More Tampa Bay veterans get emergency room claims denied

10News found more and more veterans are getting stuck with emergency room bills they believe the VA should cover.

ST. PETERSBURG, Fla. --Gerry Malwitz was drafted by the U.S. Army when the Berlin Wall was built. After serving his country as a medic in Germany in the early 1960s, he thought his medical bills would be taken care of but now he's getting turned down.

“It’s not right,” Malwitz said.

He’s one of the thousands in the United States. In a single year, the Department of Veterans Affairs denied 98,000 emergency room claims, according to a VA undersecretary.

For Malwitz, it all started when his catheter got plugged last year.

“I was half crazy with the pain,” he said. “I was moaning and groaning.”

The VA requires veterans to seek medical attention at their approved hospitals, but it was 8 p.m. and Malwitz was 140 miles away from the nearest VA hospital.

“And I needed help now! I mean it hurt,” he said. “My heart attack was nothing compared to that urinary retention.”

So his wife took him to the emergency room. The VA does cover the cost of visiting an outside hospital without prior authorization but only in case of an emergency.

“The doctor said urinary retention hurts as bad as a woman having a baby. I'm not a woman but I told the doctor the pain I had was as tough as if I had triplets,” he said.

In the letters he received after filing his claim, the VA tells Malwitz what he had was not a true emergency.

“Treatment provided does not meet the prudent layperson definition of an emergency,” Malwitz said as he read the letter of denial.

Here's what that means according to the VA: when someone with an "average knowledge" of health believes "failure to obtain immediate medical care could result in placing the patient's health in serious jeopardy.”

Malwitz says he gets it.

“I know what an emergency is, it isn't because you got a hangnail on your big toe,” he said.

If there's any doubt that what he had was an emergency, Malwitz says he read the U.S. Department of Health definition of urinary retention as a 'potentially life-threatening medical condition (that) requires immediate emergency treatment.'

Now, he's stuck with the bill and calls from debt collectors. He fears his excellent credit is at risk.

“I don't want it destroyed by this type of garbage,” Malwitz said.

Instead of enjoying his retirement, Malwitz is spending his time on the phone trying to get the VA to reconsider its decision.

“Hours, hours,” Malwitz said getting emotional. “I wake up in the night and think of this.”

He appealed and a spokesperson for the VA at Bay Pines said they’re working with Malwitz to address his billing concerns.

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