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Last month, a decorated Gulf War hero received a letter from the Veterans Affairs Administration that said: We are working on your claim for menstrual disorder.
There was just one problem: The claim was submitted for fibromyalgia.
Make that two problems: The claim was submitted by Glenn McBride, a 40-year-old man from Roanoke, Va., who most definitely does not get menstrual cramps.
It's a bad sign when your health insurance provider can’t figure out which gender reaches for the Midol. (Hint: it's the one without the prostate.)
The Department of Veterans Affairs is notorious for bungling health care benefits, and its Roanoke regional office, which handled McBride's claim, has long been considered among the worst.
In September 2009 a surprise inspection found the office was collapsing under the weight of its own bureaucratic incompetence. Literally.
Its filing system — floor-to-ceiling stacks of overfilled file cabinets and loose claims folders — weighed twice as much as the building's structure allowed, threatening the lives of everyone inside. Inspectors also found missing and improperly filed, stored and processed claims, among other problems. The regional office was ordered to overhaul the health care processing center completely.
By last month, six months later, there should have been some improvement. Instead, McBride received a letter that included this perplexing request for additional information:
"On the VA Form 21-4138, Statement in Support of Claim you sent on October 8, 2009, you included menstrual disorder. Please specify what you intended to claim for this condition."
McBride, whose 14 years of Army service included a combat tour with one of the most highly decorated units during Desert Storm -- and did not include any complaints about menstrual cramps, so far as he can recall -- insists this was not just a clerical error. He says it's one more example of the VA ignoring or messing up claims in order to avoid paying benefits.
"If the VA does not actually recognize the request, they do not have to give the award," he said. "Sort of like a perverted form of 'See no evil, Hear no evil, Speak no evil.' Most people just throw up their hands in frustration and walk away at this point. That is the VA's plan."
The VA, asked to comment about McBride's complaint, issued a statement in which it said:
"The Department of Veterans Affairs' (VA) mission is to be an advocate for Veterans. VA has a responsibility to assist Veterans during the claims process. Part of that duty is to include all possible issues that a Veteran references in his or her initial claim package. VA regrets any confusion that Mr. McBride's claim may have caused. VA Regional Office employees have reached out to Mr. McBride to clarify the confusion, determine the types of issues he wants to claim, and identify any outstanding concerns that he may have."
Jim Strickland, a veterans advocate who writes a regular health care benefits column on VAWatchdog.org and has his own benefits-related Web site, said he wasn't at all surprised to learn of McBride's "menstrual" letter. "There are 57 regional offices and every one is operating in total chaos and in crisis," he said. "Full frontal mass chaos. Every day."
Contacted in the middle of the week, Strickland said he'd already received two e-mails from veterans who were mailed the records of other veterans. And he provided his most ridiculous example of a nonsensical claims letter, one that managed to try to collect debt and to discuss overpaying the same debt -- at the same time.
For Gulf War veterans who fought during a certain time period, certain health conditions are considered presumptive, meaning that such a high percentage of that group has been diagnosed with the condition it's presumed that it was caused by military service, and coverage is automatically granted. Fibromyalgia, a chronic pain condition, is a presumptive one for McBride.
Because of his years of experience dealing with the VA, McBride likes to provide as much information as possible when he submits claim forms. (He also gets a signed and time-stamped receipt upon delivery.) When he sent in his claim for fibromyalgia, he typed clearly at the top of the form: "This form is an official request for SERVICE-CONNECTION for FIBROMYALGIA." He included an extract of a VA "fast letter" regarding presumptive conditions — basically providing the VA with its own policy on Chronic Fatigue Syndrome, Fibromyalgia and Irritable Bowel Syndrome. "Menstrual disorder" is included in the VA's list of symptoms.
"The VA just breezed right through the facts and settled on the obscure," McBride said. "The Roanoke office clearly hasn't changed."
Strickland says the problem at the root of letters like McBride's is a bonus structure paid out to VA claims employees.
"The more work, the better the bonus is," he said. "It's strictly volume, not quality driven. There is no accountability whatsoever.
"The art of the Teflon Jacket has been perfected at our VA. They are really totally invulnerable to your criticism."
When the editor of VAWatchdog.org posted an April Fools Day joke -- "VA DOCTOR TRIES TO GIVE PROSTATE EXAM TO WOMAN VETERAN (April Fool); VA physician: 'Nobody told me the patient was a female. How the hell was I supposed to know that?'" -- McBride sent in his "menstrual" letter.
It was posted on the same site under the heading, "Today's Whiskey Tango Foxtrot? award goes to the VA's Roanoke, Virginia Regional Office."
The site's editor describes the award:
"Every now and then we get a story about the VA that just can't be. But, it is! Because, remember, we're not dealing with regular people ... we're dealing with the VA. That's when we throw up our hands and scream at the sky:
"'Whiskey Tango Foxtrot?'"
Which is longhand for: WTF.