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All Vets Are Off

Some vets say the Veterans Administration's medical cost-cutting measures are unhealthy.

Monty Dalrymple was feeling dizzy and had just lain down in his motel room when the pain hit. It is nearly impossible to explain that kind of pain to someone who has never had a heart attack. "It's almost like Arnold Schwarzenegger takes your chest and twists it like a washcloth," he says.

It was 3 a.m. on March 2, 1997. Earlier, Dalrymple, a 46-year-old disabled veteran with a history of heart trouble, had finished a $100-a-night gig playing drums with a country-Western band at a Leadville bar. "I couldn't get off the bed," he says. "I couldn't even crawl to my pants where I had my heart-attack pills." A buddy drove him to the closest emergency room, where doctors told him he was in big trouble. They wanted to fly him by helicopter to Denver.

Dalrymple told them that he was a veteran and needed to go to the Veterans Administration Medical Center in Denver. Under federal guidelines, a veteran who can prove financial need or who has a medical problem connected to his time in the service can receive free medical care if he seeks treatment at a VA facility. Some veterans can also be treated at private or non-VA hospitals and have the bill paid for by the VA if they meet three criteria: The condition must be "service-connected," the medical problem must be life-threatening, and there must be no VA facility readily accessible. There are 148 VA hospitals spread across the country; in Colorado, there is one in Denver, one near Las Animas and one in Grand Junction.

The Leadville medical staff told Dalrymple that the VA hospital in Denver was not equipped to handle helicopter landings and that he would go to Centura St. Anthony Central Hospital instead.

"Of course I said okay. What am I going to say? I was dying," Dalrymple recalls.

At dawn the helicopter touched down on St. Anthony's roof, and staffers rushed Dalrymple to the intensive-care unit, where he was treated and his condition was stabilized. It was Sunday, and Dalrymple would have to wait until Monday before a cardiologist could see him. Finally, on Tuesday, when doctors determined that he was stable enough to be moved, he was transferred by ambulance to the VA hospital. He stayed there for three more days and was released on March 7.

Three months later, Dalrymple got notice from the VA that his claim for treatment at St. Anthony's--he estimates it to total about $30,000, including the helicopter transfer, doctor bills and hospital stay--had been denied because he had failed to go to a "feasibly available" VA facility.

Dalrymple was sure it was a mistake. He had told the staff at St. Anthony's that he needed to be at the VA, and they had told him he should not be moved. Certainly the VA could understand that. "What was I supposed to do? I'm wired up and doped up. Am I supposed to get out of bed and call a taxi?"

Dalrymple went to the claims department at the VA to complain, and administrators told him he could appeal the decision to the Board of Veterans' Appeal in Washington. That board is the highest authority within the VA system for a veteran to appeal a denied benefit. But the Denver VA also warned Dalrymple that it could take up to five years for his case to be reviewed. In July 1997 he began the appeal process.

A few weeks ago--nearly two years after he appealed--Dalrymple checked with the VA and found out that his case was stalled. Officials told him it could take at least another year to be resolved.

While Dalrymple has been waiting, he has been bombarded by medical bills from St. Anthony's. He says he has tried to explain that he is in an ongoing dispute with the VA, but the collection agency hired by St. Anthony's has little sympathy. In June, a bill collector demanded more than $12,000 for a portion of his hospital stay, told him the hospital was "ready to go to court" and threatened to put a lien again his mobile home and eighty acres of land in rural Yoder.

Dalrymple, who left the service in 1993 after ten years, has been designated by the VA as 70 percent disabled and "100 percent unemployable" because of his medical problems. Over the years he's tried to stretch his disability payments by working at convenience stores and playing drums, but as a single father of two sons, he is barely making ends meet.

Michael Swan, chief of health administration at Denver's VA Medical Center, says he's sympathetic--but a review of Dalrymple's case showed the denial was appropriate. The VA paid for Dalrymple's care in Leadville, but not the helicopter transfer or any of the costs at St. Anthony's, because he should have gone directly to the VA hospital despite his critical condition.

"We transfer patients all the time with tubes in them," Swan says. Often, he adds, a patient misunderstands his situation, thinking he's in more critical condition than he really is. That is why the VA's staff does a medical and administrative review of each claim. "The seriousness in their mind versus the evidence medically are two different things."

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