ptsd Possible Caregiver Program Help?

[kazul]

Hello I feel very new to the whole VA system as I have only been out a little over 1 year and I have been tripping every step I take. I am 100% PTSD service connected TDRL and I am trying to apply for Caregivers Program. I have looked online and from what I think, my wife thinks, and my friend thinks (whom of which is also 100% service connected with PTSD and was able to get caregivers very quickly) I could qualify for caregivers based on some pretty vague criteria I have read up on for PTSD. We have applied twice and shot down damn near instantly both times on the phone first call and appealed once and was denied yet again. I do not know what I may or may not need or if there is some hidden criteria not being explained. Every time we have been denied a reason is never given and just a very vague "I am sorry but you do not qualify for the Caregivers Program". My PTSD pretty much has me house bound and my wife acts as a caregiver and takes care of me. Any advice, information, clarification, etc would be greatly appreciated and I apologize if I am being too vague.

[Berta]

Lots of info here:



http://www.va.gov/healthbenefits/resources/Caregiver_Eligibility_Check.asp

http://www.caregiver.va.gov/pdfs/CaregiverFactSheet_Apply.pdf

"My PTSD pretty much has me house bound " If a doctor states that and gives a medical rationale (such as you cannot drive,due to PTSD or to the meds for it ,are forgetful due to your PTSD, etc etc, lijke maybe you leave food cooking on stove and it burns, there is possibility that either VA would consider you for Caregiver program, or maybe, just as good , you could apply for SMC S.

Can you tell us exactly why they denied you?

You certainly fit the post 9-11 criteria.

[Navy04]

I am probably one of the first Vets on this site to get approved for the Care Giver program. I was Medically retired last year at 30% Crohn's TDRL from the Navy. I am now 100% from the VA, and collect SSDI. You qualify based on being a Post 911 War Vet, but to get approved you have to have Mental and Physical problems that keep you from taking care of your self. I tried to help to Vets with 100% PTSD and neither were approved. I have PTSD, TBI, Migraines, Crohn's Disease, 15 physical surgeries in the last 5 years, and going to have 4 inches of my Rectum removed next week. I have had 2 knee surgeries, and going to have 2 more, crushed spine with hole the size of a quarter, just diagnosed with Seizures and I am only 32 years old. Sorry for the winded response, my CareGiver Specialists told me that there are less than 1000 Vets in Texas that were approved for this program, and there are a whole lot of Vets in Texas. Also there are 3 Levels of the Care Giver Program, and I qualified for the Highest, so the VA pays my wife $2000 a month. Basically you have to be able not to feed yourself, shower yourself or go to the bathroom by yourself. Also I am not allowed to drive anymore due to my PTSD, Seizures and TBI. Also it took a lot of paperwork and Doc Appts, and almost 6 months to get approved, but then we got back pay. You can keep applying, and I wish you good luck. God Bless

[kazul]

Every time we have applied we get denied with no real reason. It is always vague and on our official denial letter from appealing the first paragraph states.

" Thank you for your letter requesting clinical appeal regarding your application to the Comprehensive Assistance for Family Caregivers Program. The information you sent when requesting this appeal as well as your clinical information used to determine eligibility was thoroughly reviewed by the Caregiver Support Appeal Committee. This multidisciplinary committee determined that you do not qualify for the Comprehensive Assistance for Family Caregivers Program."

After said sentence it is a couple pages about the appeal process. I have not had a doctor officially label me as housebound and as far as that goes I do not know who to speak to to make that possibly happen. I do have on my records memory loss and I have made it clear to every doctor I've spoken to that I do not and cannot drive due to the PTSD. It seems like half the time they will pick one topic out of a list I give and ignore everything else making anything I do or say hopeless and void. For Caregivers Program I need Mental "AND" Physical to be approved? I have always been told that it can be either or and does not have to be both but then again as I have said all we ever get are very vague answers on anything and it gets very frustrating when I just want to know what is going on.

I would also like to ask as well what is this SMC S program you speak of? I have never heard or been told of the program.

[john999]

You need to require assistance of a caregiver to take care of your basic needs. If you need help feeding, clothing, washing etc. yourself then you qualify. If you are housebound then you might qualify but you need to really need help with basic tasks of living. That is the way I read it.

[Navy04]

Great Advice John. What the Care Giver Specialist will do is the following steps: 1) Conduct a phone interview with you and your spouse. They will ask what Disabilities you are SC for, what are your current treatments and what meds you are on. 2) Specialist will ask what you can and can not do during an average day, as stated above like feeding, bathing etc. If you do not meet the criteria, then the Specialist and the VA will not go any further. 3) If you meet these criteria, then the Specialist will forward paperwork for your Psych and Physical Docs to fill out, as to what you are being treated for, and what disabilities require you to need a Care Giver. This process alone can take months to complete. 4) If your Docs fill out paperwork and submit back to the Care Giver Specialist, then the Specialist will order a Nurse to make a home visit to see how you are living and if you need home help. 5) The Nurse will submit her medical opinion report back to the specialist. 6) The Specialist will submit all the packet, to include paperwork and phone interview to a review board for the VA. 6) If the board approves your spouse to be your Care Giver, they will decide what Tier to pay her, then your spouse has to complete a 6 hour online study course. 7) You submit a copy of your Spouse's Certificate of Completion and a Direct Deposit form. It is a long process and I have just known too many who did not get approved. Just today I had 2 tubes run down my nose and mouth to my stomach. So my wife has to feed me, and help me bathe so I don't knock the tubes loose. God Bless and sorry to hear of your pain. Just don't know what else to say bud.

[kazul]

I appreciate the In-depth response Navy. I guess I was given some conflicted information in regards to the program. Then again everyone has been so very vague on every point of Caregivers from what it is to WHY I have been denied. Either that or I'm in the right and I'm just giving up hope. If I do not qualify then that is that and I am very satisfied to know something for once with the VA. Physically can I bathe, feed, etc? Yes I can but that can be so very vague black and white you know. What I have is the mental aspect of the criteria to where....I can't really leave the house or drive, it's a safety hazard to cook, memory problems severe enough to interfere with even simple tasks such as taking meds, sleeping problems that interfere with daily living (just came back from a sleep study that I had to be sent home early for not being able to sleep at all), anxiety, so on and so forth. I am sorry to hear your condition you are in Navy and I do wish you the best of luck and you for damn sure deserve Caregivers Program.