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Q171: I was in a very serious motorcycle accident in October 2017. As a result, I was life-flighted to the nearest Level 1 Trauma Center where I spent the next 3 weeks, mostly unconscious. Upon my release, I immediately contacted my local VAMC to report my situation and ask if they would cover the expenses. I was told they would NOT because they weren't notified within 72 hours of my hospitalization. When I told them I was incapable of doing that but took care of it as soon as possible, they told me that didn't make any difference. I am now saddled with thousands of dollars of unpaid medical bills that have ruined my credit. Up to this point, even my elected officials have been unable to get them to change their stance. Has anyone had similar experiences and, if so, were you successful in getting them to cover you? Any other suggestions would also be welcomed.
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A1: Were you on active duty at the time of your accident? Or was the cause of the accident something you are service connected for? If no to both of these questions then, unless someone else caused your accident, you're going to have to bite the bullet on this one; unless your patient advocate can help with the bill. (TB) 10/28/18
A2: Take the VA to court and sue the snot out of them...you can't sue the IRS but you sure can the VA...especially if you were unconscious for the first so called 72 hrs...that's ridiculous on the VA's part..just always trying to save a penny... (KS) 10/28/18
A3: Interesting. A couple of questions that I can "hear" the VA state: You were life flighted to a trauma center where you stayed for 3 weeks and then you called the VA upon discharge. I believe the VA regs reference the VA is to be notified as soon as possible (I didn't know about the 72 hours) and then transported to a VA facility when able.
Did the VA request the hospital information? Did you obtain and/or then send a COPY of the medical information? Not all hospitals are aware of the VA regs and my next question is can you receive a letter from the hospital that they were unaware of the 72 hours? And, then after consulting with your VA rep, consider an appeal and send information that supports your position why you were unable to call, e.g. comatose, etc. And, if the hospital is willing to write up the letter regarding their position you might have enough information to support your position. Keep in mind you didn't call until discharged. Were you experiencing any physical issues, e.g. neurological etc. upon discharge that would have affected your decision making?. Is this documented in the medical notes?
As a health care professional, I understand your difficulties. During a trauma one situation no one is thinking about whether "I should notify the VA" when the team is trying to save your life. But, check with your VA rep. Best of luck and hope this helps. (CS) 10/28/18
A4: Write to your congressman and get to your nearest VSO Office and tell them about your problem with the VA. They did the same to me and I was sent by one of their own CBOC by ambulance to the hospital that was 11 miles away. They told me I should have been transported to the nearest VA Hospital which was 100 miles away in Prescott, AZ and the other was 144 miles away in Phoenix, AZ. They don't care and know that no ambulance service will take you that far and if your air lifted they would not pay do to the expense. It is a game they play will all us veterans and they will never stop. You just have to put more pressure on them then they do you. Get a statement and records for the hospital where you were in. If you don't have anyone living with you such as spouse or relative even better for then you have no one that would be responsible to contact them. Good luck and fight them every step of the way. (JRM) 10/29/18