Dear Sgt. Shaft: This is a follow-up to a letter I wrote you earlier this year, which stated:
“I am a Vietnam-era 60 percent disabled vet. I was an accident victim Oct. 9, 2007, out cold until released from the intensive care unit 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.
I would now like to give you an update.
With your help, on April 10, I contacted Sen. Daniel K. Akaka of Hawaii and asked for his help. My letter to him stated:
“Dear Sen. Akaka; I pray that you can help me Senator. I am a 60-percent disabled Vietnam era veteran. On Oct. 9, 2007, I was taken to a local hospital because I was near death. The VA hospital was three hours away. The VA was contacted. I have no memory of the hospital stay or accident.
“The Danville, Ill., Veterans Administration has refused to pay my emergency medical care claiming I have medical insurance.
“I have no medical insurance. I have state-mandated liability insurance on my motorcycle which included a very small medical payment. My bills total over $100,000. These bills could destroy my family. I made an attempt years ago and could not buy medical insurance because of my service-connected disabilities.
“I have an appeal in Washington but need your help. If this ruling stands then no Illinois veteran with state-mandated car insurance would be covered for emergency medical care. Has the Danville, Ill., VA misinterpreted the law? Is a private relief bill possible? What can I do?”
The senator responded to my letter and sent copies to my state’s senators asking them if they could help me by working on a private relief bill to pay my medical bills.
Because it appeared that no help was coming from the VA or government, I approached my medical providers and asked them to set up a payment plan to pay the bills on my own so I could avoid court action against me or my family. The result was very positive.
I was treated at two hospitals: St. John’s and Memorial, both in Springfield, Ill. The doctors had already agreed to a payment plan. Memorial cut my bill 25 percent for cash payment, so I went to the bank and was able to pay off Memorial.
St. John’s bill was still at $50,000. so I asked them for a payment plan and offered them a cash payment up front. I gave St. John’s copies of my savings account, checking account and all VA records.
St. John’s would not take any of my money that day but wanted to review my case and said they would contact me about the bill. A week after being in their office, they sent me a letter and said I owe them nothing. St. John’s not only saved my life, but they did it for free to help me. I promised them if I ever got any medical payment from the VA that they, St. John’s, would get their money. They were so kind to me.
My VA appeal is still ongoing, but I have not heard anything in months.
Sincerely, Stephen Brady
As you recall the VA’s previous response in my column was as follows: 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.
I am disappointed that the VA and veterans affairs committees could not get together to resolve this type of Catch-22 situation. I do, however, applaud St. John’s Hospital for their compassion and common sense approach.
I urge the VA and veterans affairs committees to correct the ambiguous language in the Veterans Millennium Health Care and Benefits Act.
• Send letters to Sgt. Shaft, c/o John Fales, P.O. Box 65900, Washington, D.C. 20035-5900; fax 301/622-3330; call 202/257-5446; or e-mail email@example.com.