2017 Veterans Day: VA Ordeal, Bureaucratic Labyrinth, and Denial of Ambulance Payment

The Ordeal

Just past midnight on March 6, 2017, I, Publius Jr, had risen from my plastic green patio chair to close the vertical blinds of my studio apartment. The floor where I stood had my Toastmaster Breadmachine, paper shredder and a box with multiple plastic bags of assorted skeins of yarn (I’m a knitter). The chained loop to louver the blinds closed were just slightly out of my reach so I leaned my 6 foot 3 inch frame to catch the bottom of it. I pulled the blinds shut. I turned to return to go to my plastic green patio chair when I slightly twisted my torso. Something was not quite right. I had felt my muscles of my lower left back pop, er rather that’s not the right word, but I knew instantly something was wrong in the lower left of my back. I have had this same unpleasant feeling around the first of the year, also one other time on the right side of my back in late November 2013–back then I went into shock and I fainted at a housechurch in Lindstrom.

This time I thought I’d sleep it off on a hard surface like the floor with a few cushions here or there and an icepack. It was hard to sleep without sending pain shooting through my back. I couldn’t sleep on my side which is my normal sleeping position and I lay awake for the next several hours.

I catnapped off and on, waking suddenly with a reflex reaction of clenching my back/stomach upon waking up and a wave of pain rolling through me. Six to Seven hours of not being able to sleep properly switched over to my waking morning routine at about 7:30 am.

I tried to get up and my body had no strength. Instead it took me a 2-5 minutes to turn over onto my stomach then I rose up to all fours, turned my body around (my makeshift bed pointed away from the center of the room) and ambled on all fours to the bathroom.  I stood to urinate but it was so painful to be upright I knew the rest of my day would not be anywhere close to standing. I grabbed some ibuprofen–the bottle was almost empty.

On all fours I made it to my fridge to get something to eat. I could only eat what I could reach. So my meals consisted of baby carrots, Dannon Light & Fit regular yogurt, and water.

I went back to lay down hoping for decent sleep. At about 9 am I knew I wasn’t going anywhere that day so I called Keith Hardy and another member of Wordsmiths Toastmasters and left messages that I would not be attending the meeting that night. They’d have to find a replacement for the speaking role I was to do. I usually go to Wordsmiths every Monday, which is why I pass on political meetings scheduled on Mondays (it is an oasis from political posturing & chaos).

An hour later I called the VA Nurse line. It is a medical advice line that also helps to schedule appointments. I told the VA Nurse the situation and where the pain was at. She asked me a bunch of questions to include if it had happened before and I said it had in severity in late November 2013. She suggested to ice down the area, take Tylenol or another pain reliever and try to rest, and if it didn’t get better in 2-3 days go to an Emergency Room.

The VA Hospital in Minneapolis has an Emergency Room except I’ve never seen ambulances stopping there to drop off patients. It’s like what most ERs have become an Outpatient-no-appointment-necessary-intake wing of the hospital. I don’t think the VA Emergency Wing knows what the term “Emergency” means, I’ve been there before and they make you wait despite a lack patients.

I would have to wait through two to three days of misery? I couldn’t wait that long.  I had trouble standing to urinate. That problem was resolved by the empty plastic Powerade bottles I had. Using them to “eliminate” liquid waste. I couldn’t sit so “eliminating” solid waste was not possible.

To get around my apartment otherwise crawling on all fours was less painful than standing but still painful so I had to do the low crawl where my stomach was on the floor and I propelled myself  by pushing forward with only my right leg. Drill Sgts Ricky Mobley and Donnie Thornhill my Drill Sgts would applaud my form I thought.

So I made up my mind to get to the ER at Regions Hospital which is the closest hospital to my studio apartment.

I called a friend, Greg Copeland, to discuss it. I asked him if he thought the VA would pick up the cost of the ambulance. He said that since I have no other way to pay it they would have to. I’ve used the VA Hospital/Clinic System as my healthcare provider since I do not have health insurance even when I had a seasonal job to grade state standardized essay tests.

“I asked him if he thought the VA would pick up the cost of the ambulance.  He said that since I have no other way to pay it they would have to.”

I told Greg my Veterans ID Card (VIC) and another VA card said non-VA medical could be paid by the VA. So it was decided I was going to call 911 to get some relief at Regions ER.  Luckily my phone is on the floor.  I called at around 5 or 6 pm.

I didn’t want the EMTs to see my cluttered studio apartment so I put some clothes on and a sweater, wallet, iPod Touch & Charger, and waited upright next to my door in the hallway of my apartment waiting to lock it when they came. I was in terrible pain waiting for them.

The EMTs started to question me right away what my pain was. I said I threw my back out and the VA told me to go if it hadn’t gotten better. One of them put an arm under my arm to aid me out of the building. My body felt heavier for some reason. They got me into the ambulance through the side door. They took my blood pressure and they wanted to strap me onto the side on the bench seat. I pleaded with them to let me lie down on the gurney. So they let me lie down and the pain was less.

When we arrived they got me into Regions ER and transferred me to an upright chair with wheels. It didn’t look like a typical wheel chair. The EMTs disappeared and I checked in with the nurse’s station.  I was trying to be in good spirits throughout my stay.

Staying in good spirits in the waiting room of the ER is tough to do. In the 5 hours I waited a variety of different patients and their families complained about their illness the wait time and the weather. The outside air temperature was unseasonably warm in the upper 40s to mid 50s or so. I hadn’t dressed for later when I wished the sweatshirt I had on was a little thicker.

At around 11 pm I finally saw the doctor after a nurse took my vitals and asked a few questions. The lady doctor asked me the extent of the pain and where it was located. She touched areas on the lower back asked if it hurt. There were no x-rays taken. She said it wasn’t sciatica nor a spinal injury. She prescribed Aleve and some Valium and a shot of Tramadol and referred me to Physicians Neck & Back in Roseville MN for Physical Therapy.  I got the shot and paid for my prescription.  I called Greg and left a message to pick me up.  I called another friend but there was no answer. So I called a Taxi. I waited 45 minutes and no taxi. I called them again and they said it would be a 30 minute wait. No wonder why people like Uber or Lyft.

The police officer in the lobby alerted me when the taxi arrived. It was chilly out. The cabby had to smoke so he kept the window open the entire ride back. I paid him and went into my apartment. I fixed my “bed” area on the floor and took the Valium, Aleve, an ice pack and fully slept for the first time in a 24 hours.

March 7, 2017

When I woke I took my meds, the Valium seemed to make everything go in slow motion. Then I ate a real breakfast and took a needed shower and called up Greg and told him about it.

I called the VA Nurse line to tell them what happened the previous day. A different nurse asked me if I had numbness in my left leg. I said from below the left hip area around it was numb up to my upper part of the leg. The area occasionally “itched” inside the upper part of the leg.

The Nurse told me to go back to the ER. I said I was on Valium and I couldn’t drive there. She said to call 911 to get there. So like a good soldier I followed orders. I called 911.

This time the EMTs were reluctant to take me and treated me less than friendly like the day before. They strapped me to the side. My back still hurt but I was kind of fuzzy on the Valium.

When I arrived at Regions ER the same check-in nurse was still on duty from the day before.  She was surprised to see me but I told her the reason and that there was numbness in the area of my upper left leg.  I suspected that I would be waiting forever like the night before so I told her I was going to the cafeteria to get lunch.

Upon my return from the cafeteria, I asked a male nurse at the desk if they had called my name and they had but I wasn’t there.  So he told me to wait.  A half hour later I was ushered back into the exam room.  A Physician’s Assistant did the same sort of exam as the Woman Doctor the night before but her diagnosis was different–Sciatica.  Who to believe? I believe the Doctor over the PA.  She recommended the same course of action as the doctor did the previous night and told me to get plenty of rest and ice down the area.  If the numbness travelled below my knee then I should come back in.

I called up a friend, Bob Murray and he came to pick me up.  He took me to Burger King on Rice & Larpenteur to get a bite to eat while I told him the story.

Bureaucratic Labyrinth

A few days after I returned from the second ER visit I got a call from HealthPartners call center in Sartell MN.  The person on the line, “Betty” called to schedule my appointment for physical therapy at one of their Physicians Neck & Back (PNB) locations.  I indicated the Roseville location off of Center Pointe Drive would be the best one.  So I scheduled a March 22nd visit, figuring the VA bureaucrats would clear up the way for me to pay it through the VA by then.

I went online I found where it was and I planned how to get there.  I was all set to go except I had to work it out with the VA.

When I called up the VA line (there are no direct lines to doctors you have to go through phone buttons to get another list of buttons to select) to talk to my GP Doctor Gloria (leaving out her last name because she is a good doctor).  I wanted to tell her what had happened.  I talked to her then to a nurse at the VA Clinic in Maplewood who asked me to get x-rays and the other paperwork from Regions Hospital, in order to authorize physical therapy, I also needed to come in for a brief check up on my back.

By the following Friday, March 17th I was off the Valium and so I could drive to Regions to run down the paperwork.  The day before I had called the Records Department of Regions to see if I could have them transfer the information directly to the VA Maplewood & Dr Gloria.  They said it would cost a certain amount of money so I thought it would be cheaper to arrive in person and hand walk them to the VA Clinic–oddly I learned this is the most secure form of transmitting data, to hand walk it from A to B.

At Regions after I parked I got in the elevator off the parking ramp and proceeded to get lost.  With no outside windows it was hard to figure out where I was so I asked a volunteer outside their gift shop.  The “Sainted” volunteer guided me through the hallways and 3 floors on the elevator before she left me outside the Records Department.  I talked with the woman who had talked with me on the phone, her voice was familiar.  She had me fill out some paperwork and what records to send to the VA Clinic.  If it went regular mail there was no cost.  I got back to my car after remembering the route I took to get there.

I called the VA Clinic and told a PA, “Sharon,” the news the files were on their way to them but there were no x-rays or other scans because they didn’t perform them.  The PA told me to come in the following Monday, March 20.  On March 20th I talked to “Sharon,” who I had talked to the previous Friday.  She said that I wouldn’t be able to go outside the VA to get treatment but there was a program that might allow me to (kind of confusing, I know).

The VA Hospital system used to just drug up people who had back problems and they were finding this treatment not working in the long run so they decided to do physical therapy in-house at the Hospital.  Fortunately for me to catch up on their backlog of patients needing therapy I could go outside the system to get treatment under the Veteran’s Choice Program.  She provided a number to call.

Before I called the Veteran’s Choice Program number it was looking like the Physicians Neck & Back appointment for March 22nd was not going to happen being I didn’t have normal insurance but I had the VA footing the bill for my treatment.  So I called the HealthPartners Sartell MN Call Center to talk to “Betty.”  I told her the appointment I had made almost 2 weeks before I would have to cancel.  She commiserated with me about all the VA snafus she has had to deal with.  She thanked me for canceling because often on hold with people at the VA she never gets straight forward information from anyone there.

According to one of my notes I called the Veterans Choice Program on March 29th.  I had been told by the VA Clinic PA “Sharon” when I had visited her in lieu of seeing Dr Gloria who could not see me til after she returned from a vacation in April.  “Sharon,” had explained many things about the treatment.  She said when I talk to the Veteran’s Choice Program person they’ll issue a card that I’ll get before I go to my first physical therapy session.  I’ll be able to as the program is called to decide which physical therapy place I could go.  I thanked “Sharon.”

On the March 29th I got a call from “Susan,” of the Veteran’s Choice Program (VCP).  She said she was calling from South Carolina where the VCP is located.  She helped me schedule a physical therapy schedule.  Susan said that I could go anywhere, being I don’t know much about physical therapy companies I decided to go with the original referral of Physicians Neck & Back in Roseville MN.  Susan said 36 therapy sessions were authorized by VCP, if more were needed I would have to be seen by my GP Dr Gloria.  My first therapy session was scheduled for April 6, 2017.  A full month after I had thrown out my back and 2 weeks after my first cancelled appointment on March 22.

Physicians Neck & Back

My first visit was with Dr Gloria Peterson.  I told her my GP at the VA Clinic had the same first name.  She examined my back then talked with me.  I told her that I couldn’t sit for very long on a chair without having issues with my back–pain and discomfort.  This was a problem as I admin this site and do articles for it.  Also it was a problem when I got out of my car.

When I first started I was put on a sensor-rigged back press Nautilus machine.  They could measure the weight I could push and the angle I could do it at.  I weighed then about 240 and I could barely push 100 lbs on the machine.  The goal was 180 lbs through a variety of back angles.

It was tough, but the physical therapists I was assigned were fun, informative about what was going on and they really encouraged me when it got tough.  They also showed the proper way of lifting things, how to sit on a chair properly (if your knees are above your waist you’ll slouch).  When I finished in August 2017 I was sad to go.

They have a room to maintain and strengthen ones back, stomach, and neck muscles called Core, it is the same as I did with the therapists except without them.  I wanted to continue but I don’t have the money to.  The VA didn’t authorize it.  So at a future time if I don’t keep my back & stomach muscles strong I might have another back injury.

Denial of Ambulance Payment

The first sign that something was not right was on July 27, 2017.  I got a bill from the St Paul Fire Department (SPFD).  I called up the VA and after some time I got the non-VA medical billing office.  I talked to Daniel (that’s his name I didn’t get a last name).  He said the SPFD had not submitted a bill to the VA inside of 90 days.  They would have to submit some paper work to explain why they had not submitted a bill for the 2 days I had used a SPFD Ambulance.  I asked him for his number and I said I would let SPFD Billing know how to contact him.

So I called up SPFD minutes after I had talked to Daniel.  The Billing Clerk took down the information that Daniel had provided.  I asked if Daniel was correct when he said they hadn’t submitted a bill to the VA.  The clerk said they had submitted both bills on March 14th and a second time as well on July 18, 2017.  He said this happens all the time with the Veterans Administration (VA).  He said they would figure it out and I should worry about paying for the bill.

I got another bill from SPFD in September and also in October.

On November 4, 2017, I received in the mail an official notice the VA would not pay for the Ambulance Bill from the St Paul Fire Department.

I scanned the two letters in the envelope, the recent bills from St Paul Fire Department (SPFD), and also the envelope in which the VA letters came in.  Then I called the SPFD on November 6, 2017.  I talked to Ines (pronounced eye-nez) of the Billing Department.  I told her about the Official Denial of Payment Letter from the VA.

Ines sets Daniel Straight

She looked up my Ambulance Charge date.  She asked me if I had called in late July 2017, I said I had called then.  Ines said she had called up Daniel at the VA the non-VA Billing Department.  She talked to him and told me the conversation went like the following.  Daniel had told her that he has to send requests for payment of bills to Denver, Colorado.  He claimed the patient (me) that I didn’t have a zip code and therefore they couldn’t determine how to pay the bill.  Ines stopped him and said that the VA Patient (me) had an address.  Daniel asked her to send him this information by mail so he could submit the information to Denver, Colorado.  He said he was sure the bill would be paid.

It wasn’t paid.  (This is why I’m writing this narrative).

I was curious so I asked Ines while she was still on the phone for documentation, she confirmed when the Ambulance dates were, when the bills were submitted, why it takes 6-8 days for the actual bills to be produced.  I asked her how often the non-payment of ambulance bills by the VA happens.  She said it happens all the time with VA Patients.  I asked if she could give me a figure on how often it happens.  She replied, “You mean for the whole year or just one week?”  I said just one week.  Ines replied that on average there are 10-15 VA Patients’ bills are denied payment by the VA non-VA Billing Department.  That’s about 520 to 780 per year if that is multiplied for 52 weeks.  This is St Paul alone.  Imagine what it must be like in a larger city.

on average there are 10-15 VA Patients’ bills are denied payment by the VA non-VA Billing Department. –Ines SPFD Billing Clerk

Call to Action

Today on Veterans Day 2017, it is my 28th anniversary of being honorably discharged from the US Army.  I served my country well, not during a shooting war, but the tail end of the Cold War with the Soviet Union.  I had a Secret Security Clearance for the job I did for two years starting on November 12, 1987, 30 years ago tomorrow.

If I had known the kind of treatment I might receive, the Mickey Mouse Labyrinth of bureaucracy I would wander around in to receive treatment through the Veterans Administration, I might have went to college directly.

I went into the all volunteer US Army.  I served under some great Officers and NCOs, and some not so great.  My Army Buddies are friends for life.  My Montgomery GI Bill paid for most of my college expenses and I graduated with no student loans to pay off.

I see flag wavers out there now who have never served, nor can they relate to what it is like to serve in the military.  They go to their Veterans Day sales, and think it is just another holiday, it isn’t.  They think wearing Red, White, and Blue makes you a patriot, it doesn’t.  Civilians in my opinion waste their Liberties and Freedoms. The Soldiers, Sailors, Marines, Airmen, National Guardsmen, and Coastguardsmen which most Americans praise on days like today; they do not know our military personnel do not have the same liberties and freedoms as civilians do day in and day out.

I think I would enjoy Veterans Day more if Veterans were treated properly at VA Hospitals, to have their ambulance bills paid on time.  There is no excuse for some of the institutional neglect many Vets run into at the VA.

We Vets don’t complain too loud.  I think I know why. I was outside an appointment gathering my things and thinking about the appointment I just had.  I felt worse than when I went in.  I got to talking with an older woman named Judith.  She was waiting for her husband Jim, who was in with the doctor, Jim was showing early signs of dementia and possibly Alzheimer’s.  I said to her the reason why many old Vets and returning Vets have problems in civilian life is because in Basic Training we are stripped of our individuality and replaced with a concern for the team or buddies.  When there is an obstacle to overcome we do it together.  When we get out of the military and an obstacle is encountered there is no team to deal with it so We Vets tend to internalize it and downplay it.

I’m asking you, the reader, to join with me to make sure Vets across this country currently serving or served decades ago to not be alone and demand better treatment by the Veterans Administration to get Ambulance Bills paid.  Call up your Representatives and Senators in Congress and demand better Treatment for our Vets.

Together We Can Overcome Obstacles Together

This entry was posted in Health, St Paul + and tagged , , , , , , . Bookmark the permalink.

Leave a Reply