Responses-VA limits on check socket
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Title:
Responses-VA limits on check socket
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Original post
Our local VA director has informed me that the VA policy is that only one
check socket will be approved for all prosthetic patients. I recently
treated 3 AK full suction patients; 2 required 2 check sockets and 1
required 3. When the VA denied all but 1 check socket, I called and
explained the
need for more than 1 check socket at times especially when dealing with full
suction sockets and difficult to fit patients. I was told that this is the
VA national policy. Does anyone have any input on this??
Thank You
David Falk CPO
Responses
#1 Yes. Stay away from the VA or go broke!!
#2 David,
I will check on it from this end. I am a VA prosthetist-(at the moment)
It sounds absurd to think only one check socket is authorized...but then
again the VA can BE absurd. I will forward your email to my supervisor and
see what he can find out.
#3 I attended a VA clinic where no BK check sockets were covered-thanks to a
CP's suggestion to the physiatrist. It was obviously his way of getting
some recognition from the Dr.-with total disregard to future reimbursement,
etc. Sorry, I can't really comment on AK's, but I'm not too surprised.
#4 Dave: My only input is to affirm that your expectation of two to three
test
sockets being the norm for suction AKs is reasonable. I find the same to be
true
in my experience.
#5 Dear Dave,
I have many problems with the VA. Only recently I began asking my patients
to raise their concerns with their local congressmen. If enough voices are
heard then maybe some action will be taken. I too have received the same
warning regarding check sockets. Fortunately, By utilizing the Hanger comfort
flex system I can usually provide an optimum fit with only one fitting. They
don't pay for algination, and they usually give me a hard time when I try to
bill total contact. They need to open a panel discussion with professional
practitioners to address these issues.
If I can be of further assistance feel free to contact me.
#6 Here in Phoenix they do not approve check sockets at all. Count your
blessings you don't practice here.
#7 At the Gainesville, FL. VA Center it is very difficult to get one check
socket authorized.
#8 I have had to work within the restrictions of the one test socket
policy for at least the last five years at the San Antonio VA clinic. I
have tried, in vain, to explain there are some cases that require more
than one test socket, and that it would be more cost effective in the
long term. I might as well talk to a wall for all the good it has done.
#9 david,
that is why i (an a/k amputee) have been making my own sockets in my garage.
i am a difficult case, because the VA won't approve more than one check
socket, i have always had fit problems. so i had to start making my own. now,
when i have a few problems, i just re-adjust the socket and later remake it.
i try not to go to the VA, except when i want to upgrade the technology
part. then when i get the new leg if i have problems i just remake the socket
and try to have as little to do with the VA as possible.
#10 Yes !
I'd love to talk to you in more detail and at greater length on this issue.
You might consider enlisting the patient to write (I repeat - write) a
letter detailing your ability to achieve a level of comfort, stability, and
function that heretofore was not achieved. That one of the reasons is the
use of additional diagnostic sockets to improve the socket fit. I have
coined the term, Step-Wise-Refinement to indicate the improvement that is
possible with additional diagnostic sockets. When modifying the first
socket to the maximum does not generate/achieve optimum/acceptable comfort,
stability, and function, the first socket is cast - to capture the
corrective improvements to date - followed by additional model modification
to further improve the comfort and stability. This ssecond diagnostic
socket is fit, biomechanically aligned, and refined further to achieve a
higher degree possible than with only the one socket. The patient is more
comfortable, stable, and therefore more functional. This results in a much
higher quality of life than possible with one socket, and, returns the
Veteran to a higher quality of life - Which is what the VA's mission is!
#11 Do not do VA work, I have not done any of there work since 1988. If they
want cheap work then I need to it my way. They can't buy my services, and I
been asked.
#12 Post the compiled message and I will try to forward it to the internal VA
list serve.
I really think the VA needs to be shaken up. It is run primarily by
bureaucrats that haven't a clue about the realities involved.
Our local VA director has informed me that the VA policy is that only one
check socket will be approved for all prosthetic patients. I recently
treated 3 AK full suction patients; 2 required 2 check sockets and 1
required 3. When the VA denied all but 1 check socket, I called and
explained the
need for more than 1 check socket at times especially when dealing with full
suction sockets and difficult to fit patients. I was told that this is the
VA national policy. Does anyone have any input on this??
Thank You
David Falk CPO
Responses
#1 Yes. Stay away from the VA or go broke!!
#2 David,
I will check on it from this end. I am a VA prosthetist-(at the moment)
It sounds absurd to think only one check socket is authorized...but then
again the VA can BE absurd. I will forward your email to my supervisor and
see what he can find out.
#3 I attended a VA clinic where no BK check sockets were covered-thanks to a
CP's suggestion to the physiatrist. It was obviously his way of getting
some recognition from the Dr.-with total disregard to future reimbursement,
etc. Sorry, I can't really comment on AK's, but I'm not too surprised.
#4 Dave: My only input is to affirm that your expectation of two to three
test
sockets being the norm for suction AKs is reasonable. I find the same to be
true
in my experience.
#5 Dear Dave,
I have many problems with the VA. Only recently I began asking my patients
to raise their concerns with their local congressmen. If enough voices are
heard then maybe some action will be taken. I too have received the same
warning regarding check sockets. Fortunately, By utilizing the Hanger comfort
flex system I can usually provide an optimum fit with only one fitting. They
don't pay for algination, and they usually give me a hard time when I try to
bill total contact. They need to open a panel discussion with professional
practitioners to address these issues.
If I can be of further assistance feel free to contact me.
#6 Here in Phoenix they do not approve check sockets at all. Count your
blessings you don't practice here.
#7 At the Gainesville, FL. VA Center it is very difficult to get one check
socket authorized.
#8 I have had to work within the restrictions of the one test socket
policy for at least the last five years at the San Antonio VA clinic. I
have tried, in vain, to explain there are some cases that require more
than one test socket, and that it would be more cost effective in the
long term. I might as well talk to a wall for all the good it has done.
#9 david,
that is why i (an a/k amputee) have been making my own sockets in my garage.
i am a difficult case, because the VA won't approve more than one check
socket, i have always had fit problems. so i had to start making my own. now,
when i have a few problems, i just re-adjust the socket and later remake it.
i try not to go to the VA, except when i want to upgrade the technology
part. then when i get the new leg if i have problems i just remake the socket
and try to have as little to do with the VA as possible.
#10 Yes !
I'd love to talk to you in more detail and at greater length on this issue.
You might consider enlisting the patient to write (I repeat - write) a
letter detailing your ability to achieve a level of comfort, stability, and
function that heretofore was not achieved. That one of the reasons is the
use of additional diagnostic sockets to improve the socket fit. I have
coined the term, Step-Wise-Refinement to indicate the improvement that is
possible with additional diagnostic sockets. When modifying the first
socket to the maximum does not generate/achieve optimum/acceptable comfort,
stability, and function, the first socket is cast - to capture the
corrective improvements to date - followed by additional model modification
to further improve the comfort and stability. This ssecond diagnostic
socket is fit, biomechanically aligned, and refined further to achieve a
higher degree possible than with only the one socket. The patient is more
comfortable, stable, and therefore more functional. This results in a much
higher quality of life than possible with one socket, and, returns the
Veteran to a higher quality of life - Which is what the VA's mission is!
#11 Do not do VA work, I have not done any of there work since 1988. If they
want cheap work then I need to it my way. They can't buy my services, and I
been asked.
#12 Post the compiled message and I will try to forward it to the internal VA
list serve.
I really think the VA needs to be shaken up. It is run primarily by
bureaucrats that haven't a clue about the realities involved.
Citation
“Responses-VA limits on check socket,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 23, 2024, https://library.drfop.org/items/show/215968.
