For veterans who need things like wheelchairs, walkers, and artificial limbs, getting them from the Department of Veterans Affairs can be a difficult, lengthy process. According to the agency’s own numbers, thousands have waited longer than 30 days for their requests to be fulfilled.
Nearly 3.4 million veterans received approximately 21 million prosthetic devices, sensory aids, items, and services from the VA in 2017. The department receives, on average, 657,000 new requests each month for prosthetic items and medical devices.
A VA spokesperson said the agency’s goal is to review and fulfill requests as soon as possible, ideally within 30 days. The department now processes them within five days on average nationwide.
But the VA reports that about 8,500 equipment requests across its system have waited longer than 30 days. More than 2,500 have been pending for two months or more. The VA says it's improved its processes and cut down on delays. But some patients, like 24-year-old Navy veteran Whitney Hardin, still await medical devices and equipment.
Last year, Hardin was diagnosed with Rasmussen’s encephalitis, a rare neurological disorder that inflames her brain and causes near-constant seizures. Doctors later concluded that the condition was related to injections she got when joining the Navy in 2011.
Hardin recently underwent her third brain surgery to relieve the symptoms. While it helped manage the seizures, it limited her mobility. She now relies on a host of assistive technologies, including a wheelchair, ramps, shower modifications, a leg brace, and a specialized walker.
“The walker is a huge part of my rehab,” Hardin said. “It helps me start to be able to get more mobilization on my own around the house and out and about — anywhere that I can — outside of therapy."
Getting the walker wasn’t easy. Hardin’s doctor ordered it from the VA in April, right after she began outpatient rehabilitation. But the VA had trouble getting one of the parts and couldn’t immediately fill the order.
"All they said was: 'We have it on order for you,’ ” Hardin said. “But I'm just kind of used to it — I guess, at this point — to know that I'm just going to have to wait.”
As of mid-October, the VA still had not come through with the equipment. Hardin ended up getting the same walker from Project Mend, a San Antonio-based nonprofit group that refurbishes medical equipment and offers it to people at a cost saving. In 2017, it served nearly 400 veterans and expects to serve upwards of 500 this year. Fulfilling Hardin’s walker order took just a few days.
According to Project Mend CEO Cathy Valdez, veteran clients sometimes face delays at the VA.
“When the veteran comes to us, oftentimes the story that we hear is that the veteran might be eligible to receive, for example, a scooter or a wheelchair from the VA,” she said. “But they're gonna have to wait to be able to get that — maybe a month. Two. Three. And they need that right away. They don't need to wait— or maybe can't wait that long.”
The Process Behind Prosthetics
Fred Downs, a prosthetics consultant with Paralyzed Veterans of America, said lengthy delays in fulfilling about 8,500 medical equipment requests is cause for concern.
"I'm not comfortable with that number,” he said. “I need to know more facts. What’s it composed of? What type of orders?”
Downs was the national director of the VA’s prosthetic and sensory aids service for 30 years and has also worked with the department’s procurement and logistics arm. He said there are legitimate reasons why some cases drag on. Equipment might require special fabrication, multiple fittings, or coordination with outside vendors.
But according to Downs, complex cases are one thing while bureaucratic obstacles are another. He said he isn’t sure which category the VA delays fall into.
As it turns out, VA isn’t either.
Downs said the department is still analyzing the data.
"The thing that we all worry about are those cases where a veteran needs a wheelchair. It's prescribed. And so the veteran goes home and doesn't hear anything from the VA,” he said. “This is where we hear a lot of problems. Like, 'Well what happened to it? He's still sitting home after two, three, four months and it's not there.’ What the heck? Somebody’s dropped the ball big time.”
A History of Delays
Last year the VA Inspector general found a host of problems with the way some medical centers were handling prosthetics cases. Understaffing, lack of accountability, and issues with logistics and warehousing often played a role.
VA Secretary Robert Wilkie said that this year’s numbers actually represent a marked improvement.
“Across the country, last year, 64,000 prosthetic requests were 30 days old or older. We've now gotten that down to 8,500,” he said.
Since then, the department has changed some of its processes. They've made it easier to track equipment requests and are holding medical center directors more accountable for fulfilling them. The agency is now trying to determine how many delayed requests are acceptable.
Wilkie said he’s proud of the VA’s progress so far.
“That is certainly a case where we have moved out, and it shows America that the department does have the potential for agility and adaptability,” he said.
Back in Texas, veteran Whitney Hardin continues to adapt as well. She’s made strides with her rehab and mastered the track at her physical therapy center.
“I'm doing 336 feet twice,” she said. “Two laps — on the walker.”
Hardin believes there’s a chance her VA walker will still come in. If it does, she plans to donate the one she’s using now to Project Mend so that it might help someone else.
This story was produced by the American Homefront Project, a public media collaboration that reports on American military life and veterans. Funding comes from the Corporation for Public Broadcasting.
Carson Frame can be reached at firstname.lastname@example.org or on Twitter @carson_frame