Know Your Rights

Reprinted from PN October 2012

Learn all you can about your entitlement to medical care as a paralyzed veteran.

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I sometimes have an urge to write in detail about an esoteric subject that some of our readers may find boring and wonder why I did so. As you read this editorial, I hope you don’t place it in that category of “Please help me, there goes Hoover again!”

If you do so, you will severely regret not having read what I am writing about, because it goes to the core of something you should be deeply concerned about: your entitlement to medical care as a paralyzed veteran.

One of the most important documents relating to our health and rights within the Department of Veterans Affairs (VA) system, as spinal-cord injured veterans, is VHA Handbook 1176.01. You most likely have never read this document and are not familiar with it unless you are deeply involved with Paralyzed Veterans of America (PVA) management at the national level in some way or you are a PVA service officer. 

This document and the related document, VHA Directive 1176, spell out the structure of the VA Spinal Cord Injury System and lay out in detail the rights you have to care within the system. A cursory knowledge, at the minimum, of specifically 1176.01, is something you should have; you may use the Internet easily by simply typing in their names and going to one of the sites that refers to them.

I hope to stimulate your interest enough so you read the contents of both on your own volition. Let’s begin with 1176.01.

Appendix A to 1176.01 sets forth the listing of the VA Hub and Spoke System in the United States. This lists the hospitals that do not have SCI centers (Spokes) and the closest hospital that does have an SCI center (Hub), which in theory you are supposed to use if you need care. However, you are not mandated to use that Hub, despite what you may be told. 

To explain this further, Paragraph 11 of 1176.01 states, “However, in the interest of preserving continuity of care, veterans with an existing relationship and treatment history at an SCI center that is outside the designated catchment area will have their preferences respected by the referring and accepting facilities in accordance with VA travel regulations.” This means if you were initially rehabbed or have received treatment at a center outside your current Hub, you can choose the other center.

This has certain parameters attached, but PVA service officers can assist in expediting this process. You may not be satisfied with the quality of care at your current Hub, or a different one may offer specialized care that is not available at your current Hub. Paragraph 13.d explains this even further. Make sure you read it to gain an additional understanding of your rights.

Regarding another important fact, if you happen to be admitted to a non-SCI VA facility, they can’t keep you there for serious conditions related to your paralysis. Paragraph 13.d (1) states, “Veterans with SCI/D admitted to any VA medical center are to be transferred to the SCI center in 72 hours for acute medical and/or surgical conditions and non-self-limiting conditions.” If a facility proposes keeping you longer than that period, it is violating VA regulations. If the local Hub cannot admit you, it must find a facility that can.

Going further, paragraph 14.b (3) outlines the responsibilities of the person designated as the SCI coordinator at a non-SCI VA facility. These duties are comprehensive, and you should familiarize yourself with them. You certainly should find out who the SCI coordinator is, because that person is responsible for ensuring that the rights you have fewer than in 1176.01 are complied with by the non-SCI VA facility.

I’ve focused on three important items in VHA Handbook 1176.01 to give you an idea of topics covered in this document. These three are only a few in the listing of areas very important to SCI/D veterans. In a future editorial, I’ll address some areas of VHA Directive 1176. 

PVA’s service officers are intimately familiar with this document, and if you need clarification, contact one of them. 

I hope you’ll take the time to read 1176.01 and 1176. You’ll go into the hospital more informed about your entitlements and rights as an SCI/D veteran. Good luck. 


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