Imagine losing both your legs while serving your country only to be told the Department of Veterans Affairs can't provide you the wheelchair you need. The VA’s not sure when one will become available. So they tell you to stay in bed.
This is the situation many severely injured veterans find themselves in today. Amazingly, it's what the VA's own rules direct the agency to do.
These rules are called standards of care. And they're woefully inadequate for veterans with catastrophic service-related disabilities.
The VA must overhaul the way it cares for veterans and ensure disabled vets get the care they need, whether within the VA or outside it.
The VA's standards of care, drug formularies, and rules for access to medical equipment are designed for the average disabled veteran -- say, a mobile 60-year-old man with a bad back.
There are thousands of veterans who have different needs. Many are young people returning home with missing limbs or traumatic brain injuries. They may have small children -- or be unmarried and living with older parents.
Up to 4,000 veterans of the wars in Afghanistan and Iraq are classified as "catastrophically disabled." That means they've suffered at least one injury that "permanently compromises their ability to carry out the activities of daily living," per the VA's official guidelines.
The VA doesn't take the needs of these veterans into account. An octogenarian triple-amputee undergoing physical therapy faces the same wait times and treatment options as a vet with a bad knee. There's zero flexibility for the catastrophically disabled.
Lack of access to adequate to urgent care is particularly galling.
One vet who lost an arm, a leg, and his ear drums at the hands of an explosive device battles chronic infections. Without ear drums, water easily gets into his inner ear. That fluid incubates infection, which can become life-threatening. But the standard of care and medical appointment triage system directed he wait two weeks before getting treatment, even though his injuries grew worse by the second.
His family lobbied for a shorter wait. But he still had to idle for four days, during which his condition deteriorated.
Catastrophically disabled veterans struggle to obtain the right drugs. VA administrators often reject coverage without explaining why. That could have severe consequences. According to Vietnam Veterans of America's Executive Policy Director Rick Weidman, "Lack of proper medication at the proper time because it wasn't on the formulary can lead to all kinds of health impacts that can cost [more]."
Men and women who have sacrificed their bodies for their country are being repaid with indifference. These standards of care inflict needless suffering.
Fortunately, Congress and the president are beginning to address these problems. President Trump recently signed the VA MISSION Act, which dramatically expands veterans' medical choices.
More remains to be done. Standards of care need to be customized for the catastrophically disabled so they can receive expedited and specific treatment. The VA must also revise its formularies so vets with catastrophic disabilities can access the drugs, devices, and medical equipment they need. Finally, catastrophically disabled veterans need separate access standards for getting non-VA healthcare, so they can go to the doctor of their choosing rather than travelling to see an "approved" provider.
Veterans with catastrophic disabilities have made sacrifices in the service of our nation. Giving them anything but optimal care is not just disrespectful -- it's inhumane.
Bob Carey is a retired U.S. Navy Captain and chief advocacy officer at The Independence Fund. This piece originally ran in the Houston Chronicle.
