Fighting the VA ~ Our "other" job ~ Part 2

Other than help my husband navigate the world each day, I have to find out how to take care of our family. I've been handed a husband who can't provide for us and many civilians think that the military or the VA just "takes care of everything" with a POOF! I'm sorry, but it's nobody's job to take care of us. It is not the military's job to care for wounded soldiers' families. There is no division of the military that is assigned to the caring about a soldier's future. The VA is the agency that takes that on, but even then, there are two sections of the VA and they don't communicate with each other. Aside from all the bureaucratic levels of mess that exist, there is also nobody to train anyone on how to navigate through it! Wives or family members of these wounded soldiers have to just figure it out.

The purpose of this post is to give a little overview of what I've figured out.

The VA has two parts: the VBA (Veterans Business Administration) who is in charge of ratings and compensation and the VHA (Veterans Health Administration) who is in charge of treating your illnesses and injuries. When a soldier is hurting and he's sent to the VA, he goes to the VHA, the doctors who will run tests and write things down and prescribe medicines and recommend him to other departments for treatments. They give opinions on how injured a soldier is and try to predict how these injuries will affect the soldier's livelihood and relationships, but none of this will pay the bills. It's the VBA that a soldier needs to contact in order to have his medical records looked at for them to determine the meaning of those predictions. They will decide how disabled from working that soldier is. A soldier cannot just call up the VBA and talk to someone  and bango it's good to go. The soldier has to find a VSO (Veterans Service Officer) to contact the VBA through the process of filing a claim. For each injury a soldier has a claim must be filed. A VSO's job is to know what injuries are claimable based on the book of codes the VBA uses to determine disability. In my husband's case, his injuries are so bad that he could never understand what I've just explained! This is all my job.

Not all VSO's are good ones and all VSO's are very busy with large caseloads. It will behoove you to know what your VSO knows so you can help things along. If you don't, then your family's well-being and your future is left up to a guy who is really busy and might not know very much. You could end up waiting a year or more only to have claims denied because your VSO didn't know what he was doing. I am not that kind of wife, I will not leave my families well-being and our future up to a guy in some office!

There is a book of codes that can be found on the internet called e-CFR (electronic code of federal regulations). Title 38: Pensions, Bonuses, and Veterans' Relief has a Part 4 - Schedule for Rating Disabilities that itemizes the rules the VA uses to determine ratings. In these rules you will see how they define the severity of an injury and how that equates to a percentage.

38 eCFR Part 4

I familiarize myself with these codes so that I can make sure the VHA (i.e. doctors) writes the correct wording for the VBA to recognize easily. The doctors don't know what this book of codes says and so it makes it difficult when the soldier awaiting a decision from the VBA has to hope the VBA sorts through hundreds of pages of medical records and comes to an accurate conclusion and a fair rating. Regarding Dean's TBI, if I didn't know the scale they used to rate it, I wouldn't know what they are looking for and I wouldn't make sure they got brought up. If we don't bring them up then they won't get written down and without them in the medical records, the VBA can't find evidence of it.

Another reason reading these codes is helpful is so that we don't waste time wanting higher ratings for things that don't rate higher or claiming injuries that they don't rate. An example of this is Dean's broken vertebrae. This injury is not a claimable injury. There is no rating for it because it is healed and does not stop Dean from working. So even though it was a service connected injury, that is not how the VA works. Other examples: Tinnitus - no matter how bad it is, they don't rate it higher than 10%; Migraines - no matter how bad they are or if they occur everyday, they don't rate it higher than 50%. These are helpful things to know so you don't waste your energy and time being exasperated over things being the way they are.

There is another link in this process. Once you get a VSO to file the claims for the injuries that have been tested, documented, and treated by the VHA, you will be scheduled for a C&P exam (Compensation & Pension). A C&P exam is when the soldier has to go to an exam by what I like to call the "insurance adjuster" type of doctor. It is this doctor's job to judge how true your claim for injury is and how severe it actually is. It is their job to see if a soldier is faking an injury or embellishing his claim. It's this doctor's job to try and save the VA from having to pay so much. These doctors are often not friendly and they will tell you that they are not there to help you get treatment or give you medicine.

Once a soldier has the C&P exam those documents are put in a big file along with medical records and evidence that must be provided by the soldier (i.e. sworn statements, letters from wives and family members, military documents, etc). Then the VBA can make a determination of rating based on their CFR. A rating equates to a dollar amount and that's how a soldier is compensated for his disability. Of course there are many soldiers that get an unfair rating decision and they have to appeal, but without reading the CFR they won't know what is fair and what's not fair.

I hope this has cleared some things up about what soldiers and sometimes their caregivers have to go through to get VA compensation. Please ask away if you have any questions :)

Fighting the VA ~ Our "other" job ~ Part 1

Caregivers know what we have to do aside from taking care of our husbands, children and homes. But it occurred to me that civilians don't have any understanding of the "fight" we have to endure with the VA or the Army or Social Security or the courts. We have to become knowledgeable in medical codes and laws and rules in order to get our husband's what they deserve!

Our husbands joined the military for their various reasons and were trained to be killers for the United States military. The US military needs killers to keep everyone else safe! Then the President calls up our soldiers and asks them to carry out unthinkable and unspeakable acts which endanger, injure, and forever change our soldiers. In some circumstances a soldier returns home with injuries and in even fewer circumstances these injuries are so severe that they can't work.

If you have read anything else in my blog you know that Dean can't work. His injuries (TBI and PTSD) make it so he can't hold any stable employment. He is actually unable to keep himself safe and alive.

• He doesn't eat unless I tell him and without eating he would likely lose consciousness (since he gets very dizzy and weak when he hasn't eaten) and eventually he would get lethargic and eventually I imagine he'd die. 
• He doesn't take his meds unless I give them to him and without his meds he'd likely be permanently hospitalized as he'd have such severe headaches that he'd probably kill himself to stop the pain and he'd have such nightmares that he'd likely kill himself to stop the craziness and without the anti-depressants he'd likely kill himself because his depression would tell him he doesn't deserve to live. 
• He doesn't shower unless I tell him. Now I don't think not showering would kill him, but it would cause sores and smells that would likely make people stay away from him. Sores could become infected and he could die from an infection since he wouldn't recognize the seriousness of it.
• He can't be in public on most days without anyone there to help him understand others words and actions and without help to respond in a way that wouldn't be threatening. Most days it's like his brain's wires are crossed. He will sit by the window with his eyes and his head hurting while his sunglasses are hanging on his shirt and he won't think to put them on. He'll be laying in bed resting and be shivering cold and won't think to put the blankets on himself. With this kind of disconnect at home, in public it's really confusing for him. When people look at him and he doesn't know what that look means or if someone bumps him and he can't figure out that that was an accident or if someone talks to him but he didn't hear them and they get all defensive...he can't understand these social interactions. In public and around people he tries so hard to be polite and acceptable that when things happen that he feels his ability to control himself slipping away, he has to get out of there. When you add in the fact that in his mind everyone in that store or on the street is a potential terrorist/enemy and he has to spend his brain power trying to assess the danger he gets really exhausted. When he has to talk to someone, say at the post office, he slowly asks a question hoping his words make sense to them and then quickly blurt out their words to answer him, he didn't know what they just said so he asks them to please talk slower. Then they look at him like he's some kind of dummy and they talk down to him. Then he gets angry because they are being disrespectful and he has to get out of there without his question being answered. Now the thought of having to go out and talk to people causes the same anxiety. If he were left to do these kinds of things alone he'd either kill someone once he reached his breaking point, kill himself due to the overwhelming despair he feels, or he'd never leave the house. 

These are just a few examples of how Dean wouldn't be safe if he were left to care for himself. The are also examples that illustrate how he is unable to work. He may, on a good day and with me helping him achieve that good day, be able to "work" for 6 hours or so but he couldn't do that day after day nor could he do this without me helping him have good days, and a person can't live working 24 hours a month.

When a soldier's injuries are interfering with his livelihood he is usually advised to seek help at the VA. When a soldier's injuries are so bad (like Dean's) that he can't get himself to the VA and he certainly can't understand what to do with whatever they tell him, we have to hope that that soldier has someone in their life to help them! That's where I come in. 

Secondary TBI

TBI wives will know what the title of this post means. It's a term we use with each other as our best way to describe what has happened to our poor brains and it's met with a laugh and a nod as other TBI wives know what we're talking about.

Secondary TBI is felt when we get to that point where information, ideas, and 'things to do' start falling out of our brains. It's when we have filled our brains with SO MUCH that anything else leaks out. We don't control what leaks out, when it leaks out, or how much leaks out and we only discover it's missing when we are reminded of what we forgot. At first it happens slowly and we may think "Man, I better get more organized" and we write things down and program our phones. Soon we forget where that sticky note is and forget to enter something into our phone and after that happens over and over we panic "What am I going to do??? How can I stop this?". Following our failed attempts to stop this inevitable process, when we've gotten so used to having to make excuses to everyone we've let down, we come to accept this as our own "new normal". We've progressed to the realization of "Oh crap, whatever! There is nothing I can do about it" and that's when we know we have somehow caught our husband's injury.

I say that all with sarcasm that I hope you can hear because of course, we cannot catch our husband's injury. I'm sure our problem is probably caused by some manifestation of burn-out or just the pure math that one can't possibly be the brains of two people successfully for any length of time. Oh well, such is this life :)

Dangerous driving, not going to happen again

Today was the 2nd day in a row of drill for Dean (the split training drill where he goes and sits in an office building). He was thankfully only there for half a day but because it was the second day he was SO wiped out that the brain wasn't hardly functioning. In the morning, I always try to assess whether he is awake and aware enough to drive before I let him out the door, but now I have a new danger to deal with regarding driving.

Dean passed a driver's test from the VA. I believe he passes because he drove a truck for 25 years and it's part of his long-term memory and that part of your memory that remembers how to ride a bike. I believe he can safely operate a car and he knows the laws/rules of the road, but there is more to think about and today I had that brought to my attention.

He's been choking a lot more often on his food lately so I reminded him this morning (silly me to think he'd remember) not to eat and drive at the same time!!!  He forgot that warning and went through a drive-thru after drill. He said he spilled most of his burger all over himself (which was his biggest concern) but he continued to say "I've been having tunnel vision and problems with my peripheral vision today, every time I tried to look at something other than right in front of me I swerved all over the place". Holy crap!!! I'm feeling really stupid for letting him drive today! I have to remember that he has bad judgement where he thinks he can do things he can't do or he doesn't think something will be a problem that IS a problem. 

What am I going to do? I mean, he does only drive to drill once a month at the most...some months I drive him. Driving to drill is the drive I worry about because it is 47 miles one way (a little over an hour) and that is a LONG time for him to sustain focus on anything. That is the only time during a month that his car gets driven if at all. The rest of his "little drives" are 5 blocks away to the Hardware Store to 6 blocks away to NAPA Auto Parts about once a week or the very periodic 2 mile drive to Safeway maybe 2 or 3 times a month. 

I think I'm just going to have to make it my focus to drive him to drill and just always offer to do it. I think he actually likes when I drive him but he doesn't want to "put me out" because it makes for a very long day for me (I spend 4 1/2 hours in the car between 6 am and 5 pm). This will just have to be one more thing that I "suck it up" and pretend with my best fake smile to really want to drive him! 

I can't wait for him to be out of the Guard!

The morning of drill

Dean had to go to drill this morning as part of his split training (that is where his unit will be doing things this weekend that he can't do yet he still needs to put in his time....so he comes on non-drill days to do other small things they need, like put stickers on folders or separate papers). It still takes a huge toll on him!!!

Last night, go to bed early. This morning: I help him get his uniform on and tie up those boots. I fix him coffee and a nice, warm breakfast (rather than him having his usual cereal), an omelet and the house smells wonderful. He's signing onto ebay to check the status of an auction, then he remembers "Oh ya, I need to eat" so he comes into the kitchen (where I am still cooking) and he gets a bowl and his cereal. I say "I'm cooking you breakfast", he says "Oh! You are??? Great!" and of course I'm thinking 'what do you think I'm doing in here and why the house smells so yummy?' but I just say "Yep". He gives me a hug and says "You're such a good wife"  :)

Then he's eating and trying to find something in his general seated vicinity and that's all it took. He starts choking....and this one was a bad one. I can hear the large chunks of food getting coughed back out of his lungs. Now he gets mad because he can't do what he is trying to do while he eats. As he keeps trying to make himself stop he doesn't stop and he continues to mini-choke on every bite. Now he's super pissed and slams the table and he's all flustered!

He finishes his breakfast and starts to gather things and because he can't think straight anymore he puts things in his own way and trips and almost falls down (walls are great). He asks me to please make him stop because he can't seem to stop with a desperation like he's going to be in trouble. He still has 15 minutes until he has to leave and he doesn't really have anything left to do but while he is wearing that uniform he feels owned and it shows!

I give him the rundown: Do you have your phone? Do you have your GPS? Do you have new batteries in your hearing aids? Then I tell him that I put the pile of things he had gathered to take to drill (he gets bored there and needs reading material, snacks, cigars, etc), which were piled on his passenger seat, into a duffle bag so he could easily carry everything into the building. I walk him out to the car and give him the final prep talk...."If you get flustered, be late and pull over and call me, it's better that you are late than be lost, confused, or dead. They aren't expecting  you at a certain time and a hundred guys will wonder where you are....it's just you"

Now I wait. In an hour he should send me a text saying he got there safely.

Caregiver Retreat

It's been a while since I've written....things have just been all over the place. Some   days we are "in a groove" and it just feels like groundhogs day over and over and what is there to write about on those days?  Then other days it's me crying for silly things or me mad over dumb things....Dean yelling at dumb things or Dean apologizing for our life which breaks my heart!

We had been on a house hunt and found out that we need to put it on hold for a little longer. We are both trying to have faith that God will take care of us and lead us to the home that is meant for us. Dean has trouble with keeping this faith and trusting God. He thinks he's done something wrong to deserve this and that God is punishing him. I have to help keep his spirits up daily.

The other big thing in my life right now is an upcoming Caregiver Retreat in South Carolina put on by Independence Fund (Gary Sinise's organization). I am so beyond excited to go because it sounds like they really made this retreat about pampering us wives!!! At the same time I'm terrified to have something nice! I can't explain that one???  I guess I suffer from a similar "I don't deserve anything good" syndrome that Dean does? Those emotions coupled with such anxiety just preparing for this! I really wish my family was on board. I wish they took a more active part in having compassion for Dean's injuries. Instead I have a paid respite provider coming out to put in 20 hours of work in 3 days time not including nighttime, my step-daughter being paid to come out to pick up the other 2 1/2 days, and my MOMS group saving grace...my babysitter Nicole who will be taking care of Little Dean by taking him to school and feeding him dinner and letting him play at her house so he doesn't exhaust daddy while I'm gone.

All this planning makes a caregiver realize how much she needs a break!!! For a caregiver to go through THIS MUCH just to have a break, it HAS TO be necessary!

I am worried about nighttime. I am the kind of person that has to be prepared for the worst. Let's say daddy puts little Dean to bed and then he snacks on some popcorn which he does every night...but then he chokes. What if he chokes so badly that he needs an ambulance but little Dean is sleeping....then I have to think that the next morning Caroline will be here and will knock at the door and when nobody answers she'll call 911. It's a horrible thought, I admit, but I have to make sure that little Dean is safe! This horrible scenario can really only happen on Thursday night, Sunday night, or Monday night...so there are a couple nights where someone will be here. I have to just realize that I have a cell phone and it's not like I'm going to be out of contact for 5 days. I'm a little upset that upon hearing that I was going on a retreat for 5 days my dad's response was that it's "not a good idea". Rather than asking how he could help, it's just not a good idea??? I think that really feeds my "I don't deserve this" thinking and feeds my doom thinking. Like it something horrible happened it would forever be my fault because I shouldn't have gone. Such a war going on inside me :(

On the flip side, I always tend to worry this much before I do anything happy for myself and then after I'm done it was NOT NEARLY as bad as I thought it would be. So I always get confirmation that it was a good thing for me to have the happy thing.

(I'm listening to a zebra rap about an hexagon....hahaha.)

Well, I'm cried out and need to get things done. I leave in TWO DAYS!!!!

Added another "Topic"

I added a new topic that I will be writing about. I've been thinking a lot about my health lately and am trying some new things and a new way of thinking. I feel compelled to write about it and share :) The link to my other topic is on the right side of the page.