• Nikki Emord

A Guide to Navigating the VA Health System


When my dad was diagnosed with stage four pancreatic cancer in May 2019, it was easy to blame the VA for not having caught it sooner. My dad had been complaining of various ailments for quite some time and for seven months prior to his diagnosis had been trying to get into the VA to see his primary care physician. In the course of that seven months all my dad received was being yelled at by a doctor that he “didn’t have time for his goddamn questions” and a number of canceled appointments because the doctor was “too busy” to see him. Thus, the ensuing trip to an ER at a local hospital, and a diagnosis that things had spread too far.

You would think that after all that and a stage four cancer diagnosis, the VA would help to ensure my dad received whatever treatment or tests he needed, but for any veteran or veteran family that has dealt with the VA health system, you know that is never the case. Instead you prepare yourself for the immanent battle that will include being met with a brick wall when it comes to trying to get referrals and adequate response times for treatment.

After his stage four cancer diagnosis, the VA provided my dad with nothing but refusals for treatment authorizations, refusals for referrals to specialists, the inability to schedule a doctor appointment within a three-week timeframe, and a number of calls left unreturned.

Between his official diagnosis and the date of his death, my dad had 40 days. That was 40 days of fighting with the VA to demand that someone with authority give a damn about my dad’s health and 40 days of fighting to get the VA to give him a chance to fight for his life. Refusing to give up, and demanding he get the help he deserved, over the course of almost the entire 40 days, I tracked down phone numbers and resources and made call after call from Las Vegas, Nevada to Washington, D.C. to get my dad the help he needed. Unfortunately, while he did get some help and we did eventually have a slew of specialists and doctors doing their best to save his life, our timeframe was too short and the cancer ultimately stole my dad’s life. As I took the lead in getting things done and ensuring that my dad could focus on his own health, I was enraged at the VA health system and all of its shortfalls.

While I believe that no human, veteran or not, should have to have their life prioritized by an organization or system due to protocol, absolutely NO veteran deserves to have their health needs placed as a last priority at any point, especially when they need it the most. That’s why I felt driven to put together this resource. I put this together in hopes that it might help even just one other veteran be able to successfully navigate the bureaucratic bullshit and actually get the care they need before it’s too late. A word of advice when seeking help through the VA, if urgency is essential, do not take no for an answer and continue to leave messages and keep calling your contacts every day, or even every hour, until you get what you need.

While this guide is mainly relevant to those dealing with the Las Vegas, Nevada VA system, knowing what to ask for and where to look may help veterans in other states as well.


VA Hospital Direct Line (Las Vegas): 702-791-9000

Calling this number takes you to the general line for the hospital where you can be redirected to departments you request. Be sure to know which department it is you are looking for prior to calling, as it can often be hit or miss with the helpfulness of the call operators. As you get transferred from one department to the other be sure to write down names, departments and any direct call back numbers or extensions to help ease your outreach for future needs.

If you are unsure of exactly where you need to be transferred to, or you have found yourself being led to a dead end, when speaking with or visiting the VA hospital ask to be transferred to, or seek out, the Customer Service Manager at the VA. This person can generally expedite processes quicker than general advocates to help get you to the right department.

VA Patient Advocate Direct Line (Las Vegas): 702-791-9000 Ext. 15436

Patient advocates are your first stop. They can hear your issues or needs and depending on the urgency of the veteran’s situation can help get the ball rolling, they can also help reach out the VA medical director or refer you to someone who can get you what you need, however, this can be a timely process. Depending on urgency, I also recommend visiting the VA hospital with the veteran present to meet with an advocate in person.

VA Director’s Office (Southern Nevada): 702-791-9010

Officially referred to as the Director of VA Southern Nevada Healthcare System (VASNHS), this is just above the VA Advocate’s Office, and they can help do the same thing advocates do, but may be able to expedite things a little more if needed. This page, is typically updated with the active directors for the VA and depending on the severity of the veteran’s needs, you can reach out to any and all of the directors until one gets back to you with what you need.

You can view the Las Vegas directors online, here: https://www.lasvegas.va.gov/about/leadership.asp

Inspector General’s Office (National): 1-800-488-8244

In cases of emergency or when a veteran’s life and well-being is at stake, beyond the VA Director’s office is the Inspector General’s Office. Be sure to use this resource if you can’t get what you need in a timely manner or if the veteran is not getting any help through an advocate or the director’s office. Leave a detailed message with the issue and you’ll receive a call back and a case will be filed with a reference number that will help expedite your request or needs.

https://www.va.gov/oig/

Their phone hours are [Monday–Wednesday and Friday between 9:00 a.m. to 4:00 p.m. (Eastern Time) or Thursday 9:00 a.m. to 1:00 p.m. (Eastern Time]

White House VA Hotline (National): 1-855-948-2311

All calls made to this line are answered by a live agent 24 hours a day, seven days a week, 365 days a year. This is a great resource to use when filing a complaint or request for urgent assistance. When doing so, a case number is created for you and a representative can sometimes provide you with additional resources or contacts to help you get what you need.

You can learn more about the White House VA Hotline online, here: https://www.va.gov/ve/whvahotline.asp

Nevada Department of Veteran Services:

Another resource for veterans is a separate veteran resource office within the central VA hospital and is specific to each state. While they must run most paperwork through the federal VA pipeline, sometimes they can help track down a lost form, request information on the veterans’ behalf, or know of a work-around to get what is needed.

Nevada: (775) 688-1653 https://veterans.nv.gov

You can find your state’s veteran department, here: https://www.va.gov/statedva.htm

TriWest Direct Line: 1-866-606-8198

Most VA Hospitals and healthcare options deal with a third-party company that deals with referrals to specialists and doctors outside of the VA Hospital system. In Las Vegas, that third party (at the moment) is TriWest. When helping a veteran navigate the VA healthcare system, it is essential that you are aware of what third party referral group is in play and to know of key forms.

TriWest Forms:

If you are helping a veteran with their health and medical journey, it is essential to complete and submit a written authorization form from the veteran for future use. An Authorization form should be signed by the veteran and the next of kin or caretaker, and submitted to TriWest, or whatever third-party group is involved, so that the group is authorized to discuss the veterans’ health needs without the need of the veteran to give verbal authorization over the phone each time a call is made.

To find the authorization form for TriWest;

Visit triwest.com. Scroll to the bottom of the page, and under the header “Veteran Services” Click the link labeled “Community Care Program Forms.” The first link is the “Release of Information Authorization to Disclose."

Click below to view the TriWest Authorization to Disclose form:

http://triwest.com/globalassets/documents/veteran-services/authorization_to_disclose.pdf

Another key form to be aware of is a Secondary Authorization Request (SAR) form which is required for all tests and specialists outside of the VA hospital beyond the initial pre-approved doctor. A new SAR will be required for each new test and each new doctor referral beyond the original referral. This form can typically be filled out and submitted by the current or requesting doctor, however it can also be found on the provider’s website. To expedite these forms with the VA, request that the doctor filing the form submit the request as urgent.

Here is the “Secondary Authorization Request (SAR)” form for TriWest: http://www.triwest.com/en/vapc3-provider/Find-a-Form/Secondary-Auth-Request.pdf

For Urgency and Wrongdoings:


State Senator’s Office:

Your representatives and elected officials are in office to serve you, be sure to use them as a resource if the urgency and authority is needed. They can help push cases through to the VA for extra support and can let the VA know that they have been made aware of what is taking place, if errors or malpractice is occurring.

You can find the contact information for your state senators here: http://www.senate.gov/states/statesmap.htm

There’s no doubt that like all practices, some bad seeds can get into medical positions that impact and can negatively encumber a veterans’ health. For severe issues dealing with specific doctors, and depending on the severity of the case, you can choose to file a complaint with your State Board of Medical Examiners via phone or you can file a written complaint online.

To find your state’s medical board, click here: https://www.fsmb.org/contact-a-state-medical-board/

Nevada State Board of Medical Examiners: 1-888-890-8210 or 775-688-2559

or you can file a complaint online at www.medboard.nv.gov

You can also choose to file a complaint with the Chief of Clinicians, Chief Clinical Officer, Medical Director and/or Chief of Staff within the VA as well.

You can view the leadership roles of the Las Vegas VA system, here: https://www.lasvegas.va.gov/about/leadership.asp

Additional Resources:


Non-VA Care Coordination Department (Las Vegas): 702-791-9066

This office can help with coordinating services and payments for veterans receiving medical care outside of the VA health system.

Veteran’s Crisis Line (National): 1-800-273-8255 (press 1) or text 838255

This is a situational resource for veterans who are specifically in a crisis or who are having thoughts of suicide. Do not hesitate to call if you feel you need urgent help.

VA Benefits Assistance (National): 1-800-827-1000

https://www.ebenefits.va.gov/ebenefits/contact

Here you can find the basic breakdowns and resources pertaining to VA disability and benefit options.

DAV (Las Vegas): 702-224-6850

This is a nonprofit that has an office within the Las Vegas VA hospital and helps provide veterans with additional aid in navigating the VA system.

Veteran’s Choice Program:

Effective June 2019, the VA will no longer offer community care to veterans under the Veterans Choice Program (VCP).

If there is serious wrongdoings or life-threatening errors being made that you are fighting against, you can also reach out to your local news media. You’d be shocked by the number of wrongdoing stories they have that are ongoing and known about.

** It should be noted that the programs and procedures within the VA system change rather regularly, so if you come across a new contact or procedure that you feel is essential for helping veterans receive proper healthcare, please contact me or leave a comment with the updated information.

© 2019 by Nikki Villoria Emord

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