Friday, May 23, 2008

Downgraded Diagnoses

Here is an open letter to the Congressional Veterans Affairs Committee Chairmen:

To: Senator Daniel K. Akaka, Chairman, Senate Committee on Veterans Affairs
Congressman Bob Filner, Chairman, House Committee on Veterans Affairs
Honorable Members of Both Committees

From: Kurt Priessman, MSgt, USAF (Ret), B.A., M.B.A., Veterans Advocate
The Veterans of this Great Nation from All Wars

Subject: This is not an Isolated Incident

Chairman Akaka and Filner, Ranking Members, honored members of the Committees on Veterans Affairs, interested Senators and Representatives, ladies and gentleman of the presenting panels, Veterans and Citizens of the United States of America,

Today is a special day, a day not for exercises in obfuscations or excuses, nor grandstanding or indignation, but a day to shed light on a system that is broken, a corporate culture rife with adversarial processes, denials, cover-ups, and rule-making ad infinitum. This country’s veterans deserve better.

Suicides and PTSD among veterans are nothing new; they have just become more prevalent in the media which has covered them more attentively. Veterans today are faced with combat unlike any before, where the enemy is vicious and use the populace as shields, where human suffering seems unending. And unfortunately the suffering does not end after the battles in the Afghan mountains, or the streets of Sadr City or Basra, it continues in the constant bureaucracy, outlandish, outrageous procedures and requirements of proof, and trivial excuses of a system that is forced to cover-up statistical information that verifies its own failures.

Eighteen Veterans die each day from suicide, seventeen more a day die while waiting for their claims to be adjudicated. It is becoming increasing clear from internal e-mails that the practices described herein are insidious, prevalent, and long-standing. This is not about anything other than a total failure of leadership gone too long, without anyone’s accountability.

I submit to the Congress that the following practices come from the highest levels of the Department of Veterans Affairs, through Secretary Peake, Deputy Secretary Gordon Mansfield and Dr. Michael Kussman, conveyed through internal memorandums and e-mails to Regional and Medical Center Directors, to Program Administrative Officers in every line of the Veterans Health Administration and the Veterans Benefits Administration. The practice of not documenting, downgrading, and denying applicable diagnoses is prevalent in the Veterans Health Administration and also in the Department of Defense.

From real experience I will give you two actual instances.

The first was a discussion with my VHA primary care provider about my military health record, in which an inch worth of visits only reflected one instance of blood pressure and temperature taken in twenty years although it was standard practice that these were taken at the onset of every visit to a military clinic, thus making my claim of service connected hypertension unproveable.

My provider responded, "Yes, I know, I had a patient walk in the other day with blood pressure of 235/178 and no diagnosis of hypertension. I called the physician of record, and he asked me if I hadn't heard about not documenting diagnoses, especially if they were compensable."

The next instance was the result of a C&P exam. I was hit by a truck while serving in Thailand and was nearly killed. I escaped through quick reflexes, as I turned my thigh towards the vehicle and stood on my tiptoes. I was flipped high in the air over the truck, rather than being run over, which saved my life. I was in the hospital three days. Shortly thereafter I began experiencing continued knee pain, back pain and back spasms.

When the C&P exam took place, the exam showed degenerative disk disease of the spine, degenerative joint disease of the spine, knee, hips, and iliac joints and arthritis. Yet the examiner stated that due to a lack of treatment it was unlikely my condition was related to the accident although I had never injured my back at any other time and my primary care provider attempted to schedule both CT scans and a MRI for three years before she finally got approval from the clinical line’s Administrative Officer. Thus denial of expensive diagnostic tests (CT scans, MRI), is another ploy used to deny benefits.

The doctor I got for an independent medical opinion, a renowned radiologist, stated that my spinal injury was common in traumatic accidents of this kind (with medical citation), and then asked the VA examiner that if she felt it was less likely than not the accident caused the condition, what did?

The answer is obvious, but unfortunately it is not medically related. The answer is that denial of nexus for service connection is just another ploy used by the Department Of Veterans Affairs. In an arrogant manner, the Department denies Veterans. They do not have to provide or explain a reason even when that reason is ungrounded by any evidence.

Additionally, although required by law, re: The Veterans Claims Assistance Act of 1991, paragraph 5103 A(3)(b) and (c), when I requested assistance in finding retiree medical records from the USAF (a governmental department) with specific information as to where and when, help was not provided. Yet the examiner cited the fact that records did not reflect treatment during that specific time period. This is exacerbated by the failure of the Department of Defense and other government to release evidence that would substantiate Veterans claims. It thus becomes obvious that another ploy to deny benefits is not to assist veterans in compliance with the law.

Another ploy is the arbitrary and capricious disregard of its own rules and regulations. Despite a requirement to give Veterans the benefit of the doubt, this is always denied and not usually remedied until a case is taken to the Court of Appeals for Veterans Claims seven years later.

The answer is tied to money, an unscrupulous corporate attitude, and a prevailing attitude among Republicans in Congress and the White House that the benefits given to Veterans are entitlements.

As a career military man, I feel that this abhorrent attitude is beyond belief. Veterans who have served and continue to serve earn every dime of every benefit the law provides. Until the attitudes towards these benefits changes in the Administration and Congress, Veterans will be faced with being nothing more than chattel, “volunteers” lining up to give their lives, only to be dismissed and left to die. Please think! The health care, disability payments and pensions, burial, educational, rehabilitative and home loan guarantees are not entitlements, are not entitlement programs, they are earned benefits.

I am sure the Secretary will state that the e-mail in no way reflects the attitude of the Department and is an isolated incident. Or that it should be obvious from their outstanding PART Report that they are the best of the best. As a former civil servant, involved in the formulation of this report for another Department, I remind you that these reports, their criteria and results, are nothing more that self initiated assessments meant to reflect positively and that negative criteria are weeded out and dismissed.

In conclusion, I ask Congress not to believe for an instant that the administrators of the Department of Veterans Affairs have not instituted "unwritten rules" intended to deny benefits to Veterans. Veterans across this country would be more than willing to testify to Congress on their experiences and if given impunity from retaliation, so would responsible providers and employees of the Department.

With sincerest thanks for your continued efforts and support,

Kurt Priessman

Kurt Priessman, MSgt, USAF (Ret0
Vernon, Texas

Proud Vietnam Veteran,
Proud Father of an Iraq/Afghanistan Veteran

Thank you Kurt!


”It is a stain on this nation's honor that the Department of Veterans Affairs has become a deadlier and more difficult adversary to the American veteran than any they have ever faced on a battlefield." -- VNVets

"With malice toward none; with charity for all; with firmness in the right, as God gives us to see the right, let us strive on to finish the work we are in; to bind up the nation's wounds; to care for him who shall have borne the battle, and for his widow, and his orphan--to do all which may achieve and cherish a just and lasting peace, among ourselves, and with all nations." -- President Abraham Lincoln

"Without a decisive naval force we can do nothing definitive, and with it, everything honorable and glorious." --President George Washington

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