Filling out long and confusing forms isn’t a process that endears most people to government agencies—and it’s for a good reason. Forms and applications usually require information not readily available, or it might be difficult to know exactly what to put down, in fear of a possible rejection due to a mistake. That’s why VA has developed a chat system to help Veterans who are filing an application for health benefits—also known as the VA Form 10-10EZ. As you fill in the information online, a button at the top right of the page opens a chat box. There, a trained representative will answer questions and concerns about the application process.
If you haven’t yet applied for health benefits, give it a shot and let us know how the process went.
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VA Directive on State Marijuana Programs
Department of Veterans Affairs
Veterans Health Administration
Washington DC 20420
VHA DIRECTIVE 2011-004
January 31, 2011
ACCESS TO CLINICAL PROGRAMS FOR VETERANS
PARTICIPATING IN STATE-APPROVED MARIJUANA PROGRAMS
1. PURPOSE: The Veterans Health Administration (VHA) Directive provides policy regarding access to clinical programs for patients participating in a State-approved marijuana program.
2. BACKGROUND
a. Department of Veterans Affairs (VA) providers must comply with all Federal laws, including the Controlled Substances Act. Marijuana is classified as a Schedule I drug under the Controlled Substances Act.
b. Veterans who recieve their care from VA and who have a desire to participate in one of several State marijuana programs might ask their VA physicians to complete State authorization forms.
c. State laws authorizing the use of Schedule I drugs, such as marijuana, even when characterized as medicine, are contrary to Federal law. The Controlled Substances Act (Title 21 United States Code (U.S.C.) 801 et al.) designates Schedule I drugs as having no currently-accepted medical use and there are criminal penalties associated with production, distribution, and possession of these drugs. State law has no standing on Federal properties.
d. VHA policy does not administratively prohibit Veterans who participate in State marijuana programs from also participating in VHA substance abuse programs, pain control programs, or other clinical programs where the use of marijuana may be considered inconsistent with treatment goals. While patients participating in State marijuana programs must not be denied VHA services, the decisions to modify treatment plans in those situations need to be made by individual providers in partnership with their patients. VHA endorses a step-care model for the treatment of patients with chronic pain: any prescription(s) for chronic pain needs to be managed under the auspices of such programs described in current VHA policy regarding Pain Management.
3. POLICY: It is VHA policy to prohibit VA providers from completeting forms seeking recommendations or opinions regarding a Veteran’s participation in a State marijuana program.
4. ACTION
a. Deputy Under Secretary for Health for Operations and Management (10N). The Deputy Under Secretary for Health for Operations and Management is responsible for ensuring that medical facilityy Directors are aware of the prohibition of completing forms for participation in State marijuana programs.
b. Chief Officer Patient Care Services. The Chief Officer Patient Care Services is responsible for providing clinical guidance to VA providers regarding factors to be considered when determining how substance abuse, pain control, or other treatment plans could be impacted by a Veteran’s participation in State marijuana programs.
c. Medical Facility Director. Each medical facility Director is responsible for ensuring facility clinical staff are aware:
(1) Of the prohibition of completing forms for participation in State marijuana programs.
(2) If a Veteran presents an authorization for marijuana to a VA provider or pharmacist, VA will not provide marijuana nor will it pay for it to be provided by a non-VA entity. NOTE: Possession of marijuana, even for authorized medical reasons, by Veterans while on VA property is in violation of VA regulation 1.218(a)(7) and places them at risk for prosecution under the Controlled Substances Act.
(3) That if a patient reports participation in a State marijuana program to a member of the clinical staff, that informatin is entered into the “non-VA medication section” of the patient’s electronic medical record following established medical facility procedures for recording non-VA medication use.
5. REFERENCES
a. Office of General Counsel (OCG) Opinion on State Medical Marijuana Registration Forms – VAOPGCADV 9-2008.
b. Title 21 U.S.C. 801 et al, the Controlled Substances Act.
6. FOLLOW-UP RESPONSIBILITY: Pharmacy Benefits Management Services (119) is responsible for the content of this Directive. Questions may be directed to (202) 461-7326.
7. RESCISSIONS : VHA Directive 2010-035 is rescinded. This VHA Directive expires January 31, 2016
Robert A. Petzel M.D.
Under Secretary of Health
DISTRIBUTION: Emailed to the VHA Publication Distribution List 2/4/2011
THIS VHA DIRECTIVE EXPIRES JANUARY 31, 2016
VA Directive on State Marijuana Programs
http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2362
A few years ago I submitted a health related claim to the VA based on my participation as a subject in the Edgewood Arsensal (MD) experiments (google the term for more information).
This is where the USArmy exposed approximately 7700 service members over several decades to biological/chemical/Nuclear agents and/or antidotes.
The US Senator (spear headed by Senator Kennedy) put a stop to the program in 1975.
Anyway, my response from the VA were as follows:
1. The experiments never took place. I did not know what I was talking about. Then the Department of Defense declassified the program.
2. Well, the experiments did occur, but YOU were not involved. So I did a Freedom of Information Act (FOIA) request and got my 57 page thick file showing I was subjected to at least 3 experiments (some information was redacted).
3. The VA acknowledged that yes the experiments occurred and I was one of the test subjects exposed to various nerve agents, but there is no known connection to my medical issues and the experiments.
4. The VA did conduct a half day physical consisting of blood work, an EKG, and an 10 minute interview (that was in August 2008).
Now about every 3 months I get the same form letter that the VA is requesting my service file from my service and that I should not contact my service as the VA is requesting the information.
So yesterday I called the VA. After a 23 minute wait, I finally got a person. I gave my file number and asked what the VA needed (since I had sent copies of everything in)? The telephone answer did not have a clue what the VA needed. He said he could “close the file” if I wanted!
So it seems that the VA is doing the waiting game – waiting for the alleged remaining 50% of the subjects to die off before they make a decision.
And I am supposed to be impressed with the VA?
Alex-
I have recently had a fellow veteran apply for benefits online and it seems to have gone smoothly. What it the general length of turnaround for applications?
As the service officer for a local Legion Post, he asked for help. I guessed that he could potentially be a P-5. I am not really sure how the prioritizing works. Is spousal income part of the equation? Assets? Would it have been better for him to wait until he had been on medicaid/Disability to increase his chances?
And, lastly, how do veterans get downgraded in the priority rating? I have a WW2 vet in my post with this problem and it seems he is paying ungodly amounts for RX meds.
Thanks!
I would like to know what the VA’s stance is on Medical Marijuana. Recent Medical Studies from numerous sources including Harvard show that marijuana inhibits cancer tumor growth or stops it completely in Brain, Lung, Breast and Skin Cancer and seems to regenerate Brain Cells and cause Brain Cell growth. The “Wonder Drug” everyone has been looking for seems to have been right under our noses, so to speak, all along.
Are local VA clinics required to follow Federal Drug Laws or can they follow State Laws on prescribing Marijuana? It is my understanding after questioning several local VA medical personnel that they are required to follow the Federal Laws.
What is the official VA stance on the use of Marijuana and do you expect it to change in the light of recently confirmed Cancer inhibiting properties of Delta 9 THC, the active ingredient in Marijuana?
Bill, please refer to VHA Directive 2011-004. It clearly states that it will “administratively” not prohibit its use. However, my local VA, located in Ann Arbor, Michigan, is actively prohibiting its use. I know what Webster has to say regarding the definition of the word “administratively,” but the VA has a different definition from what I have seen so far. Several medical personnel have stated that the VA has relaxed it stance regarding it, but others state that it has not. I’m also curious what the VA means by “administratively.” I will quote the passage in question which is located under Section 2: Background, paragraph d: “d. VHA policy does not administratively prohibit Veterans who participate in State marijuana programs from also participating in VHA substance abuse programs, pain control programs, or other clinical programs where the use of marijuana may be considered inconsistent with treatment goals. While patients participating in State marijuana programs must not be denied VHA services, the decisions to modify treatment plans in those situations need to be made by individual providers in partnership with their patients. VHA endorses a step-care model for the treatment of patients with chronic pain: any prescription(s) for chronic pain needs be managed under the auspices of such programs described in current VHA policy regarding Pain Management.
VA Directive on State Marijuana Programs
Department of Veterans Affairs
Veterans Health Administration
Washington DC 20420
VHA DIRECTIVE 2011-004
January 31, 2011
ACCESS TO CLINICAL PROGRAMS FOR VETERANS
PARTICIPATING IN STATE-APPROVED MARIJUANA PROGRAMS
1. PURPOSE: The Veterans Health Administration (VHA) Directive provides policy regarding access to clinical programs for patients participating in a State-approved marijuana program.
2. BACKGROUND
a. Department of Veterans Affairs (VA) providers must comply with all Federal laws, including the Controlled Substances Act. Marijuana is classified as a Schedule I drug under the Controlled Substances Act.
b. Veterans who recieve their care from VA and who have a desire to participate in one of several State marijuana programs might ask their VA physicians to complete State authorization forms.
c. State laws authorizing the use of Schedule I drugs, such as marijuana, even when characterized as medicine, are contrary to Federal law. The Controlled Substances Act (Title 21 United States Code (U.S.C.) 801 et al.) designates Schedule I drugs as having no currently-accepted medical use and there are criminal penalties associated with production, distribution, and possession of these drugs. State law has no standing on Federal properties.
d. VHA policy does not administratively prohibit Veterans who participate in State marijuana programs from also participating in VHA substance abuse programs, pain control programs, or other clinical programs where the use of marijuana may be considered inconsistent with treatment goals. While patients participating in State marijuana programs must not be denied VHA services, the decisions to modify treatment plans in those situations need to be made by individual providers in partnership with their patients. VHA endorses a step-care model for the treatment of patients with chronic pain: any prescription(s) for chronic pain needs to be managed under the auspices of such programs described in current VHA policy regarding Pain Management.
3. POLICY: It is VHA policy to prohibit VA providers from completeting forms seeking recommendations or opinions regarding a Veteran’s participation in a State marijuana program.
4. ACTION
a. Deputy Under Secretary for Health for Operations and Management (10N). The Deputy Under Secretary for Health for Operations and Management is responsible for ensuring that medical facilityy Directors are aware of the prohibition of completing forms for participation in State marijuana programs.
b. Chief Officer Patient Care Services. The Chief Officer Patient Care Services is responsible for providing clinical guidance to VA providers regarding factors to be considered when determining how substance abuse, pain control, or other treatment plans could be impacted by a Veteran’s participation in State marijuana programs.
c. Medical Facility Director. Each medical facility Director is responsible for ensuring facility clinical staff are aware:
(1) Of the prohibition of completing forms for participation in State marijuana programs.
(2) If a Veteran presents an authorization for marijuana to a VA provider or pharmacist, VA will not provide marijuana nor will it pay for it to be provided by a non-VA entity. NOTE: Possession of marijuana, even for authorized medical reasons, by Veterans while on VA property is in violation of VA regulation 1.218(a)(7) and places them at risk for prosecution under the Controlled Substances Act.
(3) That if a patient reports participation in a State marijuana program to a member of the clinical staff, that informatin is entered into the “non-VA medication section” of the patient’s electronic medical record following established medical facility procedures for recording non-VA medication use.
5. REFERENCES
a. Office of General Counsel (OCG) Opinion on State Medical Marijuana Registration Forms – VAOPGCADV 9-2008.
b. Title 21 U.S.C. 801 et al, the Controlled Substances Act.
6. FOLLOW-UP RESPONSIBILITY: Pharmacy Benefits Management Services (119) is responsible for the content of this Directive. Questions may be directed to (202) 461-7326.
7. RESCISSIONS : VHA Directive 2010-035 is rescinded. This VHA Directive expires January 31, 2016
Robert A. Petzel M.D.
Under Secretary of Health
DISTRIBUTION: Emailed to the VHA Publication Distribution List 2/4/2011
THIS VHA DIRECTIVE EXPIRES JANUARY 31, 2016
VA Directive on State Marijuana Programs
http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2362
As a veterans advocate, for those that are computer literate, this would be of great benefit. What concerns us is that when the VAMC pushes for enrollment to increase their operational budgets, but lack the doctors and nurses to adequately care for those enrolled. VAMC Dayton has been known to advise our veterans “unless you are 50% or greater service connected, we cannot assign a Primary Care Physician, you will use Urgent Care until further notice.”
Then we utilize other departments within the VAMC, such as Mental Health, to send out a referral to ensure the veteran receives a Primary Care Physcian as necessary. This affects numerous veterans that may be in the adjudication process but do not have a rating, that are in dire need of services.
Hopefully the manning levels will come up in the future and those needing the proper care receive it.
Would someone explain why this is needed? It seems to me that a Veteran needing medical care should just go to his local VA hospital, apply and then get treatment in one step. Period. Is the VA health care planning on a million man HEALTH CARE TREATMENT backlog, similar to the one with VA benefits? I cant think of another reason why it would be necessary to apply for health care treatment “in advance” so that the VA may take their time processing the health care treatment application, like they now do with VA benefits. It is pretty scary knowing the VA wants us to “apply” for health care benefits, when it would seem like health care should be included in a “Bill of Rights for Veterans”.
Rosey, Veterans have been able to apply for health benefits online for awhile now, this just adds a live chat feature in case they need to ask question or need help. It’d be just like filling it in at a medical center, but from the convienience of home. Doing it online makes it easy for a lot of people who find it difficult to go down to a medical center just to fill out paperwork (be it a job, a medical condition, kids, etc).
And I’m not entirely certain what you think should happen. DoD and VA don’t share one big database for a number of reasons. So when you leave the military, the only way VA accepts you into the system is by registering. And this is a way many people do that.
Alex
Often the Veterans who need health care the most are the ones least likely to have a computer to apply online. You still did not answer the two questions: First, why cant Vets simply go to their VA and get health care applications approved immediately? And second, is this an omen , where we can expect long delays in healthcare applications, like we now have with Veterans disability compensation applications? If the VA takes as long to process healthcare benefit applications as they now do to process disability compensation applications, then surely many of those Veterans seeking health care will no longer need it because by the time it is approved they will already be dead. I simply cant imagine waiting 6 months to apply for health care, only to have to appeal it and then wait sometimes 5 or more years to go through appeals.
It’s not cause and effect Rosey. I really doubt VA anticipates a rush of applicants so big that the only way it can handle it is through online processing. The ability to walk into a VA Medical Center and process through the eligibility office remains, and I think it’s safe to say it always will. This just makes it easier on the part of Veterans who choose to sign up online. Comparing a health application to a disability claim is apples to oranges. Different rules and different laws apply, as does the whole process of deciding the action.
Alex,
When is the Under Secretary of the VA Health Benefits Administration going to show up on the Blog site like Under Secretary for Disability Assistance, Mr. Pamperin? If you don’t know; please refer my question to the General?
Also, did you find anything About the Senate and House Veteran’s/family member Caucus submitting a guest post? You said you would get back with me over a week or so ago.
What are the plans for the VPBlog to have “other blogs”?
Are there any plans to “tweak” the VPBlog format?
It would be nice to have a specific place on the blog to speak out about concerns, suggestions, and as well be able to track the responses, etc.
For instance, I have to search around to see what you have posted last to see if you will answer my “unrelated” post? If you don’t understand, email me or call me.
Thanks for doing what you do and for your positive attitude; it is difficult at best at times for those of us who are using the dysfunctional systems in the VA frequently.
For All Veterans and Family Members, I would like the Secretary to explain:
Why the VAMC Directors do not have an “open door policy”?
Why they don’t have an email address that these complaints, etc. can be sent to them?
Why all VAMC’s do not have an Advocacy Committee made up of Veterans and Family members that meet on a frequent basis with with the VAMC Director with concerns, complaints, suggestions from the Veterans and family members they are supposed to be serving?
Why is there not a Ombudsman at the Secretary’s level to deal with the concerns of Veterans/family members?
Why is it that the Recovery Coordinator Programs which should be at all VAMC’s (and are not) are only highly suggested instead of mandatory?
(I’m trying to get assistance for my husband with a VAMC who does not have a RCP with its accompanying WRAP Program and peer support group) (Most of these RC positions have been up and going for over two years and some are not sharing what they are supposed to be doing and their 3 or 5 year plan at the local VAMC. (that’s not transparency)
I’ve been waiting several days for a person from the West Palm VAMC who is over the CBOCs to call me as well as a PA from a VAMC. In my endeavor, I have two kudo’s–Ms. Johnson in the HBA office and the Lead in the Eye Clinic.
I am being told that there is no program that can help my husband with his cognitive and memory problems in the VA system; apparently, I can only get help from the VA with this when/if he gets to a nursing home stage or needs daycare!(from the Outside Community)
I have been referred to two Community resources by a CBOC SW: one which was inappropriate as they had NO services for this level; as well as another who did not have anything as well!!
As well as there not being any programs for Veterans; tere are no support programs, seminars, retreats, etc. for spouses that are dealing with “caretaking” issues of these Service Connected disorders.
I have a Masters in Rehab Counseling and I know there are programs that can be set up for Vets and their family members that are experiencing these issues.
VA’s own research states that more likely than not the PTSD Vets will experience issues of memory/cognitive (dementias) including Alzheimers (still haven’t heard the VA speak the truth about how the toxins of A/O also affects the brain (which acts like a closed head trauma);
I’m talking to VAMC docs and Social Workers that don’t even know this information–VA’s own research!!
Are you aware that there are A LOT of Vet Centers that don’t have support/therapy groups for Spouses? NOT a new issue!
To whom do I speak to get this help? I’m posting this at AUS Duckworth posts to see what she will suggest.
Why is there not an email that “customers” can send their complaints, and suggestions, etc. to the Director of each VAMCs?
(as well an email to CC the Under Secretary of the HBA/and/or the Secretary)
I don’t think “upper management at the VA (Secretary and his Under Secretary are aware of just how much dysfunction, ineffectiveness, and/or lack of competent services are in the “field”.
As well, why IRIS does not respond in a timely and substantial manner?
Who does IRIS come under? Are they going to do a “guest” commentary?
Also, please post the “new” 800 Hotline at the VA. I had it and misplaced it and why is it not readily available?
I think I posted about my experience in trying to use the VA HOTLINE for homeless issues and the Secretary needs to know how IT is not working well.
In trying to find a homeless Vet help, I did call the 800 Homeless Hotline and was told, ” call the local VAMC homeless program; call the VAMC Patient Advocate; and if that doesn’t work, call your representatives in Congress! IS this the answer that is supposed to be HELPFUL? (It was a Call Center in a VAMC in NY)
The VA cannot think that the Veterans/Family members will believe they want to “fix” things if they continue to say, “mail it” instead of using 2011 technology!! The message is clear..”we really don’t want to know”!
You CAN”T Fix it Unless you Know aout IT!
Appreciatively,
BH
Vetwife Advocate
Brenda,
That’s a lot of information, but I’ll try my best for my side:
When is the Under Secretary of the VA Health Benefits Administration going to show up on the Blog site like Under Secretary for Disability Assistance, Mr. Pamperin? If you don’t know; please refer my question to the General? – I hope Under Secretary Pamperin motivated more high level executives to write a guest piece. We usually don’t solicit around for guest posts; they come to us. But we encourage it often when someone would like their message to get out.
Also, did you find anything About the Senate and House Veteran’s/family member Caucus submitting a guest post? You said you would get back with me over a week or so ago. – I’ve had difficulty finding a way to speak with them. Do you have their contact information?
What are the plans for the VPBlog to have “other blogs”? – No concrete plans yet, but we’re looking to get one launched about VA Careers at some point. Other blogs will come naturally when employees with writing talent make themselves known.
Are there any plans to “tweak” the VPBlog format? – Yes, we are in the process of bringing a professional on board to manage the tech side of the blog, and start to do new and exciting things with it.
It would be nice to have a specific place on the blog to speak out about concerns, suggestions, and as well be able to track the responses, etc.
For instance, I have to search around to see what you have posted last to see if you will answer my “unrelated” post? If you don’t understand, email me or call me. – Comments are all we have at the moment, until we can identify a better way. I can’t think of any other solutions right now, since the post acts as a natural collection point for related content.
Thanks for doing what you do and for your positive attitude; it is difficult at best at times for those of us who are using the dysfunctional systems in the VA frequently. – Thanks, I appreciate it and understand the frustration.
Also, I just did new patient orientation at the DC Medical Center, and they mentioned an open door policy with the hospital director. Should be a VA wide policy, so ask your patient advocate about it.
If you’d like to send a message to the Office of the Secretary, you can email secva@va.gov
Exactly Stan, if it proves itself then it could be expanded to other applications.
I didn’t find the old method of applying for healthcare to be particularly cumbersome, but any tool that streamlines the process is a good thing. If it gets off the ground and demonstrates some measure of success in helping veterans apply for health benefits, maybe adding a chat feature to VONAPP would help on the C & P side of the house. I have used IRIS, and I got a prompt response to my questions, but real time answers when filing a claim would be helpful, and would likely speed up the filing of, and resolution of claims.
I agree with you Stan, real time answers when filing a claim would be helpful, and would likely speed up the filing of, and resolution of claims. sometime it hard to find a word to type than to say. Fast Computer Repairs