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broncovet
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James Cripps seems to know a lot about the caregiver act, perhaps he will chime in.
However, my advice is to go ahead and appeal the denial to the BVA, skipping the "higher level reviews" as you may need to submit additional evidence. You could probably get an advance on the docket, due to his dementia and advanced age. Over 75, I think, pretty much gets an advance on the docket.
While you are appealing, my advice is to also apply for Aid and Attendance (Smc L). He could get that if he needs help with ADL's. (Assistance with daily living).
"If" awarded SMC L (the lower levels which do not require a nurse) it should be around 900 extra per month in his check, for 2024. I think 2024 SMC L is about $
4859 per month for married Vets with no other dependents.
It wont matter even if a family member provides the care, he could still get A and A.
If he needs a nurse the Aid and Attendance could well be higher than that.