Gulf War Veteran Struggles to Get VA Benefits after Failed VA health care

Written by Edward Marshall, Staff Writer, The [Harper's Ferry, W.V.] Journal

Disabled Gulf War veteran Philippe C. Cote sits recently with his daughter Anna at his side. The medications he takes daily for chronic pain resulting from a 1991 spinal injury sit in front of him. (Journal photo by Edward Marshall)

(HARPERS FERRY, W. Virginia - Sunday, August 2, 2009) - "It's almost like a war."

That's how local disabled U.S. Navy and Gulf War veteran Philippe C. Cote described his more than 16-year struggle with a spinal injury and the seemingly unending bureaucratic red tape he has faced while seeking treatment and disability benefits.

Cote, who graduated at the top of his class and who was awarded a National Defense Medal for his service, suffered a 20-foot fall onto concrete in 1991. He received an honorable medical discharge and in 1993 was given a 50 percent service-connected disability rating.

Over the years, his condition steadily grew worse, he said, as did the constant pain. More than a decade after the accident, he finally would seek help from the Virginia Spine Institute after he said Veterans Affairs Medical Center treatment failed to work. To his shock, he said his new doctor would tell him he had broken several small bones in his back and needed immediate surgery.

Cote blames what he says is the negligence of doctors within the VA for failing to realize the severity of the injury.

"If this is happening to me and this is happening to other veterans, what do you think is happening to the guys and girls coming back from Iraq and Afghanistan?" Cote asked. "The VA's medical care and their practices are exactly what this country is in for if we pass this nationalized health care system."

Today, Cote, who is married with a five-year-old daughter, is unable to walk without the use of a cane, suffers from permanent nerve damage and constant muscle spasms. The simple act of drinking coffee now requires that he use a large glass measuring cup for a container, because spasms have caused him to break nearly every coffee mug in his home.

Unable to work, he was fired from his job in 2007, losing his health insurance and nearly his home. He once made a six-figure salary in the private sector. Now he is forced to subsist on food stamps and about $900 a month in benefits while trying to take care of his family.

"I want to set the record straight. I am no war hero. I am not a purple heart (recipient), but I served my country," Cote said.

Finally, some answers

Since the fall that injured his spine, Cote has been in and out of VA Medical Centers in Washington, Martinsburg, Dallas and Fort Worth for his back pain and muscle seizures.

In December 1994, he moved to Jefferson County and shortly afterwards began treatment at the outpatient facility at the VA Medical Center in Martinsburg. As the years progressed, Cote said VA doctors told him they didn't see any reason for him to be in so much pain.

"Then it turned into 'Well, we're concerned about the fact that you are always wanting pain killers' and this and that," Cote said. "The whole issue ended up being turned around on me with the insinuation that I was just there for pain medication."

Earlier this week, The Journal contacted Barbara Corbin, public affairs officer for the VAMC in Martinsburg, seeking comment about Cote's claims. Corbin said she could not comment about a patient's medical history unless the patient had signed a release form.

In 2007, Cote sought help from the Virginia Spine Institute in Reston, Va., where doctors ordered a nerve test and an MRI. When images from the tests came back, Cote said he was told that he had broken several small bones in two vertebrae. He also discovered he had a fused joint at the bottom of his spine and permanent nerve damage.

"(My doctor) goes through the image, looks at me, turns around and says, 'When did you break your back?'" Cote said. "He looked up in amazement. He said 'How are you even walking around?' I said, 'Because I have to. I have a family to feed.'"

The diagnosis came from Dr. Thomas Schueller, the founder of the Spine Institute. Cote was immediately scheduled for surgery a week later in June 2007. The surgery would take four hours longer than expected, because of the amount of scar tissue that had accumulated.

"I slipped 11 millimeters," Cote said of his spinal injury. "(Schueller) said he'd never seen anything like it in his life."

In November 2007, Cote lost his job and his insurance, which forced him to discontinue any further surgeries on his spine. He continues to see a pain management specialist at the Spine Institute on a bi-monthly basis, though he pays for his medication out of pocket.

Hopes dashed

Cote said in the beginning of 2008, he felt optimistic that with continued home therapy, he would eventually be able to return to work, but that hasn't been the case.

He then decided to file a claim with the VA to have his disability status re-evaluated. He also filed a claim for dependent benefits.

The paperwork was sent at the end of May 2008, and Cote received a response from the VA in February, which increased his disability rating to 60 percent. That was despite the fact, Cote said, that he believes he is entitled to 100 percent disability and that his physician has stated he is unable to work.

Cote said the response didn't include dependent status or benefits for his family.

"I was counting on the 100 percent, and I was counting on the fact that I was entitled to my benefits for my child," Cote said.

Once Cote realized that the fight for his disability benefits was going to continue, he contacted the law firm of Binder & Binder to represent him while he filed for disability benefits with the Social Security Administration.

Cote officially filed for Social Security benefits in December 2008. His claim was denied in April, and Cote said it was denied because he was told he was too young to be disabled. He is appealing the decision.

Dan Moraski, public affairs specialist with Social Security Administration's press office, refuted that claim, stating the agency provides benefits to disabled individuals as young as 18 years old who, in some cases, have only worked for a year or a year-and-a-half.

"We don't deny people for being too young," he said.

Instead, it appears, Cote's claim likely was rejected because of his 60 percent disability status. Moraski said benefits only are provided to those who either have a medical condition that is so severe they are unable to work or those who have a terminal illness and are not expected to live long.

"We don't provide for partial disabilities," he said.

Brick walls

In July, Cote contacted the office of U.S Rep. Shelly Moore Capito, R-W.Va., for help.

"In cases like this, where a constituent is facing challenges in their interactions with a federal agency, the congresswoman's office can serve as a liaison to help constituents navigate the federal bureaucracy," Jonathan Coffin, Capito's press secretary, said. "In this case, we've made an inquiry to the VA on behalf of Mr. Cote. We're still awaiting the response from VA officials, but we'll continue to work with him and monitor his case as it moves forward."

Cote's monthly income is still $974 and his wife has been unable to find work.

His mortgage payment on his house was $850, but he filed a hardship claim with Wells Fargo. A loan modification has adjusted his interest rate, and he now pays about $364 a month.

His prescriptions cost about $250 a month.

Cote has filed with the Department of Health and Human Resources in Charles Town for Medicare and Medicaid coverage for his family, though only his daughter was granted coverage. He now receives $517 a month in food stamps.

"I'm to the point where I don't know what to do anymore," Cote said. "I can understand why people are driven to such extremes, because you are just running up against a brick wall to get what is rightfully yours."

-Staff writer Edward Marshall can be reached at (304) 263-8931, ext. 182, or emarshall@journal-news.net