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Family Caregiver Program Eligibility For Ptsd Rated Sc Veteran Post 9/11

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Draggin'

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I am only providing the information that show that a veteran with SC (Rated and Service Connected) PTSD could be eligible for the new Caregiver program that just started in May 2011. Others may be eligible and there is a lot more info out there! Hope this helps, I wanted to figure this out before applying with the wife.

Here's the link to where I found the info: VA-2011-VHA-0012-0001.pdf (EDIT-since I posted this, the VA has moved the information that was attached to this link, and I have yet to find it elsewhere)

Before I go further, I must say this. Although I am thankful for this benefit...I do find it backwards and unfortunate to not take care of the previous generations of veterans first. Thanks to YOU for MY freedom. Draggin'

___________________________________________________________________________________________________________

A veteran or servicemember is eligible for a Primary or Secondary Family Caregiver under this part if she or he meets all of the following requirements:

a) The individual is a veteran

b) The individual has a serious injury, including traumatic brain injury, psychological trauma, or other mental disorder, incurred or aggravated in the line of duty in the active military, naval, or air service on or after September 11, 2001. (PTSD).

c) Such serious injury renders the individual in need of personal care services for a minimum of 6 continuous months (based on a clinical determination), based on any ONE of the following 4 clinical criteria: (Only showing #2 of the 4)

2. Need for supervision, assistance or protection based on symptoms or residuals of neurological or other impairment or injury is the 2nd alternative basis for a determination that an individual is in need of personal care services.

Also stated as:

Need for supervision or protection based on symptoms or residuals of neurological or other impairment or injury means requiring supervision or assistance for any of the following reasons (p.26):

  • (1) Seizures (blackouts or lapses in mental awareness, etc.);
  • (2) Difficulty with planning and organizing (such as the ability to adhere
  • to medication regimen);
  • (3) Safety risks (wandering outside the home, danger of falling, using electrical appliances, etc.);
  • (4) Difficulty with sleep regulation;
  • (5) Delusions or hallucinations;
  • (6) Difficulty with recent memory;and
  • (7) Self regulation (being able to moderate moods, agitation or aggression, etc.).

d) A clinical determination has been made that it is in the best interest of the individual to participate in the program.

e) Personal care services that would be provided by the Family Caregiver will not be simultaneously and regularly provided by or through another individual or entity.

f) The individual agrees to receive care at home after VA designates a Family Caregiver.

g) The individual agrees to receive ongoing care from a primary care team after VA designates a Family Caregiver.

Edited by Draggin'
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Here is just about everything you need to know about the Caregiver Program. They are currently working or developing the final rule or law for the program.

http://veterans.senate.gov/upload/Caregivers_part%201.pdf

 

In here you can see the point system they are using on the Katz Scale for physical and or mental disabilities. There seems to be a lot of different interpretations to these qualifiers throughout the program and across all of the VAMCs and the Providers conducting the evaluations. This was caused by the pressure the Senate Veterans Committee was putting on the VA Secretary to get the program up and running since a year had already passed after the Senate had passed this bill. The staff throughout the VHA desperately needs more training on the program especially the Caregiver Support Coordinators (CSC). Some seem to be the keeper of the gate so to speak.

THank you for the link info but it is no longer available.... Can you cut and paste the scale for us?

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katedaffron here is the link to the above https://www.gpo.gov/fdsys/pkg/PLAW-111publ163/pdf/PLAW-111publ163.pdf it's from 2010 

Tbird
 

Founder HadIt.com Veteran To Veteran LLC - Founded Jan 20, 1997

 

HadIt.com Veteran To Veteran | Community Forum | RallyPointFaceBook | LinkedInAbout Me

 

Time Dedicated to HadIt.com Veterans and my brothers and sisters: 65,700 - 109,500 Hours Over Thirty Years

 

diary-a-mad-sailor-signature-banner.png

I am writing my memoirs and would love it if you could help a shipmate out and look at it.

I've had a few challenges, perhaps the same as you. I relate them here to demonstrate that we can learn, overcome, and find purpose in life.

The stories can be harrowing to read; they were challenging to live. Remember that each story taught me something I would need once I found my purpose, and my purpose was and is HadIt.com Veterans.

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On 6/8/2011 at 6:15 AM, Tbird said:

If anyone who has PTSD and no qualifying physical disabilities please post your experience applying for this.

 

I asked some questions about this and was given the impression PTSD alone does not qualify. That's been some time ago before they started this program.

I was told I didn't sound like I qualify based on my doctors note. Being P and T due to my sTBI doesn't automatically infer I qualify I forgot to tell her I'm also given SMC S for being housebound not sure if that helps? As if them lumping my PTSD and my TBI wasn't bad enough.

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I applied for it. I'm in the mental hospital a couple times per year. I tried committing suicide with my meds. I have no control over my meds, knives are locked up, and I have no guns. I'm 100 Permanent and Total based off PTSD. Also homebound. My wife helps me create goals for the day to get stuff done. Can't watch my kiddos by myself. However, still trying to use voc rehab to get a job and I failed out a couple times. I was denied I think because I was using voc rehab. I personally don't agree with it, but it is what it is. 

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On 6/7/2011 at 3:38 AM, Draggin' said:

My wife and I applied for this and are in the process of getting approved.

 

In my case the caregiver coordinator called my doctor, but the doctor said since he has only seen me a couple of times, he wanted to see me to fill out his portion of the paperwork. I am not sure that the docs are required to interview the patients or not. But, I do know that the doctor only had 48 hours to complete the interview. The doc called me and left a message on Friday to come in on Monday at 8am. This is what I did (along with wife). Doctor talked to me alone, which is different as my wife always goes with me to help me remember things. Within 2 hours of seeing the doctor the caregiver coordinator was calling my wife and following up with her. Wife is now awaiting training packet from Easter Seals. She has to complete it and then they will send someone to do a home visit.

They did not ask about driving, either with me or my wife...which I found bizarre. Although the coordinator mentioned travel pay for my wife. But they do not seem to use inability to drive as part of the critieria. Seems logical to me that driving would be considered under safety risk but I guess it's not?

 

Those of us with "less big" (not that I am making small of anyone's disabilities and problems) and apparent problems still need help! Which is why they have different levels of severity considered when it comes to the amount of hours they give to the caregiver (they give you points based on the clinical evaluation). This is not a case of all or nothing.

 

They seem to be in a big hurry to get people started on this...finally. I truly hope that they get this implemented as intended and move on to help more veterans soon.

 

Good luck to all of you!

Draggin'

 

I THINK I AM CONFUSED ON ALL THIS.

My brain don't seem to comprehend anything any more/ sorry

Are you applying for A&A for your spouse as you as her caregiver  and your service connected 100% for a MH Condition  such as PTSD?

YOUR SPOUSE HAS MEDICAL RECORDS FROM Dr's declare her unable to take care of her self??? OR THE OTHER WAY AROUND?

I am not an Attorney or VSO, any advice I provide is not to be construed as legal advice, therefore not to be held out for liable BUCK!!!

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The following is current as of 03/202

Always check the VA's Page for the latest information.

PDF CSP_Eligibility_Criteria_Factsheet.pdf

Eligibility Criteria Fact Sheet

Veteran Eligibility Requirements:

A Veteran or Service member may be eligible for a Family Caregiverif all of the following requirements are met:

1. The individual is either:

  • A Veteran; or
  • An Armed Forces member undergoing a medical discharge from the Armed Forces.

2. The individual has a serious injury (including serious illness) incurred or aggravated in the active military, naval, or air service line of duty.

  • For purposes of PCAFC, serious injury means any service-connected disability that (1) Is rated at 70 percent or more by the VA or (2) Is combined with any other service-connected disability or disabilities, and a combined rating of 70 percent or more is assigned by VA.

3. The individual is in need of in-person personal care services for a maximum of six (6) continuous months based on any one of the following:

  • An inability to perform an activity of daily living;
  • A need for supervision or protection based on symptoms or residuals of neurological or other impairment or injury or
  • There is a need for regular or extensive instruction or supervision, without which the ability of the veteran to function in daily life would be seriously impaired.

4. Participating in the program is in the individual's best interest.

5. Personal care services provided by the family Caregiver will not be simultaneously and regularly provided by or through another individual or entity.

6. The individual receives care at home or will do so if the VA designates a Family Caregiver.

7. The individual receives ongoing care from a Primary Care Team or will do so if the VA designates a family caregiver.

Family Caregiver Eligibility Requirements

A Family Caregiver must:

1. Be at least 18 years of age.

2. Be either:

  • The eligible Veteran’s spouse, son, daughter, parent, stepfamily member, or extended family member; or
  • Someone who lives with the eligible Veteran full-time or will do so if designated as a Family Caregiver. 

3. Be initially assessed by the VA as being able to complete caregiver education and training.

4. Complete caregiver training and demonstrate the ability to carry out specific personal care services, core competencies, and additional care requirements.

In addition, there must be no determination by the VA of abuse or neglect of the eligible Veteran by the caregiver.

Stipend Levels:

The amount of the monthly stipend the Primary Family Caregiver is eligible to receive is determined based on information gathered during the VA’s Evaluation of the Veteran’s personal care needs.

  • Level One: The Primary Family Caregiver’s monthly stipend is calculated by multiplying the monthly stipend rate [Office of Personnel Management (OPM) General Schedule (GS) Annual Rate for grade 4, step 1, based on the locality pay area in which the eligible Veteran resides] divided by 12 multiplied by 0.625.
    • For example, the GS rate at grade 4, step 1, in Dallas, Texas, 2022 was $34,916 annually.
    • Thus, the monthly stipend for a Primary Family Caregiver of an eligible Veteran in Dallas, Texas, at this rate ($34,916, divided by 12 multiplied by 0.625) was approximately $1,818.54 in 2022.
  • Level Two: If the VA determines the eligible Veteran meets the definition of“unable to self-sustain in the community” for the purposes of PCAFC, the designated Primary Family Caregiver’s monthly stipend is calculated by multiplying the monthly stipend rate (OPM GS Annual Rate for grade 4, step1, based on the locality pay area in which the eligible Veteran resides)divided by 12 multiplied by 1.00.
    • For example, the GS rate at grade 4, step 1, in Dallas, Texas, in 2022 was $34,916 annually.
    • The 2022 monthly stipend amount for a Primary Family Caregiver of an eligible Veteran in Dallas, Texas, at this rate($34,916, divided by 12 multiplied by 1.00) was approximately$2,909.67

Definitions

Unable to Self-sustain in the Community

For purposes of PCAFC, "unable to self-sustain in the community" means that an eligible Veteran either:

Requires personal care services each time he or she completes three or more of the seven activities of daily living (ADL) listed in the definition of an inability to perform an activity of daily living in this section and is fully dependent on a caregiver to complete such ADLs; 

or

Has a need for supervision or protection based on symptoms or residuals of neurological or other impairment or injury on a continuous basis; 

or

There is a need for regular or extensive instruction or supervision, without which the veteran's ability to function in daily life would be seriously impaired on a continuous basis. 

Inability to Perform Activity of Daily Living (ADL)

For purposes of PCAFC, the "inability to perform an

ADL" means the Veteran or Service member requires personal care services each time he or she completes one or more of the ADLs listed below. 

  • Dressing or undressing oneself
  • Bathing
  • Grooming oneself in order to keep oneself clean and presentable
  • Adjusting any special prosthetic or orthopedic appliance that, by reason of the particular disability, cannot be done without assistance (this does not include the adjustment of appliances that nondisabled persons would be unable to adjust without aid, such as supports, belts, lacing at the back, etc.)
  • Toileting or attending to toileting
  • Feeding oneself due to loss of coordination of upper extremities, extreme weakness, inability to swallow, or the need for a non-oral means of nutrition(walking, going upstairs, transferring from bed to chair, etc.)

 Requiring assistance with an ADL only some of the time does not meet the definition of an "inability to perform an ADL"

Tbird
 

Founder HadIt.com Veteran To Veteran LLC - Founded Jan 20, 1997

 

HadIt.com Veteran To Veteran | Community Forum | RallyPointFaceBook | LinkedInAbout Me

 

Time Dedicated to HadIt.com Veterans and my brothers and sisters: 65,700 - 109,500 Hours Over Thirty Years

 

diary-a-mad-sailor-signature-banner.png

I am writing my memoirs and would love it if you could help a shipmate out and look at it.

I've had a few challenges, perhaps the same as you. I relate them here to demonstrate that we can learn, overcome, and find purpose in life.

The stories can be harrowing to read; they were challenging to live. Remember that each story taught me something I would need once I found my purpose, and my purpose was and is HadIt.com Veterans.

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