The official blog of American Veteran Magazine, the national quarterly publication of AMVETS.

Thursday, March 26, 2009

CNN reports VA to reimburse Army vet for ciritcal surgery

This afternoon, CNN broke the story of retired Army Sgt. Erik Roberts of Ohio, whose leg was badly wounded in an IED attack in Iraq.

Roberts sought an emergency procedure outside of the VA system to clear an infection in his surgically-repaired leg after doctors in a non-VA emergency room warned him that his leg may need to be amputated, if they did not act quickly.

Though the VA had not approved of the procedure, Roberts decided he couldn't take any chances, and had a private doctor operate. A few days before, Roberts had sought treatment at the VA, but he was told not to worry.

Robert's third-party insurance absorbed most of his $90,000 hospital bill for the operation, but he was left with a $3,000 tab for the subsequent antibiotic regimen.

At first, the VA refused to cover the cost, until CNN broke the story and Ohio Senator Sherrod Brown implored them to pay.

The Roberts incident raises several critical questions about the VA health care process and financial recourse for wounded warriors who need emergency treatment.

According to section 1725 of Title 38, U.S. Code--the body of laws outlining veterans' benefits--the VA can reimburse veterans for out-of-system emergency procedures if a reasonable person would seek such treatment. However, upon receipt of treatment, the veteran is supposed to return to VA system care as soon as possible.

Though the time line seems incomplete, it seems reasonable that Roberts would act as quickly as possible to save his leg--especially if the VA seemed reluctant to take action.

However, once the procedure was complete, should Roberts have followed up with the VA? Why did the VA deny his request for out-of-system care in the first place?

To me, Roberts met all of the criteria to be reimbursed for outside treatment, and I'm happy to see that the VA complied. But how can we streamline the system to ensure that veterans like Roberts receive timely treatment in the future?

Thankfully, the House Committee on Veterans Affairs is working on amending the current law to ensure fewer veterans fall through the cracks when they seek care outside of the VA health system.


1 comment: