I was recently seen by my VAMC Emergency Department for chest pain radiating to my neck and left side. I received excellent care, including a sense of resolve by the emergency physician to find the root cause, since the pain has become chronic and is not a cardiac problem. I am pleased that my primary care physician shares her enthusiasm for pursuing this problem until an accurate diagnosis that explains the root cause is found (my former PCP did not share this view - he was more "technician" than "scientist").
Since the emergency visit occurred on a weekend, I waited a week until my next scheduled appointment to request travel reimbursement for both the appointment and the emergency visit. The VA employee who prints out the travel reimbursement vouchers did not give me one for the ER visit, citing a memo that had been posted last year stating that travel for emergency room visits would no longer be reimbursed. She didn't even provide me with a copy of the memo, much less any information on my due process rights for challenging her refusal to provide me with a reimbursement form, and she looked at me as though I had three heads when I asked about the legal basis for the change to my previous travel reimbursement entitlement.
The Patient Advocate was unaware of the change in reimbursement but understood my request for the legal basis. He said that he would find the answer and contact me,but he has not yet done so.
To provide transparency in VA decisions and actions, I believe that all VHA publications, from the local through the national level, right down to memos announcing changes to clinic hours, should include a statement of the legal authority for the information contained in the publication, as well as guidance on exercising due process rights if the reader is harmed by or otherwise wishes to challenge the contents of the publication.
In addition, if the legal basis is something other than Federal law or Executive Order (such as agency policy or local-level discretion), the citation should be considered incomplete until it traces its legal authority back to the Federal law that grants such discretion to the VA.