Barry Coates dead; veteran was at heart of VA scandal

Barry Coates, the U.S. veteran who became the human face of the Veterans Affairs scandal over delays in care in 2014, died on Saturday of the cancer that wracked his body after waits for medical care at a VA facility. He was 46.

Coates became a national figure representing delays in medical care at VA hospitals after he was featured prominently in a CNN investigation in January 2014.

The CNN investigation that included Coates was the first national story about delays in care across the country that year. It led to a national controversy resulting in the resignation of VA Secretary Eric Shinseki, and ultimately a law that provided $16 billion to overhaul the Department of Veterans Affairs, passed by Congress and signed by President Obama.

Barry Coates testifies during a Veterans Affairs hearing in 2014.

After the CNN story about him, Coates was asked to testify before Congress about the delays in his medical care. When he got to Washington, Coates told lawmakers he had suffered for months, waiting for a simple medical procedure that might have saved his life.

Coates testified he was dying of cancer because the procedure was delayed at several VA facilities, including the William Jennings Bryan Dorn VA Medical Center in Columbia, South Carolina.

Leaving some lawmakers in tears and making national news again, Coates described in detail how he waited months, even begging for an appointment to have a colonoscopy. But he found himself on a growing list of veterans also waiting for appointments and procedures.

About a year after first complaining to his doctors of pain, Coates said, he was able to get a colonoscopy. Doctors discovered a cancerous tumor the size of a baseball. By then he had Stage 4 cancer, and it was only a matter of time before he was overtaken by the illness, he told lawmakers.

From his first interview, Coates, a simple but articulate man from rural South Carolina, spoke eloquently about how veterans should be treated better, and deserved more after all the sacrifices they had made for their country.

"Due to the inadequate and lack of follow-up care I received through the VA system, I stand before you terminally ill today," Coates told members of the House Committee on Veterans' Affairs.

The lawmakers who heard him testify were shaken by his description, and about the numerous deaths of other veterans outlined in CNN's investigation.

"This is an outrage! This is an American disaster!" Rep. Jackie Walorski, an Indiana Republican, nearly screamed, her voice quavering, during that congressional hearing, in April 2014. "My dad was a veteran. He died of colon cancer," she said, crying softly. "This is so personal to me."

Coates remained friendly and kind, was never hostile, and even kept his humor as his illness progressed. Speaking with his down-home and polite country manner, the Army veteran had a remarkable ability to touch many people with his story.

Coates' family said he died Saturday from the cancer that had been left untreated by the VA for so long. After his time in the national spotlight, Coates continued to rail against the VA and fight for veterans to get better treatment, continuing to speak with reporters and helping them understand the VA crisis and scandal as it unfolded.

Coates' son, Shane, 23, on Wednesday described his father's fight and how he remained committed to helping other veterans to the end.

"Everything they did at the VA was dragged out, it was never a quick appointment for anything," Shane Coates said. "He had to wait so long to get any treatment. After what happened to him, he just wanted to fight for other veterans."

"He wanted to show the world that when you go fight for your country, it's not right that you come home and then you have to fight just to get basic medical treatment," Shane Coates said. "The way they treated him, and other veterans, it's just not the way any veteran should ever be treated. It's just not right."

Coates was buried Wednesday in Bethune, South Carolina, after a service at the Timrod Baptist Church. In addition to Shane, Coates is survived by his father, Barry Coates Sr.; his wife, Donna; his brother Randall; his sister Dawanna; and by four other children: Scotty, 25; Breanna, 24; Troy, 22; and Tyler, 16.

Understanding C & P Exams

When you are ordered to attend a Compensation & Pension examination, YOU MUST ATTEND. 

Failure to show up is likely to terminate your application for benefits immediately or cause significant delay. I don's suggest rescheduling the exam, even if it isn't convenient for you! It doesn't matter if you don't understand why you are scheduled for a C & P exam. That isn't important. You must attend and you must understand how the process works.

The C & P exam is usually done by a health care professional who works for a company that is a contractor to the VHA. We call these people C& P Examiners.

Separating Fact From Fiction

The Do's & Don'ts of the C & P Exam

• NEVER try to fake any symptom. If you aren't prescribed a neck brace, don't wear one.
• Do not allow the examiner to cause you pain or discomfort during the exam by manipulating joints, etc.

• Don't ask The examiner for any insight about how your claim will be decided. 
• You may request that a family member or friend join you during the exam. 

The examiner may agree or refuse your request.

• DO NOT attempt to secretly record any part of the exam.
• DO make notes for yourself before you go. This is the only way you'll 

be sure to tell the examiner all the details you want to share.

• DO NOT over-exert yourself trying to please the examiner. This exam is 

about your worst symptoms, not the best.

• DO be courteous at all times.
• DO NOT complain to the examiner about all the

indignities you've suffered. Focus on the reason you're there.

• DO use your common sense. This exam probably won't make or break 

the decision about your claim but it can help.

 The C & P Examiner does not make the decision about your claim!

The Ratings Veterans Services Representative (RVSR) is a primary decision maker of the outcome of your claim for VA disability compensation benefits. Once the veteran has filed for the compensation benefit a folder or file is created and data (called evidence) is added to the file for consideration by the RVSR.

The condition you claimed will likely have some past evidence in the form of a Service Medical Record (SMR) or records of diagnosis and treatment from civilian providers. No matter the amount of evidence you have, it's likely that the Veterans Service Representative (VSR) or the RVSR will request that a VA contractor perform a C & P exam on you.

The C & P examiner will not treat you or order any medications. Lab work, x-rays and other such studies may be ordered by the C & P examiner. The depth of the examination is determined by order of the VSR or the RVSR and is included in the request for examination. When you have filed a claim or VA has decided to review the status of your condition, the VSR completes an order to have you attend a C & P exam. The order is very specific as to exactly what the VSR believes should be examined. If you have claimed a condition of your left leg, the C & P examiner will only address issues about your left leg.

The examiner has no authority to go beyond what is ordered by the VSR. Frequently the examiner will not have your medical records or any other history available. That is often the case when the VSR only wishes to determine the degree of function of a joint, as in a knee injury. In that instance, the examiner won't consider that the history or treatments over time is of any particular importance. She or he will only be looking for the physical effects that are observable and measurable at that moment. The knee may be flexed and rotated so that the examiner can record those motions for comparison to the norm. If there is scarring, crepitus (joint noise), swelling or redness, all of that will be noted in a report.

In other cases, the VSR or RVSR may request that the examiner give the medical record a very thorough review to determine whether or not a condition originated in the time of military service. A claimed back injury may have a reference of a similar injury in the SMR of 30 years prior to the date of the claim. The examiner will be asked for an opinion that will state that the condition of today is or is not likely to have resulted from the injury in the SMR or if it is a condition that is of different origin and likely happened long after the ETS.

This is sometimes referred to as a nexus letter and may connect the condition you allege today with an event that happened many years ago.

(VR&E) - "What is that?"

GET THE EDUCATION AND JOB TRAINING YOU NEED!!

Vocational Rehabilitation and Employment (VR&E), is an earned veteran benefit that (nearly) ALL veterans are entitled to. Vocational Rehabilitation can change your life, I say this from experience. This VA benefit can do it all once you learn what to ask for and how to ask for it.

People in the military get hurt, it’s all part of the job. Whether you're infantry (front line as some people like to call it), infantry support (everyone else), or just performing normal duties daily, injuries will happen. Some of these injuries are so severe that they cause permanent disability and can even end a military career. Leaving you with what one specific skill. What if no one is hiring for a prior service Military Cook, Police Officer, or Infantryman. What are you suppose to do?

Well that is where VR&E comes in. Congress authorized the Vocational Rehabilitation program to assist Veterans with service-connected disabilities to prepare for, find, and keep suitable employment. For Veterans with service-connected disabilities so severe that they cannot immediately consider work, Vocational Rehabilitation offers services to improve their ability to live as independently as possible.

The VA (Veterans Administration) provides the funding, service and management of Vocational Rehabilitation through a program called VetSuccess. This VetSuccess program provides for:

• Comprehensive rehabilitation evaluation to determine abilities, skills, and interests for employment
• Vocational counseling and rehabilitation planning for employment services
• Employment services such as job-training, job-seeking skills, resume development, and other work readiness assistance
• Assistance finding and keeping a job, including the use of special employer incentives and job accommodations
• On the Job Training (OJT), apprenticeships, and non-paid work experiences
• Post-secondary training at a college, vocational, technical or business school
• Supportive rehabilitation services including case management, counseling, and medical referrals
• Independent living services for Veterans unable to work due to the severity of their disabilities

Who is Eligible for Vocational Rehabilitation?

Active Duty personnel are eligible if they expect an honorable discharge upon separation, apply for and receive a memorandum rating of 20% or more from the VA, and apply for the Vocational Rehabilitation and Employment (VR&E) VetSuccess program.

Disabled Veterans are eligible if they have received a discharge that is other than dishonorable, have a service-connected disability rating of at least 10%, or a memorandum rating of 20% or more from the Department of Veteran Affairs (VA), and have applied for the Vocational Rehabilitation and Employment (VR&E) VetSuccess program

Whether you are Active Duty or a veteran, you need to know that that this is NOT an automatic benefit. You need to take steps to get the benefit – you need to APPLY for it!

Period of Eligibility

You have 12 years to use your VR&E VetSuccess services, starting from your date of separation from active military service, or the date you’re notified by the VA with your service-connected disability rating. You can get the period of eligibility extended if a Vocational Rehabilitation Counselor (VRC) determines that you have a serious employment handicap.

 Eligibility VS Entitlement!!!!

We've all been in the military so you know that being eligible and being entitled (and actually RECEIVING) benefits are two different things. You're going to have to jump through some hoops. The first hoop is meeting with a Vocational Rehabilitation Counselor (VRC) for a comprehensive evaluation to determine if you’re entitled to services. The evaluation includes:

• Assessment of your interests, aptitudes, and abilities
• Assessment of whether service connected disabilities impair your ability to find or hold a job using the occupational skills you’ve developed
• Vocational exploration and goal development leading to employment or maximum independence at home and in your community.

What does all that mean? You have to prove that you’re disabled, and that you know what you want to do with your vocational rehabilitation. 

Entitlement Determination

The second hoop is the entitlement determination. The entitlement determination is where the VA counselor determines whether or not you have an employment handicap. You have an employment handicap if your service related disability impairs your ability to get or keep a job.

REMEMBER

Now, if you disability rating is under 20%, or if your 12 year period of eligibility expired, then you’ll need to qualify for a serious employment handicap.

Email: ccutts@cjhelpsvets.com
Twitter: @cjhelpsvets
LinkedIn: Cj Cutts

PTSD and Holidays

For you or anyone else spending time with family and friends over the holidays can be fun, but the flurry of festivities can also add stress. This is particularly true for someone with Posttraumatic Stress Disorder (PTSD).

If you or a family member has PTSD, it does not have to negatively impact the holidays. There are healthy ways to cope and manage stress.

Here are a list of tips that can help you manage your PTSD symptoms over this holiday season:

• Make a list of your favorite coping tools that you can use for different types of situations. Keep them on hand, in the event something triggers you.
• Bring stress management tools with you wherever you go with online tools and apps such as PTSD Coach and Mindfulness Coach.
• Create a playlist of music that you can listen to when you are stressed.
• Make a folder of favorite photos. Look through them to take your mind off what is stressing you.
• Write a list of the reasons you want to change your habits or reactions. They help motivate you.
• Set time limits for activities that are difficult for you.
• Reward yourself for your hard work with a healthy activity.
• Reach out for support if you need it. Know who you can rely on for help. If your symptoms of PTSD are getting worse or you feel down, reach out to your provider or call the crisis line.

If you know someone with PTSD, there are things you can do to make sure the holiday season is pleasant and enjoyable for everyone:

• Educate yourself: Read about PTSD Symptoms, and how PTSD affects your loved one.
• Talk to your family member about what they need to feel comfortable during the holidays. If your loved one needs services, call Coaching into Care for advice in talking to them about treatment.
• Keep important resources at hand, such as the Veterans Crisis Line, a confidential toll-free hotline, online chat, or text. Veterans and their loved ones can call 1-800-273-8255 and Press 1, chat online, or send a text message to 838255 to receive confidential support 24 hours a day, 7 days a week, 365 days a year.

For more advice or tips on dealing with PTSD or any other veteran issues I can be reached

Email: ccutts@cjhelpsvets.com
Twitter: @cjhelpsvets
LinkedIn: Cj Cutts