stories

Getting into the VA

By: Justin Straughan, Air Force Veteran

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When, in 2008, the opportunity to become the first in my family to attend college was swiftly taken away due to the Florida State Legislature’s educational budget cuts, my feelings of overwhelming joy and pride quickly soured to something ugly, festering, and equally powerful. My desire to achieve a higher education set into motion a series of events, starting with military service, finding my own way to enter college, and challenges I never foresaw dealing with the bureaucracy at the US department of Veteran Affairs ~ the VA.

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My VA story begins because I was disgusted with Florida for playing politics with my future. Coming from a family with no idea how to apply for college, let alone pay for it, I had stood alone before the monolith that is higher education. Now it was replaced with something more imposing: a life-changing swerve beyond my control.

 

I had made a promise to myself that I would find a way to pay for school without taking out loans, as I’d previously seen my family face financial turmoil after borrowing money and struggling to pay it back. And so, I began to research the military, and the G.I. Bill, an education benefit offered to service members by the military, yet administered by the VA. I needed a steady career that could overlap with my desire to make the world a better place. And so, I enlisted in the U.S. Air Force in 2009. I served for four years, as a Ground Radar maintainer in a combat communications unit. After I was injured in service, but before my discharge, I was reassigned to the Honor Guard to conclude my service. My injury developed from knee issues from cartilage damage due to flat feet and the intense high-impact lifestyle in a combat unit. My medical condition became became severe enough that the Air Force chose to code me ‘non-deployable’, meaning I was unable to re-enlist and faced imminent discharge. 

Soon after my separation, I began seeking care at the VA. Like any healthcare system, the VA isn’t perfect. Yet I am fortunate enough to be treated by VA clinicians who’ve truly cared and inspired me to go into medicine myself.

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My first major hurdle with the organization was securing a ‘service connection’, meaning the VA agrees your medical conditions happened because of military service. This opens the door to be seen at VA hospitals. A representative for Disabled American Veterans (DAV) advised me that I would need to file and win a disability claim against the VA before I could receive care for my military-related disabilities. The representative advised me that filing a claim while still in the military was recommended because it was ‘pre-emptory’. We filed my first claim two months before separation. That is when I learned the disability claim process can take years ~ and possibly decades if VA denies your claim and forces the veteran to appeal. Little did I know how correct the DAV’s statement about VA would turn out to be.

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My first appointment was with a VA compensation department doctor in the Viera clinic to evaluate my claims. During this compensation and pension exam, he flexed my knee three times for my range of motion test under his own power, ignoring both the cracking sounds and my exclamations for him to stop. He incorrectly wrote in my chart that I was fine, that I had no disability. A VA bureaucrat then denied my claim. VA’s mistake meant that I went with limited care for my orthopedic conditions, as care is tied up to service connection, until a certain point. I later had non-VA doctors lose my imaging. It took me obtaining an independent doctor of my choice’s medical opinion as well as a lawyer for VA appeals to receive a fair rating for my knees. I should not have had to fight the organization for benefits because the information about my injuries was already contained in my USAF Medical Records.

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VA’s claim process resulted in reduced care for approximately 8 months while I frantically wrote letters to Senators Bill Nelson and Marco Rubio, and my representative at the time, John Mica and later Ron DeSantis. I was largely ignored except by Senators Nelson and Rubio.

In contrast, the healthcare team outside of the Compensation and Pension department, on the medical side of VA’s facilities were faster and far more dependable. The New York Harbor Healthcare and Daytona Beach Orthopedic teams, for instance, was able to diagnose issues that other doctors had missed, including some musculoskeletal damage I have incurred. They’ve been able to recommend lifestyle changes necessary to prolong the use I have in affected areas, while my physical therapists have worked diligently through these injuries. In short, VA practitioners have been exemplary in their willingness to take the time to do little things that have made a large impact in my life.

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My only other negative healthcare experiences with VA’s bureaucracy were through community care and billing departments. I have found that I do not feel well cared for by these private providers. Due to decades of underfunding and efforts to privatize the VA care system, VA sent me to private doctors, resulting in non-VA providers sending me bills for care that was supposed to be free.

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I am a very knowledge-oriented individual, and as a person entering the medical field, I expect to be able to learn about the treatments doctors want to administer, not only because it is my body but also to be able to improve my own clinical knowledge. 

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When VA sends me to a for-profit provider, I often feel like just another number in a healthcare system that is all aboutnumbers and processing as many patients as possible in order to make as much money as fast as possible. On the two occasions I have had to visit Emergency Rooms, getting the private hospital billing department to properly bill the VA was a challenge. I ended up having to fight a black mark on my credit report for past-due collections for almost a year in each case. 

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More recently, I visited a private provider chiropractor who refused to see me if I didn't submit to a full back X-ray. This was a strange demand, as respected physician resources say that for acute lower back pain, X-rays are not recommended or required for treatment. The opulent office décor along with the doctor’s assurance that this was a necessity for any patient suggest that billing for unnecessary medical imaging on the taxpayer’s dime is commonplace.

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My undergraduate degree was in Political Science, after attending Columbia University. This was funded largely through the Post 9/11 GI Bill and Yellow Ribbon Programs. I utilized this degree to work in local level politics and work toward learning about writing healthcare policy. I have since taken pre-med courses to round out my experience and apply to a Master’s Degree program in Physician Assistant in order to become a healthcare provider myself. This degree is through the VA’s Vocational Rehabilitation program. Through my entire post-military life, the VA has paradoxically erected barriers and given me the way to move forward and become something more than a statistic. It would be wrong of me to look back at the organization and not want to return the favour in some way, so I share my story and work to improve the bureaucracy within in order to help veterans avoid similar pitfalls and make the system for fair and equitable for all while still respecting and being a proper steward of taxpayer monies.

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I have ironically found the highest quality of healthcare at the hands of an institution with a bad reputation: the Department of Veteran Affairs. Is VA perfect? No, especially their Compensation and Pension department’s delay and error prone system for veterans trying to make use of the system. But I have found myself far more satisfied with care in their hands than the times I have had to utilize civilian healthcare. The bottom line, 13 years later, is that I am finally nearing my goal of a productive civilian career, a decade and a half to overcome systemic challenges caused by out-of-touch ‘bigwigs’ in Florida’s legislature.