Appeal

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As many of you know, the VA rejected our caregiver application. Our caregiver coordinator (who we will call Rob) called and gave us the news. I'll admit it: I burst into tears. Rob offered to help us with the appeal process because he believes "they made this decision erroneously." He's been like an unofficial advocate ever since. I am very grateful for his help, because appealing is not easy. I am also grateful for my friend and former coworker who has been through this process already. She helped me apply in the first place, and talked with M and me after we got the decision. 

First we had to wait for the official letter with the Eligibility Team's decision. In the letter, they stated that their reason for denying caregiver status was that M had not been in need of care for 6 months. They were right about that, it had been 5. I remember thinking, "Could it really be that simple?" But...This is the VA. Of course it couldn't. The reason in the letter did not match the explanation they gave in M's records. Rob said that in the letter, they only have a few options they can select, so they pick the closest one.

I had to go elbow deep into M's medical records, and the documents sent to  the Eligibility Team. It was incredibly frustrating. For M to qualify, they need assistance every single time they attempt at least one "Activity of Daily Living," (ADLs). The VA has 7 ADLs (Dressing, grooming, feeding, bathing, toileting, prosthetics, mobility). The Eligibility Team claimed that M does not qualify for any of them...even though they absolutely do. They reference the documents sent to them, but all of those documents support us. One of their quotes is so contorted that I believe they either only skimmed the documents for words that would support a denial, or they were being deliberately obtuse. The Eligibility Team even made things up. They claimed that M goes places alone. None of the documents sent to them say that, and one even says the exact opposite. I printed all the necessary pages and underlined sections in different colors for each ADL. M easily qualifies for at least 4.

Rob told us there were a couple types of appeal we could try. It's great that he took the time to explain it to us, because the letter they sent to "help" us appeal, told us next to nothing. We decided to file two types at the same time. One has a low success rate, but HAS to be decided on 45 days after receiving the letter. The other sounds like a better chance of success, but would take much longer. 

I spent most of my last break writing the appeal. I tried to imitate the style of the documents I was reading. I thought maybe if I sounded at least a bit like them, they'll see they can't bullshit me easily. I was listening to Celtic Woman, and I was still furious. Rob told us it would be like writing a college paper (which is why I was the one that wrote it). We would need to cite our sources. And oh boy did I. One of my paragraphs has a citation after every single sentence. I explained  the Eligibility Team's decision and then broke down, 1 ADL at a time, why they were wrong. I quoted documents without twisting the words, referenced relevant medical records, and  even threw a VA ruling about what counts as a prosthetic at them (not joking, we found and quoted the Federal Register at them).  Every tap of the keys filled me with rage. I kept rereading what  the Eligibility Team had to say, countering it, and thinking about all the pain and struggling M has to go through just to exist. Their condition is so dismal as a result of neglect from the VA. Neglect that magically went away when the emergency room contacted them in December. The idea that they would hang my partner out to dry yet again…

I finished the appeals. Printed them. And charmed them before I sent them out in the mail. Now we wait to hear back. I have enough candles, paper and rage to last decades. I will do this over and over until they give my spouse the damn care they deserve. They have crossed the wrong witch.