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Q737:  In 2018 I had an accident with my car falling on my arm and cutting it very seriously. I had to go to the ER and ask them to contact the VA for payment. I also supplied my own med insurance info. The VA never paid a dime and I was out serious copay from my own insurance. I would like to know how to recover my outlay for this injury?

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A1:  First, thank you for your service! Second, disclaimer here, I am not an attorney and nothing I state should be considered or construed a "legal advice."

    

I suggest you, or anyone, not give their private insurance info to the hospital, if you want the VA to pay. VA will not (generally) pay once someone else pays. VA is a very, very, extremely, slow payor(sp), months maybe yrs and it could cause a hit to your credit report, if you worry about stuff like that. If the hospital can get their money sooner, they will bill the insurance company and once they have paid the VA will refuse. Insurance companies pay more and faster, so hospitals usually bill them. Also, many business's do fraudulent things, including hospitals and when caught blame some new person in the office or a computer glitch.

   

Hospital admissions personnel are "required" to ask if the patient served in the military, at admission. You and the hospital are required to notify the VA within 72 hrs of your admission. Failure to do so could cause nonpayment. This also allows the VA to transfer you to a VA facility, to save the VA money.

         

    

  

  

  

  

  

  

  

            

You can fight the VA for reimbursement but it may take yrs and you'll probably lose. If it were me, and the copay was substantial, I would contact the hospital, requesting a refund of your copay and state that they should have notified and billed the VA, and if they don't you will and should take them to court. You could mention that In lieu of court action that they "should waive and refund the copay, to you" and give them something like 30 or 45 days to respond.   (RH)  6/16/21

        

A2:  Sorry to hear about your accident. Had you not provided your civilian insurance and gave the your VA ID medical card, then they would have filed with the VA. There is a federal law that if another policy pays a dollar then the VA cannot pay anything. You can try to file with Community Care at your local VAMC and see if you might get lucky.  (DS)  6/16/21

       

A3:  When you go to the ER and are hospitalized you must ensure the VA is notified. Some hospitals and ERs will. However, you have a responsibility to do so. The number is 1-=844-724-7842, the VA will give you an Authorization Number to give to the Hospital. That being said, A Federal Judge ruled in 2019 that even if the VA is not notified, they are still responsible for your care. Contact an Accredited VSO from the Am Legion, VFW, Am Vets or another Veterans Service organization for assistance. I have had to clear up several situations during my career as an Accredited VSO. Do not listen to a Stockade Lawyer! (over 25 years).  (GH)  6/17/21