CAREGIVER PROGRAM UNDER FIRE

President Obama signed the "Caregivers and Veterans Omnibus Health Services Act of 2010"  (the "Act") into law and over 20 thousand family members of our disabled veterans have received benefits as daily caregivers under the "Act".

The Caregiver Program

Most caregivers receiving benefits under the "Act" are spouses or relatives who end up quitting their normal jobs in order to care for the veteran.  Veterans who require near constant care are usually those suffering from traumatic brain injury (TBI), severe PTSD, multiple amputations, and other serious disabilities.  The "Act" provides these caregivers with benefits such as a monthly stipend, medical training, healthcare, and the ability to seek their own rest when needing a break from the daily care of a loved one.

The Caregiver Program, as established by the "Act" is handled under the umbrella of the Veterans Health Administration (VHA).  All decisions regarding eligibility and treatment are made by coordinators at local VA Medical Centers (VAMC).

The VA Decides to Drop Caregivers

While it is not a surprise to many of us, the sad fact remains that many VAMC's are now dropping caregivers with little to no notice. For example, the Portland, Oregon VAMC has cut 66% of its caregivers from the program. A South Texas VAMC has cut up to 48%; and the Charleston, South Carolina VAMC basically gutted it program over a 3 year period by a 94% percent reduction in caregivers.

Appealing a Decision to Drop a Caregiver

The VA has determined to treat Caregiver "benefits" as "clinical" decisions and not "benefit/compensation" decisions. By doing this, the caregiver and veteran are robbed of their ability to appeal the decision to drop a caregiver to the Board of Veterans Appeals (BVA) or the Court of Appeals for Veterans Claims (CAVC).  While the decision to end Caregiver benefits can be "appealed", the appeal cannot go any further than the Veterans Health Administration's own internal review.  

While in nearly all cases involving VHA determinations, the veteran has the ability to appeal to the BVA and beyond, if needed. This includes claims not just for "compensation" or "pension" due to disability, but also decisions involving certain “medical determinations.”  For instance, if a veteran is eligible for nursing home placement or is entitled to healthcare is something that can be appealed to the BVA or even into Federal Court. It is very telling therefore, that the VHA has determined that all decisions made in regard to the Caregiver Program are considered “clinical” decisions by VHA.  This is no accident.

Caregivers initially approved by the "Act" are caring for veterans with permanent, 100% disability ratings.  These are veterans who often cannot speak for themselves and are the most "at-risk" members of our veteran community. The inability to properly appeal a denial of entitlement to the Caregiver Program can very well leave these veterans without needed care if local VAMC does not grant a favorable finding on one of the internal appeals. 

To learn how to properly appeal a decision to remove a Caregiver or a decision to not approve a Caregiver in the first place, please call HALE LAW OFFICE at 1-800-522-4595. DON'T GIVE UP! DON'T DELAY!

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