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The Veterans Voice
"Fighting for Our Veterans-Supporting Our Troops"
Proudly Serving All Branches & All Eras Since 1999
Mondo Times
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Thomas W. Stoddert, US Army Retired, is right on every point and I applaud his courage to write a very exacting letter.  My tenure at Madigan Army Medical Center as the NCOIC of the Department of Medicine made me aware of mismanaged policies and management issues.  I worked with a wonderful staff of professionals and paraprofessionals who conducted themselves very appropriately and courteously, with politeness, knowledge, experience and timeliness.  However, all of our efforts were frequently clouded by the frustrations of personnel shortages, ancillary demands of personnel, frustrations secondary to multi-echelon mismanagement issues, and numerous other problems.

The Department of Medicine includes 13 separate sections, clinics, and sub-departments, each with specific medical missions comprised of doctors, PA's, nurses, medical technicians, and support personnel, including military and civilian staff.  Some clinics have direct access through central appointments while many others required a referral from the primary care provider.  All too often miscommunication between various services and ancillary personnel would complicate scheduling problems.  An appropriate example: Patient "A" might be scheduled to see doctor "Z" in a specific clinic, but Dr. Z had to cancel all appointments because he/she had to support another military mission somewhere else on post or deploy to another country.

Frequently, the appointment schedule confusion was not because of medical staffing, but due to Central Appointments or Tri-Care issues for providing less than appropriate information to the patient and the provider.  Regardless who was at fault, the senior enlisted member of each clinic, section or department always tried to resolve relevant matters at the lowest level before involving the members of the Patient Representative Office and Patient Affairs Office. 

As the NCOIC or the department, I coordinated with the Patient Representative Office and Patient Affairs Office and designed placard's which identified the OIC and NCOIC of each clinic, section and department with a current photograph and a customer service statement bent on resolving problems or complaints at the lowest level.  The commanding general at the time accepted the design and ordered that it be implemented throughout the hospital.  The implementation was done in 2000 and I hope it is still in place. I am confident that the NCO's and OIC's at each level are fully capable of resolving conflicts and complaints, providing they get support from the senior management of medical care at Madigan Army Medical Center.

On the other hand, I and many others have all too often witnessed many frustrated and dissatisfied patients and family members who lack the patience to allow the system to work as it is designed.  These patients complain every chance they get and they become very loud and ugly about it, making treats, breaching the chain of command, and writing letters and memos to anyone who will listen.  The members of the Patient Representative Office and Patient Affairs Office do everything possible to bring providers and patients to a equitable arrangement, resolve appointment conflicts and ultimately bend-over-backwards.  Still, the patient complains and will ultimately use the same tactic every time they feel the need, regardless of how well or how often they have been treated with the same professional level of care that all patients and family members are given.

I am not blind and I do not wear rose colored glasses.  I know there are problems with the management of care at Madigan Army Medical Center and other military medical facilities.  However, there is no single mission in the military service that is as resource intensive as the medical mission on a daily basis.  Then the medical facilities must comply with and satisfy military and civilian laws, protocols, standards, inspections, and funding agencies.  All of this while still supporting the military missions of deployments, training, education, reassignments, and command emphasis issues. 

So, yes, a problem exists, but it will take the collective initiative of the soldier's at each facility to make the improvements, with the support of the Army Medical Corp senior management and mass influence of money and personnel.

Sincerely,
Alan B. Candia
U.S. Army (Ret.)   

Reader's Response Below
Question:
I am rated 100% unemployability. My ratings are as follows.
30% for chlorache from Agent Orange exposure
30% for PTSD
40% for diabetes
It also says on my award letter, "No Future Exams."
My question is do you think they can re-examine me in the future and take away my benefits?
Thank You,
Bob Clark

Answer:
Bob, Thanks for writing in to the "Veteran's Voice."

The VA can require a future exam at any time  if they feel there may be an issue of fraud or if a   gross mistake was made. But generally in cases like yours where they say no future exams,
they mean just that.

The VA can, if they have sufficient reason, propose to lower a rating percentage only if they        believe you may have gotten better or something has happened and they have to review
certain awards. This can happen as an example as the result of a mandate from Congress. The   issue of PTSD, was getting a lot of nasty attention by the national press and the VA went back   and started looking at this issue when it was awarded to  non-combat veterans.

However, the general rules are basically after five years, service connection can not rescinded,   but the rating percentage can be lowered; after ten years there can be no reduction in the rating percentage or severance of a service connected condition unless there was fraud.

All this to say, if you got a fair rating and they have said no future exams, just run with it. The  VA does not like to hassle vets when they do not need to.

Now, the down side, FYI. The VA does  routinely check up to see if you are working and so does    the Social Security Administration. They both allow you some grace in making some extra income because they know staying home vegetating is harmful. However, 100% unemployability is just that and both agencies frown on a veteran receiving benefits because they can not work and then go out and work full time. So check carefully and see what they allow you. I was told recently that these rules may have changed not too long ago.

Assuming you are not working you may want to consider doing volunteer work in the community and/or working with veterans. Here is where the fun starts. The VA, through the education department,  will sometimes purchase items to make a veteran's life more meaningful. In my case they helped me purchase computer equipment so that I can write like I am now and aid other veterans. Now that there is a war on, there are many opportunities to use your talents and experiences for others, particularly other vets.

So good luck and welcome home.
Thom
Thank you for your courage to tell it like it is!   The General is a good person but what can one person do?   Do you know who the members of her so-called command group are?   The Deputy Commander for Administration is ineffective, disinterested, weak and lame.   The Deputy Commander for Clinical Services is pretty smart but he is a poor leader, has no clue what his subordinates are supposed to do and he is leaving in a few weeks.   The Deputy Commander for Nursing is also lame and she is about to retire.   The Hospital Sergeant Major is also about to retire!    In addition to the problems you described, there are many others.   For example, I wish someone would approach Mr. and Ms. Horrell  and ask them what they know about nepotism and the merit system!   Madigan is a wonderful institution and has many great people but the fat, ineffective and overstaffed upper management needs to replaced and realigned now!  

Husband of a very concerned member of the Madigan Team  
Thomas W. Stoddert, US Army Retired, is right on every point and I applaud his courage to write a very exacting letter.  My tenure at Madigan Army Medical Center as the NCOIC of the Department of Medicine made me aware of mismanaged policies and management issues.  I worked with a wonderful staff of professionals and paraprofessionals who conducted themselves very appropriately and courteously, with politeness, knowledge, experience and timeliness.  However, all of our efforts were frequently clouded by the frustrations of personnel shortages, ancillary demands of personnel, frustrations secondary to multi-echelon mismanagement issues, and numerous other problems.

The Department of Medicine includes 13 separate sections, clinics, and sub-departments, each with specific medical missions comprised of doctors, PA's, nurses, medical technicians, and support personnel, including military and civilian staff.  Some clinics have direct access through central appointments while many others required a referral from the primary care provider.  All too often miscommunication between various services and ancillary personnel would complicate scheduling problems.  An appropriate example: Patient "A" might be scheduled to see doctor "Z" in a specific clinic, but Dr. Z had to cancel all appointments because he/she had to support another military mission somewhere else on post or deploy to another country.

Frequently, the appointment schedule confusion was not because of medical staffing, but due to Central Appointments or Tri-Care issues for providing less than appropriate information to the patient and the provider.  Regardless who was at fault, the senior enlisted member of each clinic, section or department always tried to resolve relevant matters at the lowest level before involving the members of the Patient Representative Office and Patient Affairs Office. 

As the NCOIC or the department, I coordinated with the Patient Representative Office and Patient Affairs Office and designed placard's which identified the OIC and NCOIC of each clinic, section and department with a current photograph and a customer service statement bent on resolving problems or complaints at the lowest level.  The commanding general at the time accepted the design and ordered that it be implemented throughout the hospital.  The implementation was done in 2000 and I hope it is still in place. I am confident that the NCO's and OIC's at each level are fully capable of resolving conflicts and complaints, providing they get support from the senior management of medical care at Madigan Army Medical Center.

On the other hand, I and many others have all too often witnessed many frustrated and dissatisfied patients and family members who lack the patience to allow the system to work as it is designed.  These patients complain every chance they get and they become very loud and ugly about it, making treats, breaching the chain of command, and writing letters and memos to anyone who will listen.  The members of the Patient Representative Office and Patient Affairs Office do everything possible to bring providers and patients to a equitable arrangement, resolve appointment conflicts and ultimately bend-over-backwards.  Still, the patient complains and will ultimately use the same tactic every time they feel the need, regardless of how well or how often they have been treated with the same professional level of care that all patients and family members are given.

I am not blind and I do not wear rose colored glasses.  I know there are problems with the management of care at Madigan Army Medical Center and other military medical facilities.  However, there is no single mission in the military service that is as resource intensive as the medical mission on a daily basis.  Then the medical facilities must comply with and satisfy military and civilian laws, protocols, standards, inspections, and funding agencies.  All of this while still supporting the military missions of deployments, training, education, reassignments, and command emphasis issues. 

So, yes, a problem exists, but it will take the collective initiative of the soldier's at each facility to make the improvements, with the support of the Army Medical Corp senior management and mass influence of money and personnel.

Sincerely,
Alan B. Candia
U.S. Army (Ret.)   

Reader's Response Below
Thank you for your courage to tell it like it is!   The General is a good person but what can one person do?   Do you know who the members of her so-called command group are?   The Deputy Commander for Administration is ineffective, disinterested, weak and lame.   The Deputy Commander for Clinical Services is pretty smart but he is a poor leader, has no clue what his subordinates are supposed to do and he is leaving in a few weeks.   The Deputy Commander for Nursing is also lame and she is about to retire.   The Hospital Sergeant Major is also about to retire!    In addition to the problems you described, there are many others.   For example, I wish someone would approach Mr. and Ms. Horrell  and ask them what they know about nepotism and the merit system!   Madigan is a wonderful institution and has many great people but the fat, ineffective and overstaffed upper management needs to replaced and realigned now!  

Husband of a very concerned member of the Madigan Team  
Question:
I am rated 100% unemployability. My ratings are as follows.
30% for chlorache from Agent Orange exposure
30% for PTSD
40% for diabetes
It also says on my award letter, "No Future Exams."
My question is do you think they can re-examine me in the future and take away my benefits?
Thank You,
Bob Clark

Answer:
Bob, Thanks for writing in to the "Veteran's Voice."

The VA can require a future exam at any time  if they feel there may be an issue of fraud or if a   gross mistake was made. But generally in cases like yours where they say no future exams,
they mean just that.

The VA can, if they have sufficient reason, propose to lower a rating percentage only if they        believe you may have gotten better or something has happened and they have to review
certain awards. This can happen as an example as the result of a mandate from Congress. The   issue of PTSD, was getting a lot of nasty attention by the national press and the VA went back   and started looking at this issue when it was awarded to  non-combat veterans.

However, the general rules are basically after five years, service connection can not rescinded,   but the rating percentage can be lowered; after ten years there can be no reduction in the rating percentage or severance of a service connected condition unless there was fraud.

All this to say, if you got a fair rating and they have said no future exams, just run with it. The  VA does not like to hassle vets when they do not need to.

Now, the down side, FYI. The VA does  routinely check up to see if you are working and so does    the Social Security Administration. They both allow you some grace in making some extra income because they know staying home vegetating is harmful. However, 100% unemployability is just that and both agencies frown on a veteran receiving benefits because they can not work and then go out and work full time. So check carefully and see what they allow you. I was told recently that these rules may have changed not too long ago.

Assuming you are not working you may want to consider doing volunteer work in the community and/or working with veterans. Here is where the fun starts. The VA, through the education department,  will sometimes purchase items to make a veteran's life more meaningful. In my case they helped me purchase computer equipment so that I can write like I am now and aid other veterans. Now that there is a war on, there are many opportunities to use your talents and experiences for others, particularly other vets.

So good luck and welcome home.
Thom
Thom Stoddert
KAZMIERCZAK
VA 101: The Basics
Know & Understand VA Benefits
A.O. My Perspective
VA Rating Schedule
Understanding Basic VA Benefits
Evidence Is Everything With the VA
Don't Be Stupid,                 Get the Truth
Veterans For Peace....???
Stoddert Assignment Berlin
The ABC’s of Individual Unemployability
  Is the Army Medical   Department SHARP?

 

By Thom Stoddert
stoddertwork@gmail.com

NO, not at this time!!! The Army’s Medical Department often fails, in particular Madigan Army Medical Center located on Joint Base Lewis-McChord. Madigan is going through a program called Sexual Harassment/Assault Responsive Prevention Training (SHARP). It is training aimed at breaking the silence of bystanders when they witness sexual harassment against another, instead of just being quiet. But as several employees among the many hard working staff pointed out – why isn’t this expanded to all issues that are causing a toxic work environment which also impact the care that soldiers, military retirees, and families receive, especially while we are war.

MG. Philip Volpe, as the commander of Western Medical Region, and COL. Dallas Homas who was selected to command Madigan described in an AR 15-6 investigation that there are many “barons” who are well entrenched and not performing up to standards. Other employees have called them “oxygen-thieves.” Doctors are leaving early (moonlighting) or having their clinics open only four days a week. This investigation also notes that Madigan was three hundred million dollars over budget.

Homas and Volpe knew of the money, time, and resources being wasted and ordered internal audits. Several have described to us the waste in the office of Informatics. It was discussed often, even several years ago, that Informatics was wasting money and was inefficient.

There are many incidents of unfair hiring practices that are against the law and have been pointed out to David Aiken, Chief of Human Resources, who ignores them. This seems to be especially true in the computer technology area. Applicants are selected by their friends over better qualified applicants, work for a year or so and then moved down to a position that they can handle. Many of these newly hired employees are paid from additional budget sources leaving other areas complaining. Some of the barons even have their own separate IT staff.

The pharmacy fiefdom of the main hospital is especially sinful. Reports tell of Stephanie Fitzpatrick, a technician in the pharmacy shoulder butting others and is protected by her immediate supervisors who do nothing – may be they need to remember the ever present security cameras.

Many complaints from patients and staff relate how employees in the pharmacy and other offices are on the internet, even when they are not on breaks, accessing their Facebook accounts. The hospital’s IT section would reveal this activity. However, they have learned many administrators really don’t care.

Supervisors like Mr. Claypool in the pharmacy are aware of subordinate supervisors who work with him recording on their friend’s time-cards hours not worked and comp-time given, also not worked. Johnny Hong was moved to a smaller pharmacy and time card duties were taken from him. The pharmacy is not the only department doing this.

There seem to be many barons like COL. Steve Yost bullying subordinates, as described by several reports. Personnel in the Quality Service Division have secretly forewarned the victims of their chief’s vindictive retaliations. That is how the former Chief of Patient Advocacy found out about Lisa Danforth-Lewis illegally rewriting his civil service job description and performance evaluation.

What is the mechanism used to cover things over or to retaliate against staff? The favorite tool is to delegate the issue or problem to a committee. The committees are almost always made up of military officers like Yost who have rarely been deployed/PCS’ed and civilians who have been around for decades. Therefore effectiveness is compromised by friendships and self interest. Barons also like to give or withhold bonuses to control the favored or disfavored. Danforth-Lewis is well known for this. But fear of retaliation is the biggest factor in keeping things under control all over the hospital, because the union and the civilian personnel office often wash each other’s hands. Then the unplanned happened.

Last winter several former and present employees started meeting together off base and formed a network made up of physicians, professionals, and technicians even some from several states. The purpose of these gatherings was to share/compare notes and eventually EXPOSE the barons. EXPOSURE is the only thing barons fear. The Army ‘s Medical department is well known for covering over issues, hoping they will go away. Instead we get the Walter Reed scandal, the Fort Hood killings, the Madigan Cardiology kickbacks, the changed PTSD diagnosis which all made the news.

Later in the spring something interesting surfaced, as several former Madigan employees were going from office to office of local elected officials – all claimed to be advocates for their constituents, veterans and soldiers. All of the elected officials were Democrats except CON. Dave Reichert. He is the former detective who caught the prolific Green River killer. Only Reichert with his staffers were shocked at the packets of information illustrating the corruption at Madigan. Reichert, alone, actually did something. The packet he was given was hand delivered by Reichert to CON. Buck McKeon (R-CA), Chairman of House Armed Services Committee.

The Democratic Congressmen, Heck, Adams, Kilmer and Senator Maria Cantwell all referred interest to Democratic Senator Patti Murray, even though they were all handed the same 50 pages of documentation. Two things are especially worth noting. Senator Patti Murray was frequently at Madigan over the years for complaints from the Wounded Warrior Transition Battalion, from the hospital staff, and for other issues over malpractice. Senator Murray’s office had also been made aware of the circumstances of the death of Michael Balcone and the implications of his doctor, Alvin Tiu. Despite all this, Senator Murray may also have nominated a former commander of Madigan, to the President for appointment to the position of Surgeon General of the Army. That may explain how Patricia Horoho went from being a Colonel to a two star general in less than a week.

While Horoho was the commander of Madigan, as several employees in the Cardiology Clinic have shared, Dr Jason Davis (Major) was allowed to run rogue even after he was fined in Federal Court for taking kickbacks from a pharmaceutical company. First he was positioned over more senior doctors, including Dr. Michael Eisenhauer (Colonel) who exposed his actions. Then he retaliated against those who were witnesses at his trial. Horoho, as commander and now Surgeon General allowed this to happen as well as all the other corrupt activities discussed here. Davis was never punished by Madigan. Eisenhauer and others have yet to get justice. Tui was never investigated. HR laws are still disregarded. Murray still parades herself as a veteran’s advocate while her office stonewalls the former employees. Horoho markets Madigan as a world class medical delivery system as the money is wasted and talent hemorrhages.      

It is disgusting when the motivation of those who are caring for our soldiers and veterans, is ambition, arrogance, power, and/or laziness, rather than gratitude. Exposure will reveal good or evil, why do the barons at Madigan and hospitals fear exposure?

Thom Stoddert, former VA Rating Specialist
Bio Here
How the VA Does Not Work
Saudi Syndrome from a VA
Finding Supporting Evidence
Healing, Reunions and Branson, MO
The Rating Schedule and Special Monthly Compensation
Ordinary Info that Every One Screws Up!
Scams & VA Benefits       Part 1
Scams & VA Benefits       Part 2
Scams & VA Benefits       Part 3
VA Ratings Basics
VA Ratings for Hearing
VA Benefits Basics 10
Veteran’s Overcoming Common VA Errors
VA Math
s, DIC and Pension
gger than Most Realize
PTSD Coach
Hearing Loss compensation
Aid and Attendance, Pension, Without Strings Attached
I Hope This Upsets You!
Special Cases of Unemployability
Corruption At Madigan
An Informative War Memorial Torpedoed By Pettiness & Politics
Nigerian Banker's Corruption Surpassed by Army Hospitals
It’s All About the Evidence
Scams, Shams, and Deceit
Scams, Shams, and Deceit
Care With Compassion?
A “Combat” Clerk Typist More
Roger Flygare Should Apologize More
Care With Compassion?
Care With Compassion?