For those who have seen the video of his injury, you can completely understand why Chaz has a back injury. For those who spent years in the service throwing a ruck on their back, you can understand why Chaz has a back injury. For those who were in combat and know that you have to duck, run and cover, you can understand why Chaz has a back injury. However the Paperwork Gods in the VA cannot.
The VA rated Chaz's back as a 0% as he was medically retiring. Apparently along the way one of the raters decided since he was rated as 100% for missing the legs, his back rating was irrelevant. (Again, please note I cannot make this stuff up. I am simply not that creative.) We were told that as long as it was on there we would be fine. Well that is kind of incorrect. You see they will still treat him for his back, but they will not accept real responsibility for his back injury. Confused yet? Wait there's more.
Last March Chaz was hospitalized because of a flesh-eating bacteria he contracted in Afghanistan at some point. We tried to get into the VA that day, but they were full and we were told to use our private insurance. When we discovered the seriousness of what was going on, we were told that the VA would refund any of our out of pockets expenses because it was an emergency, life-threatening situation. We finally heard back recently and the out of pocket reimbursement was denied.
The claims adjuster informed us that since the incision was on Chaz's back and he has a 0% rating on his back then the VA is not responsible for paying for things that happen post service. And if we didn't want to incur costs, we should have had Chaz transferred to the VA instead of using our Tricare. (Which would have cost the VA even more in the end.)
Even though the VA acknowledged that they could not have treated him for what was going on with him. They even acknowledged he would have been transferred to at least one if not two hospitals before surgery would have occurred to remove the pocket of fluid that was building up. Even though Infectious Disease was able to obtain a clean sample and positivity identify what was in his back and trace it back to Afghanistan, the VA is not responsible for reimbursement. This incident was deemed to be 100% on Tricare and subsequently on us. You are probably asking yourself, "Why?" According to the adjuster the claim denial was based on where the incision was on his body, not what the actual problem was. Are you really confused yet? Hang on, I have more.
If we want to have any of our medical expenses reimbursed from that incident then we must have Chaz's back reassessed by the VA and appeal the 0% rating. We were informed that if we were lucky he'd get 30% and then we'd only have 30% of our expenses reimbursed. How long will that take? It takes approximately 12-18 months at a minimum. (Let me translate, 12-18 months really means 2-3 years in the VA time warp.)
We have decided we will have his back reassessed to help us in future occurrences, but we are done with this particular adjuster. I understand money saved is money saved, but sometimes you just pay your stupid tax and move on. This is totally a stupid tax situation.
Here's what I wish more people could understand. Occurrences like this happen everyday, multiple times per day to our veterans everywhere. This is not an isolated incident. This is just one of our incidents.
Here's the additional knowledge I wish everyone had. The staff members that we deal with on a constant basis at the Murfreesboro VA are amazing and caring and we love them like family. But those in the VA who will never see, nor talk, nor touch my veteran are the ones who hinder the healing of our veterans. They see a 0% and close the book and do not do any further research. The Paperwork Gods make the jobs of those who actually assist my veteran even harder. If you want to fix the VA you have to fix the system itself. From our experience, I suggest you start with the Paperwork Gods who sit in offices and have little to no contact with the group they are actually serving.