had handed me in January 2011 after my husband's steps redirected our life plans.

I can still remember sitting in his ICU room, then in his room on Ward 57, then in our room at Fisher House. I can close my eyes and see all the machines and hear all the beeping. I can remember sitting in the corner with an iPad or my laptop with crappy internet connections. I can remember being up before everyone else. Each time I was researching where we were going next since our twenty-year plans were blown up. 

Over the years since Chaz's injury, I have sat in so many conference rooms, asking for a "common family financial guide." I have seen the same faces in different rooms saying the same things. And guess what....still no real guide exists that everyone can use. More importantly, no guide exists that gets us and our crazy circumstances.

In college, a professor once told me if I was going to complain about it then I needed to be ready with a solution for it. About this time last year, I was in another room asking for the same thing with the same people and still, no real plans were made. I decided right then I was going to quit my complaining and just do it.

Last Fall I contacted a few friends. They reviewed the first forty pages that would eventually become the guide. Their reviews got me pretty pumped up. After tax season, I came back to the guide and over one hundred pages flew out of me. I went back to those friends and added several more to the circle. They all helped me tremendously. They gave me ideas and input that helped mold the guide into what it became.

Here it is....

I am very proud of this guide. I designed the cover. I designed the graphics, worksheets, and etc. The table of contents is hyperlinked to the topics in the text. Once you go to your topic, you will then find other links that will take you to learn more. I tried to make it as user-friendly as possible. I wrote the paragraphs as concisely as possible because I know of several readers who don't like to read but need information on our financial lives.

Currently the guide is only on Amazon. I hope to add it to iBooks soon, then to other digital platforms. My next goal is to make the guide into a workbook. I do not have a target date for the workbook, but it will make an appearance one day!

This guide is not perfect. It will need corrections as the years go by, but at least now we all have something. I feel this guide is a great start to getting our financial futures more organized. More organization will lead to less stress. One thing is for sure.....we need a lot less stress!

We really struggled with pricing the guide. Most financial books are ten dollars or more. I didn't want a price point that could discourage someone from learning, so I ruled out the market price of $10 quickly. I have been told more than once I am crazy for only selling the guide for $3.99. But for me, $3.99 is a lovely balance of being compensated for all of my time and hopefully encouraging someone to invest in their financial future.

If you are a wounded, injured, or ill family, I hope you will consider ordering a copy of my guide. I hope you will find it useful. I hope that you find it so useful you tell all of your friends!

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'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