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Jim Strickland's Mailbag: Volume #46 for 2009
NOTE:  Letters in my mailbag are reprinted just as they come to me. Spelling and grammar are left as is and only small corrections are made to improve readability, ensure anonymity or delete expletives that may offend some readers. This is not legal advice. You should always seek the advice of an attorney who is qualified in Veterans' law before you make any decisions about your own benefits.
07.29.09
Letter:
Jim,
I've enjoyed reading your answers to the questions you've received and I have one for you that I'm sure is on many veterans minds. As a result of a layoff from one of the major corporations in the USA, I've recently lost my medical coverage. I'm on 6 maintenance medications for past heart problems and diabetes. I've just submitted my paperwork to the local VA Clinic and I have a real worry now.

I use marijuana recreationally. I have for several decades. I don't abuse it. Neither do I abuse alcohol. I enjoy relaxing with one or two tokes of marijuana every other night or so, and I'm now wondering if I'll be tested for drugs as a common practice at the VA
Clinic.

If I am tested and marijuana is found in my system, will that result in the VA not providing my medications or health care? The state I'm in does not have a Medical Marijuana allowance. Like most states, it's still illegal. I'd sure like to know what I'm in store for. If it's necessary for me to quit using marijuana to retain my eligibility for VA treatment and medication coverage, then of course, that's what I would do. I'm in my 60's. I'd rather be able to continue doing as I have and not change my lifestyle.

Thank you for any advice you can provide to me and all the other recreational marijuana users that are veterans.


Reply:
There is no mandated policy for testing of marijuana at VA. In fact, when there is testing it's usually considered a normal finding as there are so many Vietnam era veterans who are recreational users.

There are only a very few occasions when it may hang you up and that's generally in a mental health setting. If your shrink is concerned about the effects of marijuana and other psychotropic drugs you may be advised to cease the use of the pot.

If you are very ill and scheduled for an organ or bone marrow transplant, you will likely be tested for all substance abuse. The transplant people are very concerned about the ability of organ recipients to discipline themselves to the regimen of medications and routines that they must abide by after a transplant.

Organs and bone marrow are in very short supply and the waiting lists are long. If a candidate for transplant can't stop using recreational drugs, he may not have the appropriate mind set to receive a donor organ and that could be wasting the resource.

If you are tested for substance use it's often a standard test for the 5 most often used substances...the SAMHSA-5. (Substance Abuse and Mental Health Services Administration-5)

That would be;

1. Cannabinoids (marijuana, hash)
2. Cocaine (cocaine, crack, benzoylecognine)
3. Amphetamines (amphetamines, methamphetamines, speed)
4. Opiates (heroin, opium, codeine, morphine)
5. Phencyclidine (PCP)

Depending on the facility and the lab itself there may be an expanded testing menu where 4 or 5 substances are chosen from a laundry list;

1. Barbiturates (Phenobarbital, Secobarbitol, Butalbital)
2. Hydrocodone (Lortab, Vicodin)
3. Methaqualone (Quaaludes)
4. Benzodiazepines (Valium, Xanax, Librium, Serax, Rohypnol)
5. Methadone
6. Propoxyphene (Darvon compounds)
7. Ethanol (Alcohol)
8. MDMA (Ecstasy)

As an aside, if you're applying for life insurance or a job, you may be tested for nicotine...the most dangerous drug of all of those.

The physicians I know in the VA system have no issue with marijuana but any of the other drugs will probably result in some counseling.

If you are having an elective surgery with anesthesia under any circumstance (civilian or VA) it's very likely the anesthesia folks will ask you about drug use and any over the counter herbal remedies you may take. It's in your best interest to be very open and honest with your anesthesiologist as the interactions of their potent drugs and your own drugs may be deadly.

Even aspirin may cause you some serious problems in an elective and otherwise "safe" surgery so don't try to keep any secrets from those people.

Finally...the VA is a federal system. Our antiquated federal drug laws still see marijuana as an evil illegal drug and according to federal law users deserve harsh prison time in our modern day dungeons. If you're in a more enlightened neighborhood such as California, you may lapse into a mind set that it's legal and as such you can use it as you will.

That's a dangerous trap to fall into.

The VA will always default to the federal law and the VA police will enforce that law while ignoring any state laws you believe may protect you. Don't ever get caught on a VA campus with your stash. Once you're on federal property all the rules change and you may be setting yourself up for a lot of trouble.
Letter:
Jim,
I corresponded with you last week regarding my friend who is a WW2 veteran. I read to him your salute, he really appreciated that. I have just about gotten all the necessary info the VA requested, medical evidence, a statment of support based on your advice how to word it, We went to our County Clerk's office and they recorded and certified his DD-214 (No Charge) Jessamine County here in KY really treats our Vets great, even providing funds for homeless vets, etc. I have a NEXUS letter his physician is signing to throw in as more ammunition. My gut feeling is that he will probably get P & T. Of course I will mail in the papers the way you advise.

On another note, I received a call from the local DAV Service Officer that a Vet had come to him yesterday about a form 21-4140 he hadn't returned to the VA. The VA is threatening to reduce his IU. The DAV Service Officer told me he didin't know how to help this VET and asked for my advice. I immediately went to your article and sample letter how to write to VA in this case.

(Larry and I write about the 4140 often, here are some links)

- http://www.vawatchdog.org/08/nf08/nfoct08/nf102308-1.htm
- http://www.vawatchdog.org/08/nf08/nfoct08/nf101608-1.htm
- http://www.vawatchdog.org/09/nf09/nfjun09/nf060409-1.htm

I downloaded a form 21-4140, wrote a letter in his name, took it to him, he completed and signed the form, the letter and I mailed it to VARO certified mail, return receipt requested. It is a shame that the DAV doesn't have the info to help vets. I provided this CSO with your article and some 21-4140 forms. It is great that any issue we have with the VA, you seem to always have a great remedy. I salute you


Reply:
That is outstanding that you were able to respond in such a positive fashion.

It's worth noting that you're an old friend to VA Watchdog Dot Org and to my work. You and I have corresponded regularly over the years and you've helped to shape much of how I deliver information in my articles. Your friendship and feedback as I've developed my work has been invaluable.

There are many like you who are very ill with their own service connected conditions but who take the time to be pro-active and to reach out to other veterans who need a hand. I happen to know your condition as one I wouldn't wish on an enemy. You've had multiple surgeries and some terribly painful experiences. Even today you have some very serious consequences of your condition that are debilitating and restricting.

You could sit in your own world feeling sorry for yourself and few would blame you for that. But you choose to travel a different road. Like the fine military man you are, you ignore your own painful wounds to live up to our obligation that no man will be left behind. You consistently carry more than your own load.

Veterans helping veterans is the most effective way we have of improving our lives.

Thanks for being on top of that.
Letter:
Jim,
I am a retired US Navy Vietnam Vet and have been retired since 1990 after serving 26 years. I did 2 tours in country and spent numerous tours as crew onboard forward deployed units of the 7th Fleet along the coast, up rivers and into North Vietnam waters
providing Naval Gunfire missions.

My question to you is I was recently called in for a review with QTC Medical personnel for some of my disabilities. Everything was fine except for one examination by a QTC Ophthalmologist. I was diagnosed with glaucoma 3 years prior to my military retirement in 1987. I was given a 10% disability rating in 1990 when I retired on my original C & P and it has been the same all along. I am a 90% service connected total.
During my examination I was told by the QTC Doctor that there was nothing wrong with my eyes and to throw away my eyedrops as I don't need them. This doctor was completely off the wall, unprofessional and I don't think he knew what he was talking about. During my military service I saw numerous Doctors who treated me along with civilian Doctors and my current Eye Doctor at the VA who has been caring for me for 19 years. What repercussions do I have if this "quack" writes me up on having no eye problems? I talked to my Eye Doctor at the VA and he told me not to worry as my record speaks for itself. Will I have to appeal the results or what other recourse do I have? I'm trying to prepare for it now prior to the results of the Award Board sending out my new C&P. Thanks in advance.


Reply:
I hear some off the wall stories in this mailbox but that takes the cake.

Let's see...you have glaucoma. The physician prescribed eye drops make it better by lowering the pressure in your eyes. On examination your eye pressures record as normal because you are using the eye drops as they are prescribed. Thus, you should stop using the eye drops?

In a similar fashion, I suppose that quack would see a man who had high blood pressure who was prescribed pills for the condition. On exam the blood pressure is normal because the patient regularly takes his pills. So this sawbones tells him he no longer needs the pills.

I shudder to think what he'd tell an insulin dependent diabetic.

I wouldn't worry about it. I know...easy for me to say. However, if this were to be taken seriously by anyone reviewing your record it wouldn't be difficult to rebut. I doubt it will come to that but if it does, I think it'll be an annoyance and not a big problem.

Keep my address handy should this cause you a problem and I'll lend a hand at the appropriate time.