Posted on 09/10/2019 8:55:55 PM PDT by 2ndDivisionVet
The Department of Veterans Affairs must reimburse veterans for emergency medical care at non-VA facilities, a federal appeals court ruled Monday — a decision that could be worth billions of dollars to veterans.
The U.S. Court of Appeals for Veterans Claims said the VA has been wrongfully denying reimbursement to veterans who sought emergency medical care at non-VA facilities, and struck down an internal VA regulation that blocked those payments.
"All of this is unacceptable," said the ruling, which ordered the VA secretary to "readjudicate these reimbursement claims."
Plaintiffs' lawyers say that based on past estimates by the VA, the department is now on the hook for between $1.8 billion and $6.5 billion in reimbursements to hundreds of thousands of veterans who have filed or will file claims between 2016 and 2025.
(Excerpt) Read more at msn.com ...
This is a very bad ruling and should be over turned. The VA was not established to cover non-service related medical conditions.
The VA was created to treat Service related issues of non career military vets. Period.
My dad was a combat wounded vet. He received two purple hearts for combat war wounds. The second nearly took his life.
As he grew older he suffered numerous medical issues. He went to the emergency room and what his insurance did not cover he paid for.
This precedent, if upheld, will bankrupt the VA. I am not a fan of the VA by any stretch but, this ruling is absurd.
I have a number of medical issues that have arisen during my service. For example, I broke my arm while headed to the gym to practice for an upcoming physical fitness test, and have impaired movement of my arm as a result. Plus, about three other issues for which I plan to seek a VA disability rating. I will retire April 1. The closest I have been to combat is when I went on a special mission to Korea, which is still a war zone.
Nice to know that you do not think I deserve care for my medical issues after 20 years in the service, just because they weren’t incurred in combat.
Good point.
They can but it wasn’t for emergency service and you had to let the VA know ahead of time.
Although he never saw combat, he has evidence he was traumatized from something he saw, and he needed psychological help, which he knows he needs to keep going on his PTSD portion.
He works full time at a large company and, strangely, is running for political office.
He is severely overweight, has diabetes, and refuses to address anything until after he gets 100% disability. I have another friend who has other issues—nearly all intangible, getting 70% disability.
The secret is to trump up anything barely referenced in a letter or email while in service, then have a non-military lawyer push your case. That is what helped these two.
I have another friend, whom I met in a prison ministry, who is perpetually homeless—by choice. He is 100% disabled but gets over $4,000 a month tax free. He eats at soup kitchens and bums for money but he gives all of his money directly to his daughter-in-law (who is a surgeon!) to help with the grandkids.
He is now doing this less, but for years he would get into free housing, then drink and go nuts, then get expelled.
Heck, I gave him nearly a thousand dollars over the years to help him when he said he had absolutely “nothing.” When he was recently in the hospital from a mugging, I had the first opportunity to talk with his daughter-in-law who marveled at this man’s decades of dedication to supplement her $200,000 annual salary.
Finding that out floored me.
I know of several others at my place of work now heading down these same pathetic paths toward free money for life—money that will be forever untouched by income taxes.
What I want to learn is what does the law say, what does the law require the VA to do; what has been the Congressional intent - and acknowledged budgeting - based on the law.
What I want to be clear about is that we should only be demanding what the law requires of the VA, not what some court has decided all on its own what IT thinks the VA ought to do.
Is this really something new that has started to happen - the non-reimbursements - or is this a new challenge to essentially long standing - and long understood - VA practice. And, which way does the law say the VA is required to act.
Why all of that? The VA can only be wrong if they made regulations and/or operational decisions contrary to the laws that dictate what their regulations can and cannot do. The law would be an expression of Congressional intent as to whether the taxpayers (VA budget) must pay for emergency care given by private emergency care services, and if so then to what extent.
Is the judge following the law, or out of sympathy to the plaintiffs trying to make law from the bench.
The veterans that are covered by the VA are mostly not retirees. Typically, they did 2 to 6 years and then got out. They had the rest of their adult lives to get a job and be covered by medical insurance provided by their employer. After retirement they would be covered by Medicare.
Most of the veterans who use the VA squandered their life.
I believe those who should be eligible for VA care are those who have a service connected disability and retired military veterans.
“The veterans that are covered by the VA are mostly not retirees.”
I learned a lot from my ex-wife’s father. He did 4 years in the Army over 30 years ago. Never saw combat and has no service related disability. Spent his career as a lawyer, and apparently set absolutely nothing aside for retirement. Because he is basically indigent, the VA covers all of his medical care, diabetes, heart condition, etc. There is something seriously wrong with that.
If it’s an emergency how in the hell can you let the VA know ahead of time emergencies don’t give you a warning ahead of time!!! TAKE CARE OF OUR VETS!!! I am getting sick and tired of all of the screaming about care for ILLEGALS yet crickets about our vets being HOMELESS, drug addicted, and in ill health!!! Low income housing is FULL of illegal families and our vets are on the streets!!! GIVE ME A DAMN BREAK!!!
Retired military have life time health coverage, I am from a retired military family and my mom and dad have Tri Care the TriCare is now their supplemental insurance with the Medicare!!!
So if Patton had survived his accident and had problems later in life you would have problem with him being treated at the VA?
After all it was not something gotten in combat.
How about those paratroopers who got injured in a training accident at Fort Irwin back in 80's who have physical problems? No treatment because it was a training accident not combat?
They are called SRI service related injuries because if you were not serving you would not have gotten injured.
Are there people who game the system? Of course. But that does not mean that only "combat injuries" are valid and the rest is just your tough luck.
The military medical runs on the "you broke it, you bought it" principle. When they break someone they are responsible to make sure the problem is treated. For as long as treatment is needed.
Before Obamacare the VA means tested both income and assets. Now the VA only means tests income.
I’m a combat vet with 21 years of service. The military is a dangerous profession even if you don’t see combat. The laws state that no matter what the medical condition is if it happened while on active duty it’s now the military and va’s job to make it right or pay compensation.
For years I saw the military deny/underrate service connection for injuries that were clearly due to military duty. This changed after the Walter Reed fiasco and congress forced the military to use the VA rating system.
Are there going to be fakers and people who abuse the system. Of course it happens everywhere and no system is perfect. Personally I’d rather see 100 fakers get the compensation then see even one truly injured vet denied it.
You are correct. This has been going on for many years.
But, as with civilians, what we have later in life to cover something not fully addressed earlier is not necessarily what we had when we got the injury. There is a perverse financial incentive to not get something adequately fixed, with former military members. These “ongoing” issues provide tax-free “disability” income that lets one get all sorts of constant handouts, due to having no income.
If a problem can’t be fixed, pay the service member a one-time disability payment and put the onus back on the person who got the payout. This is what a dismembership payment does. Whatever insurance you now have will be more diligent in getting a case nurse to see through the circumstances of ongoing issues, but now you have no incentive to worsen your issue because you have a deductible to meet.
Something like this should be done over lifetime disability payments and medical, on top, for stuff that barely is tangental to any original injury, now continuing to “show.”
“If it wasn’t from something gotten in combat, yes, I have a problem with it.”
One of my best friends fell off a ladder while working on high voltage lines in Iraq. He shattered his shoulder. He’s needed multiple surgeries and it’s still not 100%.
Does he not deserve his VA coverage?
L
What surgeries does he need to get to maximal recovery? If that can’t he achieved, what payout is he offered to settle the issue?
Workman’s compensation does a reasonable job, but not perfect, for all the rest of us. If he was a contractor, he was laid highly and should have a similar benefit. If he was military, we should do what we can and one-time payout the rest.
Also, because he was in Iraq, that would typically be considered a combat zone.
“Was he a contractor or federal employee?”
Active duty National Guard. Any other dumb questions?
L
>If it’s an emergency how in the hell can you let the VA know ahead of time emergencies don’t give you a warning ahead of time!!!
That’s exactly the point. The VA would allow you to go to a non VA Hospital for scheduled treatment such as certain surgeries or chemo therapy but if you went to a non VA emergency room you were on your own.
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