OCS injury -- minor surgery needed

Discussion in 'ROTC' started by Sampia, Aug 18, 2015.

  1. Sampia

    Sampia Member

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    My DS ended up with an umbilical hernia (documented) during OCS. He was told there that the military will cover the cost. His unit advised him to bring in all the medical records for his file and the bills. I try to let my DS handle his own affairs but he doesn't ask good questions sometimes. Our insurance is not good. High deductible and co-pays. My finances are tight right now and most docs/surgeons want office fees paid at the time of the visit. I doubt surgeons come cheap. Now that he is legally an adult, I don't want to risk medical bills hurting his credit.

    So, I suppose my question is, should I be contacting the VA hospital about this? I would rather not. Has anyone else had a similar situation? Feeling a bit lost here. And I am a nurse! I could use advice on how to proceed.

    Also, will having this cause any issues when he is ready to commission and head off to TBS? I can't imagine why it would but I am not the military.
     
    Last edited: Aug 18, 2015
  2. kinnem

    kinnem Moderator

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    In my experience, hospitals and surgeons do not get paid until post surgery. You may or may not need to do a co-pay on office visits.

    That being said, I would see if you can get documentation that Navy will pay for this. I don't think you want to be presenting your own insurance card, etc. as I've no doubt they will then contact your insurance company for their payment, just because that's how the system works. There are threads where people present their insurance for DoDMERB physicals and end up paying when Navy should be paying. Heck of an effort to straighten it out based on my reading.

    You might need to have DS hold cadre's toes to the fire on how to go about addressing this. Someone, somewhere has experience with this. Make them find that person.

    Of course, I can talk a big story, but....

    When does DS head back to school? Too soon for you, I'm sure.
     
  3. k2rider

    k2rider Member

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    I have no idea how the system works but I'd be asking if you can have it done at a Naval Hospital for starters.

    I can tell you I had the same surgery and wasn't supposed to lift over 10 lbs for (6) weeks so I'm sure any PT at all is out.
     
  4. USMCGrunt

    USMCGrunt Member

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    I would recommend he discuss with his MOI at the ROTC unit.
     
  5. Sampia

    Sampia Member

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    DS is leaving this weekend, 2 weeks before school starts and 1 week before he helps with orientation for incoming MIDN. I think he is not quite sure what to do with himself now that the intensity of OCS is done. His buddies are moving back early as well. I guess I will need to write a list of questions for him to ask and make him approach them again about the steps to get the surgery covered.
     
  6. USMCGrunt

    USMCGrunt Member

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    Years ago, my DS rolled his ankle badly during morning PT. He went to the school's clinic and got xrays and treatment. I remember lots of hassles around payment (the clinic) was not under my insurance coverage, etc. We never expected anyone else to pay but I remember lots of inquiries regarding "work place related injury," etc. My point, is that if you have the luxury of time you should sort out who will pay and how it will be covered. In our case we paid out of pocket but perhaps it could have been handled differently. Fortunately, we never had another incident like that but we had basically instructed our son that if it wasn't a life or death situation go to an in-network provider!
     
  7. NavyHoops

    NavyHoops Moderator

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    Sampia, sorry to hear about your son. Will send you a PM shortly.

    I did a search as I know this topic came up before. This one sort of touches on it:

    http://www.serviceacademyforums.com...to-an-injured-rotc-student.39164/#post-384229

    Bull might be a good resource on he navigated the system. Clarkson also might be a good one as I am sure he has had to navigate Cadets through something similar in the past. I remember there being an old thread about a I believe a young female AFROTC Cadet getting hurt at training and needing surgery. Couldn't find the link.
     
  8. CAP

    CAP Member

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    During my DD's first FTX, last fall, she injured her knee. Injuries that occur during a ROTC activity are covered under Federal Workman's Comp. We had a hassle on getting reimbursed after we ended up paying the hospital bills ourselves after she was receiving notices from collection agencies, the Feds didn't pay on time. Our personal medical insurance would't touch it either because of the Workman's Comp classification. We then ended up paying for an MRI out of our pocket because they were dragging their feet and wanted to treat her with physical therapy first, forcing her on PT restrictions. We ended up paying for it so a diagnoses can be determined so she can get off of PT restrictions as soon as possible..
     
    Last edited: Aug 19, 2015
  9. sheriff3

    sheriff3 Member

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    Somewhere deep in the bowels for the forum I believe it was Clarkson that said" If we break you , we will fix you". I would reach out to Clarkson or 'bama for help. Good luck.
     
  10. Sampia

    Sampia Member

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    He was told at OCS that he will be covered as he was considered "activity duty" while there so I would assume it would be insurance covering it and not workmans comp. I don't want unpaid or late medical bills going on his credit report just when he is starting his life as an adult. There is a VA hospital in the same town as the NROTC. Maybe it will be done there. He has assured me he will discuss it further when he returns and I will stay on top of it, from the outside if possible. Thanks for the tip on who to contact within this forum world. :) Also for the links, NavyHoops
     
  11. NavyHoops

    NavyHoops Moderator

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    Then the Military's version of health insurance called Tricare would cover it. VA wouldn't be the place. They would have him do it at a base, since it sounds like he is far from one, they will give home a list of Tricare providers that he can use. This list could be very short.
     
  12. fencersmother

    fencersmother Founding Member

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    I might check with my own insurance to see if your son, who was injured at OCS, will actually be covered under your own private insurance. Our insurance said that once a kid went to ROTC/OCS/any military service, s/he was no longer eligible nor insurable under our plan.
     
  13. -Bull-

    -Bull- Member

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    I would double check with someone in the know to see if he could actually be covered by Tricare. I'm not saying he wouldn't/shouldn't be, but ROTC cadets don't register with Tricare when they contract. Yes, they have access to military medical facilities during training, and when at school covered by Fed Workmans Comp, but it would suck to start scheduling appointments and find out he's not in the Tricare system. Also, he may be under a different Tricare option than the standard AD servicemember. Hopefully that's not the case. I also recommend checking because many cadre members aren't exactly sure where cadets fall in some gray areas. I was injured during AROTC and required surgery, it took a couple people to make a couple calls to figure out exactly how to make that happen. It's not their fault, they never deal with that stuff outside of ROTC. I, however, was injured at school and got everything covered through Workmans Comp. It can be an annoying process, but worth it.
     
  14. Pima

    Pima Parent

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    That is very interesting. ROTC is not like OCS or any military service. Most cadets/mids (@80%) are not scholarship, their ROTC class is seen as an elective at most colleges.
    I get it maybe after they become a POC, but not while they are a GMC.

    Our DS was under our tri-care program, even as an AFROTC scholarship cadet until he commissioned. They did not see him differently than our DD and DS2. Just show enrollment. This was also true when Bullet was a defense contractor with Aetna.
    ~ Just saying that the military insurance company does not see ROTC cadets/mids as military members. They see them as dependent children in college in ROTC>

    I think you are right to state check, because if they said to me he is in ROTC and must be cut from my insurance, I would throw up the BS flag! ROTC cadets as Bull stated or not typically covered by Tri-Care.

    Here is the caveat for the OP. If injured while training over the summer, than he should be covered by tri-care... at least that is what we were told. Hence, the reason they are asking for the bills. Yet, they are in a gray area from what I am reading here. They do not state if they were diagnosed/treated while at OCS, or they suffered through it, came back home and now their personal doc diagnosed the hernia.

    My own advice is this, and than throw it in the circular filing cabinet.
    1. Make copies of everything.
    ~ They have a habit of losing things.
    2. Expect to pay something if you do not follow to the letter T every direction.
    ~ They may say that he needs to go to Doc Smith, but since you already have the diagnosis from Doc Jones, you submit Doc Jones. They can deny payment to Doc Jones.
    3. Do not contact the VA. They will shut you out. Your DS is over the age of 18 and due to HIPA they cannot discuss anything with you.
    ~ I am sorry this is happening, but I think you need to seriously say to him he needs to attack this day 1 because you cannot afford to pay out of pocket for an injury that occurred on their watch.
    ~ As sad as this is to read, I would not think he should rely on the VA hospital. The backlog is still insane at most VAs. Bullet has been retired for 6 years, 10% disability, and he has never been to a VA since his out processing from the AF. The reason why is the wait time for appointments. Heck, none of our friends use the VA, they use their Tri-Care and bite the bullet for co-pay.
    4. I am with CAP. I think this will be treated like Workmen's comp.
    5. What is his career field that he wants? When will he meet that board?
    ~ IE rated than he needs to get this done ASAP. He will need to pass a different physical than the traditional DoDMERB. The healing time can impact his options. DoDMERB can look at it as he can serve in the Navy. The Navy wanting that FAA FC1 can say he can't go rate, but still serve.

    I wish you all the best. I hope it works out well. That being said, it really is now up to him to get on top of it. It is up to him to say, my folks can't afford the surgery, you guys caused it, and I need it done asap. If he decides to drop the ball, than it is his call. In a year or two, he will commission, this will be his life. He will have to fight for his future.

    Not trying to be offensive. I am just saying, he has to fight now on his own two feet, because I am pretty sure you have had the insurance conversation. If he doesn't than I think you have a bigger conversation in your future about the 4 years he will owe upon commissioning.
     
  15. Sampia

    Sampia Member

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    Thanks for the tips. Probably it's a matter of him just asking the right question of the right person. I know he was not the only one injured. He mentioned someone in his platoon broke his ankle. Injuries probably aren't all that uncommon at OCS, tough as it is. I directed him to contact the secretary at his unit. Hopefully she will be knowledgeable since she has been doing this awhile. From there, he can go up the chain of command. My concern is just getting it done ASAP before he makes it worse and so he has enough healing time before TBS (which could be up to a year down the road).
     
  16. Pima

    Pima Parent

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    Off topic, but I am confused about the term OCS. OCS in the AF world means that they graduated college and now are going through the OCS process for commissioning. Complete OCS in the AF and you are an O1. However, it appears to me that they do OCS, even as an NROTC mid.

    Can you just clarify for me how the OCS program works for NROTC mids? Is it a make or break during NROTC, like SFT is for AFROTC? Is this a true OCS program? IE...my kid decides not to do ROTC in college, graduates and goes to OCS for his commissioning source.

    Not trying to ruffle feathers, just trying to understand what you mean by OCS.
     
  17. NavyHoops

    NavyHoops Moderator

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    Yes Pima MO NROTC Midshipmen attend OCS. It is a requirement to commission. Yes, it is a true OCS program. They run different lengths of OCS at Quantico depending on if they are NROTC, MECEP, PLC, ECP or regular folks coming in after school called OCC. Yes, that means everyone, but USNA Mids attend OCS. It is a real deal OCS with USMC Drill Instructors. They do evaluate officers for leadership and it is extremely PT intensive. It is why PT is such a huge deal in ROTC as it specifically has an impact on readiness for OCS. Folks can be removed from OCS for failing in leadership or PT. Those who get hurt can be rolled. It must be completed prior to commissioning, so some have to come back to complete after their senior year then will get commissioned. My buddy's DI was my SNCOIC at my first duty station, it was actually kind of funny when they discovered it. Below is a list of the USMC OCS programs.... think I covered them all (fix me Grunt or kinnem if I messed them up):

    OCC - They do a 10 week course for either grads or college seniors not in PLC.
    PLC - Can either do 1 10 week course with OCC or do 2 6 week courses over 2 summers. This is for kids with more than 1 year left. So you will often hear PLC folks refer to attending Juniors or Seniors if they do 2 summers.
    MO NROTC - This is what you will hear called the Bulldog program and it only runs in the summer (they plus up staff) that is 6 weeks and is between Junior and Senior year
    MECEP - These are the enlisted Marines chosen to attend 4 year universities. They attend a 10 week program between their first and second year or prior to attending school (can't remember and it might have changed... someone chime in here if I am wrong). I believe they are combined with OCC classes
    ECP - Is the smallest of all programs is for enlisted with 4 year degrees to become officers. They attend a 10 week OCS class. Usually a few dozen at the most come from this path.
     
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  18. Sampia

    Sampia Member

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    It is indeed a make or break deal. All who completed the course were given the title of Marine but don't have any rank until they complete college and commission. (Not positive on that, but is how I understood it) As with all branches, I assume, the purpose is to weed out those that don't stand up to their requirements. All NROTC -MO must attend the 6 week program in order to continue with their senior year. If they get sent home, such as poor leadership, poor physical readiness, failing any of the testing areas (academics etc) or injury, they may or may not be allowed to return. If not, they are out of the NROTC program. I do believe that if they are booted from OCS for any reason other than health issues (injury, etc) that they have to repay all the money, but I am not sure on that.
     
  19. NavyHoops

    NavyHoops Moderator

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    Sampia, that is what I was led to believe also on repayment.
     
  20. USMCDad

    USMCDad Member

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    NavyHoops...you're close...minor tweaks below in [brackets]....and I know we've wandered far afield of the OP question...

    OCC - They do a 10 week course for either grads or college seniors not in PLC. [correct]
    PLC - Can either do 1 10 week course with OCC or do 2 6 week courses over 2 summers. This is for kids with more than 1 year left. So you will often hear PLC folks refer to attending Juniors or Seniors if they do 2 summers. [correct]
    MO NROTC - This is what you will hear called the Bulldog program and it only runs in the summer (they plus up staff) that is 6 weeks and is between Junior and Senior year [mostly correct; the Bulldog name is a carry over from a fairly short lived program from when I think Jim Webb was SecNav...for a couple of years they made USNA MO attend 6-weeks at Quantico too...just like everyone else. It ended for a number of reasons. Now USNA Mids that want to be selected for USMC can choose to attend Leatherneck...a two-week "cruise" at Quantico....it's OCS level skills (and evaluations) but in a slightly less harsh environment and there are no "drops" though your performance does factor into Service Selection. In other words, a USNA mid performs poorly, it's highly unlikely the USMC selection team will "choose" them....ok...I'm down a rabbit hole here.]
    MECEP - These are the enlisted Marines chosen to attend 4 year universities. They attend a 10 week program between their first and second year or prior to attending school (can't remember and it might have changed... someone chime in here if I am wrong). I believe they are combined with OCC classes. [When I went through in the '90s, we went to the 6-week program with the NROTC MO. My son tells me that now the MECEPs go to the 10-week OCC before they report to school.]
    ECP - Is the smallest of all programs is for enlisted with 4 year degrees to become officers. They attend a 10 week OCS class. Usually a few dozen at the most come from this path.[correct, though the number selected can vary from year to year].
     

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