Research - Rehabilitation - Re-Employment

Sgt. Shaft 04/21/2008

Dear Sgt. Shaft:
I am a Vietnam-era 60 percent disabled vet. I was an accident victim Oct. 9, 2007, out cold until released from ICU at St. Johns in Springfield, Ill. I was to be shipped to a VA hospital but was OK and released. Now, at the worst time in my life, the VA refuses to pay my emergency room bills that I was promised they would pay. They have destroyed my family and are working on me. My bills are more than $100,000.

They claim they cannot pay because I had state-mandated auto insurance that included a small medical benefit of $10,000, which has been paid. I was drafted in 1972 after I left Purdue University. I declined West Point and was given a top secret security clearance by the FBI. Now they do this to me.

Stephen B.
Springfield, Ill.

Dear Stephen:
In disbelief, I have referred your inquiry to top officials at the Department of Veterans Affairs and unfortunately this is the response I received:

According to the Veterans Millennium Health Care and Benefits Act (38 U.S.C. 1725), VA may only issue payment for the emergency treatment of nonservice-connected conditions if all of the following conditions are met:

• The veteran is enrolled in the VHA health care system;
• The veteran received VA medical care within the preceding 24 months;
• The veteran does not have other health insurance;
• The veteran has no other contractual or legal recourse against a third party that would, in whole or in part, pay for the cost of care.

The statute includes automobile accident reparations insurance in the definition of third-party liability. Thus, in accordance with the statute, VA payment cannot be made. The reason for VA denial for this episode of care is that third-party payment was made, in whole or in part, by the veteran's state-mandated motor vehicle personal injury protection insurance policy.

However, John Bradley, a former staff director of the House Veterans Affairs Committee, who helped draft the legislation in question, says you should file under administrative error, because they sure committed one here. What is missing from this equation is the provisions of equitable relief, as follows:

503 Administrative error; equitable relief

(a) If the Secretary determines that benefits administered by the Department have not been provided by reason of administrative error on the part of the Federal Government or any of its employees, the Secretary may provide such relief on account of such error as the Secretary determines equitable, including the payment of moneys to any person whom the Secretary determines is equitably entitled to such moneys.

(b) If the Secretary determines that a veteran, surviving spouse, child of a veteran, or other person has suffered loss as a consequence of reliance upon a determination by the Department of eligibility or entitlement to benefits, without knowledge that it was erroneously made, the Secretary may provide such relief on account of such error as the Secretary determines is equitable, including the payment of moneys to any person whom the Secretary determines is equitably entitled to such moneys.

Unfortunately, the VA legal beagles have told the secretary that he does not have the authority to grant you and other veterans involved in this Catch-22 situation a waiver.

Shaft Notes
The American Legion recently recognized Rep. Nydia M. Velazquez, New York Democrat, for her efforts on behalf of current and past members of the U.S. military. As chairman of the House Committee on Small Business, she has fought to expand opportunities for veteran entrepreneurs.

There are more than 4 million veteran-owned small firms across the nation, and more than 20 percent of U.S. service members have either purchased or started new businesses. "These men and women — who have already served our country in the military — now provide significant contributions to job growth and local economies. The least we can do is help them succeed in those efforts," Mrs. Velazquez said.

Send letters to Sgt. Shaft, c/o John Fales, P.O. Box 65900, Washington, D.C. 20035-5900; fax to 301-622-3330; call 202-257-5446 or email sgtshaft@bavf.org.

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