The Department of Veterans Affairs Part IV (Finding You Incompetent)

     As I said at the end of the last piece I wrote this will cover the VA’s process to find someone incompetent compared to a states required procedures. I think there is something very wrong with the differences. I believe most people out there will agree with me.
     When you go through compensation and pension for any reason the evaluator can find you incompetent to handle your benefits. He reports that up with the rest of his findings and the manager in your area will go from their with appointing someone to take control of your benefits. They sometimes will do a supervised direct pay which means you get paid but have to prove what you paid and why. N now first of what is the definition of an incompetent person. It is “a person that because of injury or mental illness is nit capable of handling their own business or affairs.”
     Through the VA rating agencies have sole authority to declare a veteran incompetent. They are required for due process to send you a letter giving you the opportunity to schedule a hearing and challenge those findings. If for whatever reason you do not receive this letter they will proceed however they see fit to take control of your benefits. Challenging their findings and trying to regain control of your benefits at that point becomes incredibly difficult. By the way if you check yourself into a hospital even if it is to adjust or correct your medications (psychiatric) that can be a basis to find you incompetent. Also if you go to rehab for help they can find you incompetent for that as well. Before I cover why this is incredibly unfair to a lot of people that ask for that type of help to keep functioning properly let us go over the states requirements before finding someone incompetent.
     This is accurate in most states.
          Step one: a petition for guardianship must be filed with the probate court that has jurisdiction. This is required whether it is the state, care giver or family member that is trying to have someone found incompetent.
          Step two: consult an attorney familiar with guardianship issues in that state.
          Step three: there has to be a psychiatric evaluation scheduled for the individual that is believed to be incompetent. If this person refuses to go to the appointment or dies not cooperate to the best of their ability at this appointment then the court may be petitioned for a compulsory evaluation as part of your guardianship petition. A compulsory evaluation is they force you to undergo an evaluation, often as inpatient, and is much less likely to favor the person. This is not the same as a 72 hour hold for your own welfare.
          Step four: you must have a copy of the evaluation turned in to the court attached to their forms. I will try to attach one such form from Ohio. If that doesn’t work there is a link to this firm at
http://blogs.findlaw.com/law_and_life/2013/09/legal-how-to-declaring-someone-incompetent.html
          Step five: the psychological expert for the courts will go over the evaluation and turn in his opinion to the judge as evidence.
         Step six: you have to go to a hearing with all of your evidence and supporting documents. This is on top of  everything else. At this point you should be able to get a ruling from the court of the action they find most fitting.
          Side note most states require if the person you are trying to have found incompetent is an adult them adult protective services has to be informed to run an investigation of their own.

     There is a world of difference in these methodologies to finding a person incompetent. The way the states do this, although harder to get out of if found incompetent, is leaps and bounds better than having one individual interview you and make that declaration. As there are many people like me that have mental illness that use the hospitals to help get our medications back on track. That is not saying we can’t handle our own benefits. Are all of us great with money or could we be Warren Buffet types? No. Are we capable of far more than some of these evaluators give us credit for? Hell yes. Should there be a more lengthy or in depth process to follow before this type of tag is stuck on us? I think there has to be. Since I have been deemed supposedly incompetent, and I have been rated competent recently, I am not even supposed to own firearms. I have never been charged or arrested fir any reason let alone violent offenses. I want to hunt as a way to stock the house with meat. I love venison, rabbit and elk. As a United States Marine I love shooting rifles whether it be at cans or shooting ranges. What happened to our rights as veterans that are being labeled and tagged as incompetent because we sought help or went to a compensation and pension exam and answered the evaluators questions?  On top of this idiots way of declaring someone incompetent when you have issues with a fiduciary that the VA may assign you the VA will do absolutely nothing to rectify the situation. On top of that, these fiduciaries who don’t want to play by the rules, the VA allows these companies to take 4% of your pay. The VA says if there is a family member able to do it that is the preference of the VA. I don’t believe that for a minute. The next post is going to go over field examiners, the fiduciary hub and how if your in a bad situation with your fiduciary the only way to get out.

The Department of Veterans Affairs Part III (Hospital and Inpatient Inconsistency)

     So many people have had experience with VA medical care and will tell you, if they have been to different VA facilities, that some VAs are better than others. Unfortunately, no matter how good a doctor is on paper does not mean they are any good in practical application.
      First, the primary care physicians (PCP) I have had aren’t bad when you can actually get in to see them. Maybe I have been lucky. Usually my PCPs have been willing to listen and will try many options to help with any problems. I have even had several of them ask what option to start with. One thing I have noticed is that when your PCP is in a clinic you usually have a much better chance to get in more quickly.
     I have been inpatient in several hospitals and states. From while I was in service to now. Most of my inpatient stays, although none have been enjoyable, have worked and helped me get my meds working and my head straight. The Salt Lake City VA; however, has been far above and beyond the services and benefits of any other hospital. When I was a patient there I was able to see my doctor and the entire team most days to report how I was feeling, if I felt my meds were working better and any concerns that I may have. There were also groups every day. Yes some were the same old bogus medication education groups and symptom tracking. Also some of the other classes that are typically taught. For the people who haven’t been through them they can be beneficial. If you have been through them many times they can still be helpful if the class is taught somewhat unconditionally. They also had peer groups everyday. These were great because people were allowed to vent and bring up problems. Other patients in the group, the teacher and the residents he had could all come up with different ways to face the problem or problems that you may have never thought of. Oh, one of the things that can be annoying at first is the morning and evening meetings. In these meetings everyone gathers in the meeting room, nurses and patients even some doctors join the group. Everybody goes around and introduces themselves, why they are in and a goal for the day. At the end of the day it’s the same thing but they vote for a new president, if the current one is leaving, those who are leaving the next day tell how their stay has helped. Then the rest day their goodbyes if they want and whether they accomplished their goal.
     I went to the Portland VA inpatient unit and it was a terrible experience. They did next to nothing to help fix my meds and there were very few groups and the ones I did attend were not worth the time they lasted. The one group that seemed to happen everyday was bowling on the WII. In the end I could have left against medical advice (AMA) but did not want the anyone messing with my benefits because I did so. I was in an extended program in a northern mountain state. I won’t say which one as to the sensitivity of the situation. I said in an earlier post that if someone wants to commit suicide they will find a way. I had a roommate that locked himself in our bathroom and stabbed himself in an artery in his arm with a needle he somehow obtained. I found him about 30-45 minutes later. Then had to help restrain him because there weren’t enough nurses to do so. This happened on what was supposed to be a locked or secured unit.
     The VA has to set these units up to one standard. I have refused to go to the VA hospital in Portland because of how bad it was even though I could have used the services. I can’t be the only one who feels that way. The citizens of this country, the politicians, the government and the VA all say they are horrified by the veterans suicide rate and want to slow it. This is a huge area that they could work on to do just that.
     Oh, I almost forgot about the suicide hotline. This will be really short because they have been next to worthless. Many people preach that if you are having issues to contact them. The last time I called them they listened gave no real ideas of any kind then said someone would call me the next day. I am still waiting for that call. The next issue is how the VA compensation and pension evaluators or doctors decide whether or not you need a fiduciary, someone to handle your money, and the lack of any actual requirements to decide this. For example how a state would go about the same type of process. I will also cover the VA fiduciary hubs and parts of title 38 and the pension and fiduciary handbook. These are the laws the VA had placed and the fiduciaries are supposed to follow. I found out first hand that just because they are supposed to does not mean they do or that the fiduciary hubs will do anything to make them follow the rules when they aren’t. This may take two parts.

The Department of Veterans Affairs Part II (Scheduling and Specialty Clinics)

     As in part one I will cover the topic as best as I can without going overboard. In this part I am going to cover the VA’s scheduling, speciality clinics and some ways these area can be vastly improved.
     If you actually survive the VA’s screening system and are rated to a point the VA is willing to provide you medical care you have to be assigned a primary care physician (PCP).  Most of the time this point is not a huge issue. The issue that we run into far more oft than not is that these doctors are so overloaded that it can literally take months to get in. There have been several times that I was really sick and needed antibiotics. When I called to get an appointment with my PCP I was told directly to go to the emergency room because they were unable to get an appointment for me. What really sucked about that is I’m already sick then have to go spend half the day sitting in the waiting room and the other half in a room waiting for the doctor. I often waited until 1 or 2 in the morning just so it would go faster.
     The VA also had many specialty clinics, i.e. dermatology, radiology, podiatrist and so on. Some of these clinics are outstanding. Others are absolutely horrible. They aren’t necessarily horrible because the doctors, residents and nurses are bad. It is more that it is next to impossible to get scheduled. I will give three examples. One good and the other two are absolutely ridiculous.
     Example number one. I had an EGD done in April 2014, that is a procedure where they shove a Canberra down your throat to see what is going on. This procedure takes about 20 minutes plus sedation and recovery. I was supposed to have a follow up EGD at the end of September because they didn’t like what they saw. Once I moved to Oregon in August I went to schedule the procedure and the doctors here decided it did not need to be done. About a month later I was in the emergency rim twice in 5 days because of severe abdominal pain. It took the VA another month to get me in to have the EGD done, then they didn’t sedate me well enough so I had a hard time and they did the procedure. Then they had to redo it.
     The VA is not all bad this story doesn’t reveal that however. I am Bi-Polar type 1, along with some other tags that psychiatrists have tagged me with over the years. I have been hospitalized, voluntarily, more times than I like to admit over the years. Without the VA hospitalization and my meds would be a nice thought; however, very unrealistic. You would think, since I have been in the VA system forover a decade now, that when I moved to Oregon I would be able to get refillson my medications until they found me a psychiatrist. When I went to the VA hospital in Portland to be assigned a psychiatrist and get a refill on my meds I was told that because I am new to the Oregon VA system that I would have to have my meds refilled and shipped from Salt Lake City Utah. That is absolutely ludicrous. The VA is a government agency so why aren’t they all on the same page. In November I admitted myself into the Portland VA’S psychiatric ward because I was nearly out of meds. I had no refills left. I also still did not have a psychiatrist. VA rules state after a hospital stay they have to get you an appointment with a psychiatrist within 30 days. Why on earth would this be the route I have to take to get the help I needed and asked for months before. The VA, the Secretary of the VA and President Obama all said they are hiring a bunch of new doctors, psychiatrists and psychologists to help lower the veteran suicide rates. When is this going to happen, 2055? Unfortunatelythis measure may help but it won’t fix anything. Whether you like this statement or not if someone wants to kill themselves they ARE GOING to do it. Anything sort of putting them in a straight jacket, an institution or both they will find a way. Oh and the suicide prevention hotline and the Portland VA psychiatric inpatient unit are a kin to a bad joke. I will cover that in the next part.
     The one good story I have, and given what is entailed in it, makes the other two stories look even worse. On the way back to Salt Lake City from Cedar City (southern Utah) I broke my ankle. They put me in a boot and on cruces then set me up with podiatry. I broke the same ankle again a few weeks later. After it finally healed they took x-rays and discovered that a lot of my ankle problems were a lot because of genetics. They said they could fix it by song a complete ankle reconstruction. What they did was cut the heel bone in half reposition it and put screws and pins in to hold it there. They also made and repaired some ligaments and tendons. They did this procedure to both ankles. I have to say it had made things much better especially since I love to be active and have kids. This whole experience with podiatry to fix this was fast, well explained and executed without a ton of hick ups or excuses why they couldn’t do it.
     The VA has some major problems that need immediate attention. On of the biggest problems I have is the fact that the various VA hospitals in this country are not on the same page it seems anywhere. For those patients that have medications that they have to take daily they need to be able to get those medications. Granted not all veterans move to different states; however, when I went to get my refills they have me a hard time about even getting a 10 or 14 day supply. One of my medications they didn’t even want to refill. So if a veteran goes out of state on vacation and forgets, looses or doesn’t have enough of their meds what do they do? With the specialty clinics the VA has got to provide an option to be seen outside the VA to ease some of the pressure off of the VA clinics. I had to have x-rays and a cat scan. I live almost four hours from the Portland VA hospital. They do not have a contract with anyone local so to get those images done I had to drive to Portland. My current psychiatrist abs psychologist are 105 miles from me. The VA developed the veterans choice program to help veterans that don’t have a clinic within 40 miles of them. You would think that my need for psychiatric care would qualify me to use this option. 105>40. They said I can’t use this profitable for my psychiatric care because the clinic that my primary care physician is at is only 15 miles away but offers no psychiatric services. Some sites have an option of meeting with your psychiatric doctors over Web cam at clinics. I am one who wants to have face to face conversation. Psychiatric care, one, is more comfortable and easier when you can deal with the topics you discuss in person especially with psychologists. Two, typically in person it is easier to know what is happening in the office and it is far easier to build the trust you have to have with your doctori n person. President Obama had an idea in the beginning of his presidency. He wanted to basically give veterans private insurance in lieu of the VA. I think the VA needs a lot of help. I believe, even with all the problems, the VA is a good organization and does benefit most of the veterans it serves. I also believe that I was wrong about President Obama’s idea of some kind of privatized insurance program for veterans to use when they have an issue that needs attention and the VA is telling them it will be a month, 3 months, 6 months or further away before the veteran can get help. More to come. Next up is the VA’s inconsistency in their inpatient care and the suicide prevention hotline.

The Department of Veterans Affairs (Overview and Need for Better Networking)

     For those that have served and fought for this country this is a horrible subject because the VA has been horrible to us. The politicians of this country have done absolutely nothing to fix the issues that both the Department of Veterans Affairs, herein the VA, and we as veterans face. There are some things that make some sense; however, most of what everyone has done makes little or no sense. This post will be as in depth as I can. With the considerable length of this topic I will post between 4 and 7 posts.
     In the first part I want to cover the application process. When I was leaving the Marine Corps my commanding officers had me go see the VA representative. They filed out all the paperwork and turned it in. I moved back to Utah and had to have another surgery. This one nearly killed me. At this point my mom, while I was recovering, involved a congressman to try and get the file moving. Once the congressman was involved it moved faster; however, it still took 11 months before they finally approved my file. Granted there are many veterans that the VA has screwed around longer than me.
     One thing that really pisses me off is that the VA doctors and staff that make the decisions of what your rating is often rate you almost as low as they possibly can. There are people that have lost limbs, been paralyzed, lost hearing and many other abilities and yet they are only rated down at 10%, 20% and 30%. How can you tell someone thank you for your service. Sorry about you never walking again or missing your leg, your arm we will give you nothing for sacrificing yourself for us and your countrymen. The only reason I received a 70% the first tryis because the congressman was involved.
     I have several issues with this whole process. First is the length of time that the VA takes to do anything for this countries veterans. I understand there are a lot of vets coming into the system; however, this doesn’t mean take your sweet time and do next to nothing. If they government would give the VA more money and the VA would use it to hire more individuals to aid this process then it would move much faster. At this point defund planned parenthood and transfer that money to the VA. My second issue with this process is the people that are investigating our vets are there to find reasons to disqualify them. I also understand that there are veterans that are looking for an easy paycheck. I also believe, or would like to, that most veterans are not looking for a handout but help to support themselves, their families and descent medical care. If their physical matches their SRB and is debilitating them they have earned the services of the VA. That is all I have on this part of the subject. Posting tomorrow will be medical care and specialty clinics that the VA handles.