The VA Rule That Punishes Veterans for Getting Better? | Document Everything!

"If it’s not documented, it didn’t happen."

In Part 3 of our VA "Interim Final Rule" series, the SCIIF brings in the heavy hitters: Nurse Sabrina (The System Veteran) and Nurse Patricia (The Translator), joined by USAF Lt. Col LaRae Johnson.
The military's "suck it up" culture is the exact reason veterans lose their VA benefits. Today, we are handing you the tactical checklist to build your Civilian Armor before you separate. Stop giving the VA an easy denial letter, learn how to "speak doctor," and discover why your functional limitations matter more than your pain scale.
Do not let paperwork determine your family's financial destiny.

Transcript

SPEAKER_00 0:00

Talking about the VA and the policy that it drew out, and talking about how they were going to possibly change the rating system based on medical treatment and things of that nature. But this time we kind of want to segue a little bit into what the airmen, soldiers, sailors, uh, marines, guardians can do in order to make sure their medical files are good to go, regardless of how the policy is. We want to give you the tools and make sure you have what is applicable to you. A couple of clicks, um, how to phrase your stuff and how to make sure you know what you're doing when you're talking to these medical professionals. These little things, these little steps can set you up for your future. It's not necessarily for you now, it's for you four years from now or 40 years from now, when you all are retiring or separating from the military, you guys will be taken care of because you did all the things that you needed to do in order to make that happen all those years ago. So without further ado, I'm gonna pass this to Laray, who's gonna be talking to the medical professionals out there who can give you guys some tips and some tricks on how to make sure that you can tell your truth truthfully and get what you earned at the end of your military career. So without further ado, Larae, please do the thing that you do uh so well.

SPEAKER_02 1:18

Thanks, hype. Team, we talked about the threat, the rule that the VA tried to pass. They tried to hit us blindsided, but they did not. We've also talked about the outrage, and today, hopefully, we are done being mad about it. And instead, we're fueling that, we're using that energy to get smart about everything medical when it comes to documentation. So I just want to shout out to all our medical professionals out there. We appreciate you for all that you do. And we have two here sitting with us, medical heavy hitters. We have registered nurse Sabrina and Medical Services Core Sabrina. Ladies, our mission for today is simple. We need to give the E1 to the O 10 the tactical checklist on how to bulletproof their medical records. So I want to make sure we start off by saying this to our guy to got our discussion. If it's not written down, it did not happen. That is the only rule that matters. And I'm learning that even 15 years in. It's not about working the system, it is about ensuring the system works for you. Because the day you take off that uniform, the day you decide to separate or retire, they're done. They don't owe you anything. But we want to make sure that all our hard work is not in vain and it's not for nothing. So again, it's about ensuring the system works for you when you can no longer wear the uniform. So let's start with the culture. I know service members who have walked around on a torn meniscus, right? Or a bad back, uh, or even a psionic who I think I'm experiencing right now, uh, for six months because they didn't want to be that guy or girl they called into work on Monday morning, right? Uh can you tell us why it is so dangerous, why this is so dangerous for their future claims?

SPEAKER_03 3:16

So, like you said, Larrae, if it's not documented, then it didn't happen. And that's actually like medical legal doctrine. It's it's gotta be documented. That is a legal document. Your medical record is is legal documentation. So if you don't come in to see me because your knee hurts or your back hurts, or you know, whatever. Um, and we don't get that in your chart, there's no way for us to even talk four years down, 10 years down, 20 years down about how this is impacting your daily life or how this is going to impact you beyond your military service. If it's not written down, it didn't happen. And you can't, we we can't even start to discuss what the long-term impacts are of your military service when you when you leave.

SPEAKER_02 4:03

Right. So it's important for us to have those discussions because I know earlier in another segment we talked about suffering in silence. So what I'm understanding is that suffering in silence is actually expensive for us.

SPEAKER_01 4:17

And Lorray, it's about documentation. So that culture of toughing it out can seriously hurt service members later, especially when it comes to disability claims at the VA.

SPEAKER_02 4:28

Right. Understand that. And you know, we really don't want to be downgraded. Um, and as a messillier, I can see how that happens a lot.

SPEAKER_01 4:38

Yeah. And medical records, as you know, are legal documents. So when someone walks around, say with torn ligaments or a meniscus for six months, they never go to sick call, there's no medical record showing that it happened while they were in service, then that can affect the rating. Getting seen early doesn't make someone appear weak or be weak. It creates the medical record that protects their long-term benefits and their health.

SPEAKER_02 5:04

Absolutely. See, what would y'all say is the number one piece of armor that a newly enlisted airman, newly commissioned officer can build right now.

SPEAKER_03 5:16

I always recommend keeping track of your symptoms, whether that's you know, some kind of app that you use or you're using a notebook, if you have recurring symptoms, it is important not just to write down, on this day I had a headache, but to say, on this day, at this time, this is the activity I was doing, whether you're doing something out on the flight line or you're sitting at a desk and you've been, you know, staring at a screen for four hours, migraine started at this time following this activity. It lasted this long, these were my symptoms. This is what I had to do to get relief, whether that's you know, I had to turn off the lights for an hour and a half, or I had to sit in a quiet room, or you know, I had to take this medication or that medication. It's important to keep track of those symptoms. For using myself as an example, I've got knee issues, and it's just always it's been an ongoing thing for several years, you know, and this time around at a new base, doing new things, keeping track of when when exactly it was that my knee problems started, when did it flare back up? How long are my flares lasting? What do I have to do to get my flare back into um remission for lack of a better word? And how often am I taking medications to control those symptoms so that I can keep running for my PT test, so that I can stay deployment ready? Keeping track of all those things is my my number one recommendation is keep a little tracker and bring that notebook with you to your appointment.

SPEAKER_01 6:47

And so doctors are awfully busy, and most of them do not take the time to get to know the patient personally. Um so after they've seen so many people, you just become another person to them, another number. And so if you do do your due diligence and you know yourself better and you know the issues that you're having, you know those things better than they ever could. So what they're diagnosing you as is what you tell them is wrong with you. And so if you walk in and say, ma'am, I have a log of the last three months of incidents, then people are gonna sit down and listen to you and you make their job easier as medical records professionals, and so your uh record's gonna get updated properly.

SPEAKER_02 7:27

I think that's really helpful, right? Because you're effectively writing your own medical pro profile for them. I I wish I had known that early on. Right now, again, at 15 years, I'm trying to recount all or everything that has happened to me. Um, but knowing that I can keep a journal, I can present that to my um can't think of the word right now, but it's right there. But my medical professional is definitely absolutely, absolutely. Um, and then hopefully have that help me later on when I am trying to file for my disability ratings as well. Okay. Um, so earlier in one of our talks, we mentioned the interim final rule where they wanted to rate you based on how you are on the medical or in the medication that you were originally prescribed. How do we talk to doctors so that doesn't happen to us?

SPEAKER_01 8:24

Well, most people when you ask them how they're doing or what's wrong, they always say I'm okay. That we talked about that, that that's just our military culture. But it's really a reflex and we should stop doing it.

SPEAKER_02 8:35

Why do you say that? Or or or what should we say instead? Because I can even remember like when you when you first sit down, when you go to your appointment and the questionnaire that says, Are you an excellent, very good or good?

SPEAKER_00 8:48

And I'm like, Yeah, yeah, yeah.

SPEAKER_02 8:50

Well, I had two babies, my back hurts. I know I'm not in excellent health, so let me go ahead and slide it on down. But like, what should we say instead?

SPEAKER_01 9:00

Yeah. So you should just be honest, what you just said. So my back hurts, I had two kids, you know, those things. You want to tell them exactly how you're feeling, honest, accurate reporting. If you're on medication, you want to explain how you're actually feeling and what your symptoms were before you came into the hospital or the clinic. Um, make it clear: hey, if I'm taking medicine, is it working? Or is it just managing the symptoms that you have? That way, when the medical record gets updated, it reflects the treatment that's going on with you. And so is it just controlling the condition or has it actually disappeared? You know, those types of things. So you want to just be honest and transparent, but you have to again be with someone that you trust that you can open up and actually have that conversation.

SPEAKER_03 9:45

And it's really important too to describe how you're feeling in terms of functionality. Like, how is this impacting your your daily life, your daily function? You had two babies and now your back hurts, and the little one, like you can't you can't pick her up anymore because your back hurts so bad. The the sciatica right you were talking about. Like that's that's real, and that is better information for a provider to work with than for you to just come in and say, My hip hurts, my back hurts. Um for us to know, oh, it hurts when you do a certain movement. Um, it hurts when, you know, my wrist hurts when I'm doing push-ups, but I can do pull-ups okay. Like that helps us understand where where the pressure is and and what exactly do we need to be addressing because you put it in that context of function. I had a I had a back injury, I don't know, a couple years ago back in Alaska. And the way I described the motion that would like trigger that pain for me to my provider, I told her when I pulled my carton of orange juice out of my fridge, it hurt. And so she knew it was like, okay, when there's then when there's a weight coming down on the shoulders versus, you know, if I have my arms up, if you tell your provider it hurts, you know, I can do my push-ups, I can do my sit-ups, but when I lift things over my head, if it's something that you're doing at work, when I lift things over my head, it really hurts. Or, you know, sometimes I get like this numb pain on one side or like a tingly sensation in my fingers. Like you really have to contextualize how does this impact you in your in your daily life, in your daily function? And that helps us put the picture of okay, what's going on, and how can we start developing a plan that's going to make you as whole as possible, resolve your problem, if we can resolve that problem, or figure out a way to manage it so that you are you are as whole as possible today, tomorrow, and for the next 10, 20, 30 years.

SPEAKER_02 11:36

Absolutely. I see, I think having that thorough explanation is so helpful so that our airmen and beyond know that no, just don't go in with a generalization of what you're feeling, but actual be descriptive and be clear with what we are experiencing. So I definitely appreciate that wisdom. Um, and then if there are like any airmen out there who feel like their provider is not listening to them, is it possible for them to switch providers?

SPEAKER_01 12:06

Well, I've seen people switch providers all the time. So you can always definitely switch them if it's not working out. You know, there's there's always a way around getting a new provider. Yes, ma'am.

SPEAKER_03 12:17

Okay, your patient advocate is somebody to talk to. If you feel like you're not making good headway with your PCM team, look for your patient advocate. Every MTF has a patient advocate. And that's the person that when like the process isn't so simple, they can kind of go behind the scenes and make something happen to help you say change your PCM or something. If the PCM team is saying that that's not an option. Right.

SPEAKER_00 12:39

Yeah, because we I know we all have that experience to where we had a PCM that that kind of just pushed us in and pushed us out and really didn't hear what we were saying, even if we did say the right words. It was just like Patricia said earlier, you just a number at the Y and they just got to get you in and get you out. Well, we understand it. That happening to you ruins the trust in the medical system because you had this experience where you don't want to talk to them anymore about whatever's going on because they're just gonna push me off and they're all the other medical professionals are that way. That is not the truth. We're gonna bust that myth for you right now. That is not the case. That is what Patricia is trying to get at. If you're not vibing with the PCM that you're with, you can go through the tri care system and you can change your PCM and try somebody else that actually listens to you. But you got to make sure you do your due diligence, you do your due care. You you are talking to a medical professional, so make sure you understand what you're trying to say. You can articulate very well what you're trying to say. Pilots have their own language, air crew has their own language, missiles have their own language, security forces have their own language, medical professionals have their own language. If you cannot speak their language, then you are possibly wasting their time and they're just like, oh, just a headache. See you later. Versus, hey, all the things that the tips, the tricks that uh Sabrina and Patricia have given to you, now you're good. And if they don't give you what you're needing, then again, you have patient advocate, you have PCM swap, you have all those cool things that help you. If you are not sure, I'm not sure what I'm saying. Here's what I did. It's a trick. This I love this generation. This generation has so much technology that can answer for you. I'm uh hypothetically, I'm this, and I'm suffering from this, and it's been this and this and this and this. Chat GPT, what do I tell the PCM? What do I tell them? Put it into their language so they understand. And sure enough, it came right out. And I was like, got it. Now I'm speaking my truth, and now I'm aligning to their language, and I'll be damned. If they say, you know what, this is some really serious stuff. Okay, let's figure out what they what we can do. So I just want to let you guys know that there are tools out there so that you make sure that you have the trust between the airmen or the soldier, the sailor, and all that, and the medical professionals, but you got to do your due diligence to make sure you're not wasting their time, and vice versa. I just want to make sure that that's perfectly clear out there. We're not trying to outsmart the system. We are trying to speak their language so you get your truth out truthfully.

SPEAKER_01 14:55

Sometimes, too, in the hospitals or in the clinics, there's politics going on. So it might not even be that you aren't important to them at that moment. They're just their mind is on something else. So there's terrible management. You know what I mean? Like, because I'm a manager. So sometimes they don't like who they have to work for, but they've just given them something to do, and you're that thing. And so then you might just be a casualty of war that day because you're showing up at that time when they're experiencing something, or maybe something happened at home that morning. And so there's a whole plethora of things that could be happening at that moment where your record is in front of that person. So that's why I was just, I just want to reiterate that you are your strongest and biggest advocate. You have to know yourself, your body, your health better than anyone else because all those other things are taking place too, outside of just, you know, you going to get treatment that day.

SPEAKER_02 15:58

Y'all have been so helpful. I am so thankful for all the nuggets of wisdom that you have given us. I just went ahead and put it in a little acronym, if you will. Uh, A D D is what I got. So the A is for advocate, advocate for ourselves. We are the best advocate for ourselves, and how we do that is through the two D's by documentation and being descriptive. But I also want to know is there anything else that you would love our listeners to know what other wisdom or a final order uh to those who are watching?

SPEAKER_03 16:28

I would love if our young airmen, sailors, soldiers, marines, guardians once a year or with some frequency, once a year, go into MHS Genesis and download your records, go through it and make sure that everything is accurate. Because like Patricia was saying, we're all human. We all have things going on, and you just want to make sure that you didn't say something important and it didn't make it into your record, and now 15 years down the line, they're doing the VA review, and who knows where that information is or where it was. It's super easy now with MHS Genesis. You can even send messages. You know, we've had patients do that where they're like, hey, I, you know, I noticed I looked at this note on this day, you know, and we talked about this, but I don't know, you mentioned this medication. I would like some more information on this medication. Or, you know, we talked about treatment option A, treatment option B, you know, and I I tried A, right? And can we talk about trying B? Um, you know, so now there's just more ways to communicate with your provider team and making sure that that communication is well documented in your record.

SPEAKER_01 17:38

Um download it once a year at least. And you already said it, document everything, even the minor things, every little thing, and know what is in your record. So if they have an electronic copy, you should also have a paper copy. And the biggest thing that I would say is to make friends in the hospital or in the clinic because you want somebody that when turnover happens or you know, new people come in and they don't know where your record is or you know something got lost, that you have someone, or you have some type of continuity rather of the information that you've given to them, and as it goes forward, it crosses hands to the next, you know, administration, right? That comes in of your information because it's yours. And when you make those friends and those connections, you have someone you can always call without you even having to go to the clinic or without you having to go to the hospital, or can I IM you on, you know, the chat, or can I send you an email? And we don't talk about networking enough because you know we're so busy doing our job and what we have to do that we don't think like, okay, well, I gotta go talk to this person. But it's always the small people on the totem pole that get overlooked, and those are really the people that we should be paying attention to. They're the ones that are doing the work, they're the ones that are the busy bees, you know, your senior airmen, you know, the ones that are actually really in the weeds, you know, with the records. So make those friends. I can't stress that enough. And find you a battle buddy, a medical battle buddy, a wingman, you know. So if you're too stubborn to go, you hard-headed, you don't want to listen, you have somebody that'll take you, you know, drag you in there. And so we have to look out and take care of each other, you know, especially now, because it's a totally different climate right now.

SPEAKER_00 19:26

Look, I I'll I would attest to what Patricia is trying to say. One of my airmen that actually uh do my check-in and everything else like that was one of my cadets. He actually ended up enlisting and then getting stationed at Nellis. So it was like, shout out to you and uh let to move. And he comes in and is like, all right, what's up, Major Sledge? What's going on? It was just that connection I made. That was a coincidence. But it's about, you know, again, making friends or making those connections, man. Those are the people who make things happen. And if you give them a little bit, you're right, and and you know, care about them a little bit, they give you a little bit too. It pays out uh when it comes, especially like uh medical personnel, security forces. We all talk about that. Take care of those people because those are the people who are literally supporting us as we're doing things like air crew and missile and all that other stuff like that. Uh a shout out to my personal PA, PA Pretty Man. She just had a baby and she's not, she hasn't been out, but I miss her, man. Like, like when I go in there to get you know checked out, man, it's it's a a whole different realm of conversation. And it's because, like like Patricia said, we made that that network connection. So there's that trust. I really appreciate that advice. That is a very true statement. So there it is. You've heard it from the ladies themselves. The blueprint is right there. This is about being the CEO of your own medical history and documentation. Do not let the government, the VA, or anybody else some paperwork determine your family's destiny. If you are just sitting here nodding your head like you listening to TI of 50 Cents beef, that's not enough. We need action. So go in there, log into MHS Genesis or whatever database you use for your medical records, check those out. Download a copy, put it in the drive somewhere. And if you found this valuable, and I know you did, because y'all be liking and sharing and taking our videos, make sure you guys also hit that subscribe button because that tells us what you guys want to hear more. Share this with people within your unit or or your friends or whatever the case may be. Do not let your battle buddies or your airmen or your whatever the case may be fall into a medical documentation trap. So now you have the tools, you have the knowledge. So go execute, stay safe out there, especially those out there doing the thing out there in the Middle East or anybody supporting that, man. My our prayers are out with you guys. We know you're going through something right now. We are with you. All right. I'm gonna be out there eventually. So stay informed and we will be out there soon, please. Hey, that's what I'm saying. And we will catch you guys regardless. If I'm out there, we're gonna still be producing this. The show must go on. So we will catch you guys on the next one. All right, skip out.