This post is well overdue. I have been swamped with retiring from the Air Force and getting everything set up for school.
What I would like you all to gain from this post is that congressional inquiries can be very successful. However, I firmly believe that they should be reserved until all options locally have been exhausted. Also, during the MEB/PEB process typically no surgeries can be performed unless you get approval from your PCM. I wouldn’t recommend trying to force a surgery that can wait until you get out.
Why I requested a congressional inquiry
The medical group I was assigned to refused to treat my most chronic and limiting condition for nearly a year. All that I wanted was to see a doctor what had experience treating my condition so that I could get direction on care and treatment.
What I achieved
Within three days of contacting my congressional representative he started an official congressional inquiry with the Department of the Air Force. Three weeks later my referral to see this specialist for my medical condition was approved.
A couple of weeks later I traveled down to Texas to see this specialist (paid for by the USAF). She ran many more tests that she believed would be helpful for establishing a successful treatment plan. Two weeks after that I had a telephone consult where she gave me my test results and explained my treatment plan.
It took me nearly a year to achieve this but in the end it was well worth it. I am glad that I was finally evaluated by someone that had experience treating my condition and that I have an actual treatment plan now.
I will continue to have telephone consults with this doctor to receive further direction on treatment, but most of my treatment will be handed through the VA. I have already had my first appointment with my local VA and they are all for following this specialist’s treatment plan.
///////
Below is a redacted copy of the letter I sent to my congressional representative. My year long story had to be heavily summarized, but overall it grasps what happened pretty well.
Senator ****,
I am an active duty service member in the United States Air Force and I am having issues with receiving adequate medical treatment with the ***nd Medical Group at ***** AFB. The Chief of Medical Staff at the ***nd Medical Group has denied me treatment for my service-connected medical condition CFS/ME (Chronic Fatigue Syndrome / Myaglic Encephalomyelitis) since August of 2016. I have pursued every avenue locally to remedy this issue over the last eight months and haven't made any progress thus far. My objective with writing to you is that I hope it will lead to me receiving sufficient treatment for my medical condition while I am still an active duty service member. Below is a brief synopsis of some of the recent events that I have encountered while trying to receive treatment for my medical condition.
I was diagnosed with CFS/ME by my rheumatologist, Dr. *****, on August 29th, 2016. He referred future treatment to Dr. ***** in Houston Texas. The reason for this referral was because he lacked the experience to treat my medical condition and the nearest specialist he could find was Dr. *****. From August of 2016 until present day the ***nd Medical Group has done everything in their power to prevent me from being seen by Dr. ***** or any doctor that has experience with treating CFS/ME.
In September of 2016, when my primary care manager, Dr. *****, attempted to get authorization for this referral to Dr. ***** from the Chief of Medical Staff, Lt. Col. *****, she was informed that the referral would be denied. Lt. Col. ***** expressed that shouldn’t approved of the referral because, "it is out of network and hard to justify."
My first attempt at resolving this issue was with filing a complaint with ***nd Medical Group patient advocacy office on November 23rd, 2016. Mr. ***** was the representative I worked with and he acted as a mediator between Lt. Col. ***** and myself. I wrote a letter to Lt. Col. ***** expressing my concerns with her not approving of the referral to see a doctor that had experience with treating my medical condition. Lt. Col. ***** was later replaced by Maj. ***** who decided to resolve my complaint by sending me to a local rheumatologist that ended up not having experience with treating CFS/ME. I then petitioned the ***nd Medical Group again to allow me to see Dr. ***** and I was told that if I just exhausted all the local resources then I could see her. After my Case Manager, *****, and I contacted hundreds of doctors’ offices throughout Texas, Oklahoma, Kansas, and Arkansas we narrowed the possible list of qualified doctors who treat CFS/ME down to just a few. And from those few only Dr. ***** had a record of no malpractice and she accepted insurance. When my Case Manager sent this information to Maj. ***** he still refused to authorize the referral, because he felt that we still hadn’t exhausted all possible local resources.
My second attempt at resolving this issue was with filing an Inspector General complaint with the ***** AFB IG office on April 26th, 2017. The two representatives I spoke with were Mr. ***** and Lt. Col. *****. After explaining my situation to them I was told that the Air Force had no obligation to medically treat me since they decided to medically retire me. However, they did send my complaint over to Col. *****, the ***nd Medical Group Commander, to see if he would be able to help resolve my situation.
Col. ***** assigned Maj. *****, who is the current Chief of Medical Staff, to resolve this matter. I had a meeting with Maj. ***** on May 4th, 2017 where we discussed what had happened over the last eight months. Maj. ***** expressed that it was in my best interest to continue my medical care through the local VA instead of the ***nd Medical Group, because I am medically retiring in a few months anyhow, and he would rather give me a smooth transition on my care. I told him that I have been suffering for eight months now and have been petitioning the ***nd Medical Group for treatment, and that it wasn't right for me to start this process all over with the VA. I still have nearly three months of active duty service left on my enlistment and that is still plenty of time to be seen by Dr. *****. He then expressed that I didn't know if the VA would start me at square one or not, and that it is worth at least pursuing. Maj. ***** closed the meeting by not agreeing to allow for me to be seen for further treatment through the ***nd Medical Group for my medical condition CFS/ME.
On May 4th, 2017, I attempted to enroll in VA health care at the ******* VA, but I was forwarded to an answering machine due to high call volume. I received a call back on May 8, 2017 and spoke to *****, who is a VA enrollment representative. She informed me that I was not eligible to utilize VA health care while I was still active duty and that I would have to pursue my medical treatment through the ***nd Medical Group until I separate from the service. I expressed to her that was not what the ***nd Medical Group told me, and she replied that the ***nd Medical Group was just trying to pass their lack of medical treatment for me onto the VA.
I firmly believe that the staff of the ***nd Medical Group is acting in an unethical manner by denying me medical treatment for this condition for the last eight months. And now that I am nearing the end of my enlistment they are attempting to pawn off their lack of care onto the VA. I fully understand that after I am out of the service it is up to the VA to provide me with medical treatment for my service-connected disabilities. However, I am still an active duty service member and I should still be entitled to utilize active duty healthcare benefits. The ***nd Medical Group rightfully needs to treat my medical condition but they refuse to do so, and I cannot pursue treatment at the VA until I am retired from active duty on 28 July 2017.
Thank you for taking the time to read this letter and I greatly appreciate any assistance that you can provide into resolving this situation.
***** *****
What I would like you all to gain from this post is that congressional inquiries can be very successful. However, I firmly believe that they should be reserved until all options locally have been exhausted. Also, during the MEB/PEB process typically no surgeries can be performed unless you get approval from your PCM. I wouldn’t recommend trying to force a surgery that can wait until you get out.
Why I requested a congressional inquiry
The medical group I was assigned to refused to treat my most chronic and limiting condition for nearly a year. All that I wanted was to see a doctor what had experience treating my condition so that I could get direction on care and treatment.
What I achieved
Within three days of contacting my congressional representative he started an official congressional inquiry with the Department of the Air Force. Three weeks later my referral to see this specialist for my medical condition was approved.
A couple of weeks later I traveled down to Texas to see this specialist (paid for by the USAF). She ran many more tests that she believed would be helpful for establishing a successful treatment plan. Two weeks after that I had a telephone consult where she gave me my test results and explained my treatment plan.
It took me nearly a year to achieve this but in the end it was well worth it. I am glad that I was finally evaluated by someone that had experience treating my condition and that I have an actual treatment plan now.
I will continue to have telephone consults with this doctor to receive further direction on treatment, but most of my treatment will be handed through the VA. I have already had my first appointment with my local VA and they are all for following this specialist’s treatment plan.
///////
Below is a redacted copy of the letter I sent to my congressional representative. My year long story had to be heavily summarized, but overall it grasps what happened pretty well.
Senator ****,
I am an active duty service member in the United States Air Force and I am having issues with receiving adequate medical treatment with the ***nd Medical Group at ***** AFB. The Chief of Medical Staff at the ***nd Medical Group has denied me treatment for my service-connected medical condition CFS/ME (Chronic Fatigue Syndrome / Myaglic Encephalomyelitis) since August of 2016. I have pursued every avenue locally to remedy this issue over the last eight months and haven't made any progress thus far. My objective with writing to you is that I hope it will lead to me receiving sufficient treatment for my medical condition while I am still an active duty service member. Below is a brief synopsis of some of the recent events that I have encountered while trying to receive treatment for my medical condition.
I was diagnosed with CFS/ME by my rheumatologist, Dr. *****, on August 29th, 2016. He referred future treatment to Dr. ***** in Houston Texas. The reason for this referral was because he lacked the experience to treat my medical condition and the nearest specialist he could find was Dr. *****. From August of 2016 until present day the ***nd Medical Group has done everything in their power to prevent me from being seen by Dr. ***** or any doctor that has experience with treating CFS/ME.
In September of 2016, when my primary care manager, Dr. *****, attempted to get authorization for this referral to Dr. ***** from the Chief of Medical Staff, Lt. Col. *****, she was informed that the referral would be denied. Lt. Col. ***** expressed that shouldn’t approved of the referral because, "it is out of network and hard to justify."
My first attempt at resolving this issue was with filing a complaint with ***nd Medical Group patient advocacy office on November 23rd, 2016. Mr. ***** was the representative I worked with and he acted as a mediator between Lt. Col. ***** and myself. I wrote a letter to Lt. Col. ***** expressing my concerns with her not approving of the referral to see a doctor that had experience with treating my medical condition. Lt. Col. ***** was later replaced by Maj. ***** who decided to resolve my complaint by sending me to a local rheumatologist that ended up not having experience with treating CFS/ME. I then petitioned the ***nd Medical Group again to allow me to see Dr. ***** and I was told that if I just exhausted all the local resources then I could see her. After my Case Manager, *****, and I contacted hundreds of doctors’ offices throughout Texas, Oklahoma, Kansas, and Arkansas we narrowed the possible list of qualified doctors who treat CFS/ME down to just a few. And from those few only Dr. ***** had a record of no malpractice and she accepted insurance. When my Case Manager sent this information to Maj. ***** he still refused to authorize the referral, because he felt that we still hadn’t exhausted all possible local resources.
My second attempt at resolving this issue was with filing an Inspector General complaint with the ***** AFB IG office on April 26th, 2017. The two representatives I spoke with were Mr. ***** and Lt. Col. *****. After explaining my situation to them I was told that the Air Force had no obligation to medically treat me since they decided to medically retire me. However, they did send my complaint over to Col. *****, the ***nd Medical Group Commander, to see if he would be able to help resolve my situation.
Col. ***** assigned Maj. *****, who is the current Chief of Medical Staff, to resolve this matter. I had a meeting with Maj. ***** on May 4th, 2017 where we discussed what had happened over the last eight months. Maj. ***** expressed that it was in my best interest to continue my medical care through the local VA instead of the ***nd Medical Group, because I am medically retiring in a few months anyhow, and he would rather give me a smooth transition on my care. I told him that I have been suffering for eight months now and have been petitioning the ***nd Medical Group for treatment, and that it wasn't right for me to start this process all over with the VA. I still have nearly three months of active duty service left on my enlistment and that is still plenty of time to be seen by Dr. *****. He then expressed that I didn't know if the VA would start me at square one or not, and that it is worth at least pursuing. Maj. ***** closed the meeting by not agreeing to allow for me to be seen for further treatment through the ***nd Medical Group for my medical condition CFS/ME.
On May 4th, 2017, I attempted to enroll in VA health care at the ******* VA, but I was forwarded to an answering machine due to high call volume. I received a call back on May 8, 2017 and spoke to *****, who is a VA enrollment representative. She informed me that I was not eligible to utilize VA health care while I was still active duty and that I would have to pursue my medical treatment through the ***nd Medical Group until I separate from the service. I expressed to her that was not what the ***nd Medical Group told me, and she replied that the ***nd Medical Group was just trying to pass their lack of medical treatment for me onto the VA.
I firmly believe that the staff of the ***nd Medical Group is acting in an unethical manner by denying me medical treatment for this condition for the last eight months. And now that I am nearing the end of my enlistment they are attempting to pawn off their lack of care onto the VA. I fully understand that after I am out of the service it is up to the VA to provide me with medical treatment for my service-connected disabilities. However, I am still an active duty service member and I should still be entitled to utilize active duty healthcare benefits. The ***nd Medical Group rightfully needs to treat my medical condition but they refuse to do so, and I cannot pursue treatment at the VA until I am retired from active duty on 28 July 2017.
Thank you for taking the time to read this letter and I greatly appreciate any assistance that you can provide into resolving this situation.
***** *****
