The Family Caregivers pages at the VA web site.
The VA Family Caregiver Program
Family Caregivers provide crucial support in caring for Veterans. VA recognizes that Family Caregivers in a home environment can enhance the health and well-being of Veterans under VA care.
Under the "Caregivers and Veterans Omnibus Health Services Act of 2010," additional VA services are now available to seriously injured post-9/11 Veterans and their Family Caregivers through a new program of Comprehensive Assistance for Family Caregivers. VA is now accepting applications for these services.
Who Is Eligible?
Veterans eligible for this program are those who sustained a serious injury – including traumatic brain injury, psychological trauma or other mental disorder – incurred or aggravated in the line of duty, on or after September 11, 2001.
Veterans eligible for this program must also be in need of personal care services because of an inability to perform one or more activities of daily living and/or need supervision or protection based on symptoms or residuals of neurological impairment or injury.
To be eligible for the Program of Comprehensive Assistance for Family Caregivers, Veterans must first be enrolled for VA health services, if not enrolled previously.
New Services Available to Family Caregivers through this Program
The new law will provide additional assistance to primary Family Caregivers of eligible post-9/11 Veterans and Servicemembers. New services for this group include:
* Monthly stipend
* Travel expenses (including lodging and per diem while accompanying Veterans undergoing care)
* Access to health care insurance (if the Caregiver is not already entitled to care or services under a health care plan)
* Mental health services and counseling
* Comprehensive VA Caregiver training provided by Easter Seals
* Respite care (not less than 30 days per year)
The VA Caregiver program didn't get off to a smooth start. This article gives you some background.
VA fumbles new caregiver program
Below is the VA press release about the caregiver program.
Veterans eligible for this program are those who sustained a serious injury – including traumatic brain injury, psychological trauma or other mental disorder – incurred or aggravated in the line of duty, on or after September 11, 2001.
Veterans eligible for this program must also be in need of personal care services because of an inability to perform one or more activities of daily living and/or need supervision or protection based on symptoms or residuals of neurological impairment or injury.
To be eligible for the Program of Comprehensive Assistance for Family Caregivers, Veterans must first be enrolled for VA health services, if not enrolled previously.
New Services Available to Family Caregivers through this Program
The new law will provide additional assistance to primary Family Caregivers of eligible post-9/11 Veterans and Servicemembers. New services for this group include:
* Monthly stipend
* Travel expenses (including lodging and per diem while accompanying Veterans undergoing care)
* Access to health care insurance (if the Caregiver is not already entitled to care or services under a health care plan)
* Mental health services and counseling
* Comprehensive VA Caregiver training provided by Easter Seals
* Respite care (not less than 30 days per year)
The VA Caregiver program didn't get off to a smooth start. This article gives you some background.
VA fumbles new caregiver program
Below is the VA press release about the caregiver program.
This is the application for the program.
Divorce In Military Families – How It’s Different & What You Need To Know
TRICARE - Health Care for Service Members and Others
What Do I Need to Know about the Federal Electronic Benefits Rules?
A Servicemembers Guide to Student Loan Interest Rates
Jim's Mailbag
Interactive Form and Letter Generators
What happens if you're denied?
When the self-appointed gatekeeper blocks you, what then?
Jim;
Some time ago I had written you about the Caregiver application inquiring whether you knew much or had heard much about the appeal process. You had replied you were not aware of the appeal process and if I found out to let you know.
After 4 months of appeals my wife and I were finally approved. I am a GWOT Veteran medically Retired with 23 years active and 100% VA Award with continuing medical conditions that requires my wife to do most everything at home, and drive my butt around to doctors and such. We applied in May of 2011 when the regulations came out and unfortunately we met with some sincere resistance from the VA Social Worker who was helping with the program. Apparently she thought she was St. Peter at the pearly gates and she decided who needed the program and who did not.
The application process, after meeting the 100%, GWOT, and continuing need of medical care or assistance, requires for a medical examiner (licensed) or NP to perform a medical examination after which the examiner will determine if the Veteran would benefit from the program. Without an exam, and being told by the VAMC Social worker that she had spoke with my health care team (which she never did speak with them) and they decided I did not need the program.
Since the program is not based upon NEED, and is based on whether or not the Veteran needs ongoing care I appealed the denial to the VAMC Director. When doing so I explained I had a private physician and only a very small portion of my medical records were at the VAMC so I would like to have the opportunity to bring all of my medical records, 3 volumes worth at the VARO, to anyone who was looking at the appeal. Without any notice the VAMC Director also denied us because the program would not enhance my ability to live more safely in a home environment?
I take a lot, and I do mean a lot of Morphine and Vicodin on a daily basis along with some nerve issue medications that make me like a zombie most of the time. So without including the medical issues, and basing my safety on the medication required alone, I cannot live safely at home without a caregiver or attendant, not too mention the house chores, meals, shopping, and all that necessary stuff.
I had to appeal to the VISN Network in my area. I wrote the same letter to them that I wrote to the VAMC Director explaining my multiple medical issues and medication management and again that my medical records had not been reviewed because they just don't have them. After about a month I got a call from the VISN Chief Medical Adviser and she apologized because she did not see anywhere in the Small amount of records they do have where there would be any way for am medical examiner to say that I could live alone and would not benefit from this program. Obviously I told her I completely agreed, so she approved us for the program.
So, long story with a quick wrap up. For the Caregiver program for GWOT Veterans now, and hopefully all Veterans next year, if anyone gets denied by the Caregiver Rep or social worker, file an appeal with the VAMC Director, and if that fails file an appeal with the VISN Network for your area. If the VA employees are not going to follow the process as required by the legislation that was given them, sooner or later someone with a brain will see that and will approve if they can. Make sure you know the requirements and how they are supposed to process your application.
Some time ago I had written you about the Caregiver application inquiring whether you knew much or had heard much about the appeal process. You had replied you were not aware of the appeal process and if I found out to let you know.
After 4 months of appeals my wife and I were finally approved. I am a GWOT Veteran medically Retired with 23 years active and 100% VA Award with continuing medical conditions that requires my wife to do most everything at home, and drive my butt around to doctors and such. We applied in May of 2011 when the regulations came out and unfortunately we met with some sincere resistance from the VA Social Worker who was helping with the program. Apparently she thought she was St. Peter at the pearly gates and she decided who needed the program and who did not.
The application process, after meeting the 100%, GWOT, and continuing need of medical care or assistance, requires for a medical examiner (licensed) or NP to perform a medical examination after which the examiner will determine if the Veteran would benefit from the program. Without an exam, and being told by the VAMC Social worker that she had spoke with my health care team (which she never did speak with them) and they decided I did not need the program.
Since the program is not based upon NEED, and is based on whether or not the Veteran needs ongoing care I appealed the denial to the VAMC Director. When doing so I explained I had a private physician and only a very small portion of my medical records were at the VAMC so I would like to have the opportunity to bring all of my medical records, 3 volumes worth at the VARO, to anyone who was looking at the appeal. Without any notice the VAMC Director also denied us because the program would not enhance my ability to live more safely in a home environment?
I take a lot, and I do mean a lot of Morphine and Vicodin on a daily basis along with some nerve issue medications that make me like a zombie most of the time. So without including the medical issues, and basing my safety on the medication required alone, I cannot live safely at home without a caregiver or attendant, not too mention the house chores, meals, shopping, and all that necessary stuff.
I had to appeal to the VISN Network in my area. I wrote the same letter to them that I wrote to the VAMC Director explaining my multiple medical issues and medication management and again that my medical records had not been reviewed because they just don't have them. After about a month I got a call from the VISN Chief Medical Adviser and she apologized because she did not see anywhere in the Small amount of records they do have where there would be any way for am medical examiner to say that I could live alone and would not benefit from this program. Obviously I told her I completely agreed, so she approved us for the program.
So, long story with a quick wrap up. For the Caregiver program for GWOT Veterans now, and hopefully all Veterans next year, if anyone gets denied by the Caregiver Rep or social worker, file an appeal with the VAMC Director, and if that fails file an appeal with the VISN Network for your area. If the VA employees are not going to follow the process as required by the legislation that was given them, sooner or later someone with a brain will see that and will approve if they can. Make sure you know the requirements and how they are supposed to process your application.
Appeals
Your appeal must be in writing. As with all appeals to VA making repeated phone calls and asking for help accomplishes very little. Certified mail with return receipt requested is the only sure way of getting your message delivered.
As the veteran above did, you should first appeal to the director of the VA medical center where your program is based.
Find the medical center address by clicking here.
The veteran above speaks of appealing to his VISN network director. The acronym VISN stands for Veterans Integrated Service Network. This is an office that oversees all VA activities within a geographic area.
To find your VISN area and the address of the VISN office you will appeal to, click here.
You may still appeal to the Regional Office that handles your claim file, much as you would any other appeal.
