Anyone who has been with the caregivers the last few years, have you been getting kicked out??

[prostheticsnow515]

I am caregiver for the my husband, the last few years, he is rated 80 percent with PT and Iu so he is getting disability at 100 percent, i have heard they are reassessing, now and kicking people off the caregiver program when it comes to  PTSD stuff,

 

I am hoping now, I take care of him and the kids and cant leave them to go back to work, i left work to take care of him , not sure what to do, because that is what is going to happen if they boot us from the program.

[Berta]

This October 2021 statement from VA the VA Secretary indicates that the program is alive and well-with an expansion to the program:

https://blogs.va.gov/VAntage/96666/caregivers-have-been-overlooked-those-days-are-over-va-secretary-says/

However I am sure the Caregiver program has also been critisized for good cause, and probably many caregivers have been "overlooked".

Where did you hear this news from, that people are getting kicked off the program?

I was a caregiver for two veteran husbands and I know it is not easy at all. In those days all I had was a few hours of 'respite' every week when the VA van took my husband to VA Day Care.He was dealing with a 1151 stroke but his 100% P & T PTSD made everything more difficult. I raised livestock  and had to sell my animals because he could not be left alone in the house, and livestock farmers need to spend a lot of time in a barn and in the fields.It was a full time job.

Does your family get SSDI benefits?

https://www.ssa.gov/benefits/disability/family.html

 

[broncovet]

You posted:

Quote

i have heard they are reassessing, now and kicking people off the caregiver program when it comes to  PTSD stuff,

I always "cringe" when Vets state, "I heard" or "I was told".......

Its not suprising..there is so much stuff on the internet which is not true.  Its difficult to sort out the truth.  

This is where hadit comes in.  "Its peer reviewed".  If someone posts something, and its disputed, we often post the differing opinion, and, usually, because of great knowledge on hadit, come to a consensus.  (find the truth).  

    Now, to answer your question.  Its my opinion, that, ONLY if the medical records show "actual improvement under ordinary conditions of life",  are you subject to a reduction in benefits, to include caregiver benefits.  

 There are many (legal) protections for Veterans written in to the regulations.  I shall provide a link which demonstrates those protections.  I will even give a short summary, as the regulations are not particulary easy to read and understand:

1.  To reduce your benefits, if you are P and T, its actually hard for the VA to reduce you.  First, your "so called improvement" has to be under ordinary conditions of life, not due to rest and relaxation.  Generally, this means if you have "not" gone back to work, then your improvement is "not" under ordinary conditions of life.  If you have gone back to work, then you would be subject to reduction.

2.  The VA not only has to have medical evidence of improvement, but that improvement is sustained.  Most all of us have good days and bad days.  So, you go to the VA on a day you feel great, and the doc makes notes in your chart and reduces you?  Not so fast.  Again, it has to be sustained improvement "under ordinary conditions of life" and, the exam which the VA bases your reduction has to be "at least as thorough" as the exam to which you were awarded benefits. 

This means if the doc took x rays, maybe an MRI, and made an opinion:  That leg is incapacitated based on these tests.

Now, for a reduction, they would ALSo have to have x rays, and an MRI, along, often times with 2 exams, where the doc said,

"yep, that leg is all healed..nothing on the xray, nothing on the MRI".  to reduce your benefits.  Highly unlikely.  

But, read those regulations yourself.  Now, just because there are protective regulations does not mean the VA fully complies with them 100 percent of the time.  Nope.  They often try to reduce you even when you dont meet the criteria.  But, upon appeal, usually you can beat the reductions, at least those where VA did not fully comply with this regulation:

https://www.law.cornell.edu/cfr/text/38/3.344

Dont let the VA try to take stuff away, if they do, post it on hadit and often we can help you beat it, unless your permanent disability "went away" permanently.  

 

 

 

Edited December 11, 2021 by broncovet (see edit history)

[prostheticsnow515]

Sorry for the delay, the reduce in Benefits would come in the form of the Caregiver program that i am receiving   on behalf of taking care of my husband, not sure if anyone has been taken off it lately in this forum.

[jamescripps2]

Sorry Broncovet, you are out of touch with the caregiver program, (PCAFC). The Pcafc program is adjudicated by the VHA, not the VBA. They do not follow the same rules and regulations that you and I are accustomed to. They can and are kicking people out of the program with no reason or basis required. There are no exams required to oust you from the program. We have no defense against this situation and the appeals process is a farce as the appeals are also adjudicated by the VHA. True, one can request a revue by the BVA, but the Secretary has told the Board not to hear those kind of cases at this time. Can you imagine how this situation is going to inflate the BVA backlog who are already working 200,000 cases behind?

[john999]

I think the caregiver program is a hoax. You  have to be bedridden to get the program.  I tried to get it for my wife and the program people were hostile and dismissive.  Me and the wife can be pretty ornery at times.  We both felt insulted.

[Usetacould]

My wife is being kicked off. It’s apparently paused for now though. Who knows what will happen. We have been scrambling to readjust our expenses to cover lost income.

 

[deanbrt]

On 5/5/2022 at 4:00 PM, Usetacould said:

My wife is being kicked off. It’s apparently paused for now though. Who knows what will happen. We have been scrambling to readjust our expenses to cover lost income.

 

[deanbrt]

We just went through the last in home reassessment review today. After 2 phone reviews and, for the first time, an occupational therapy review. I was uncomfortable  with it in the sense that, compared to a year ago, with a focus on my walk limitations, mental health, macular degeneration and loss of motor skills with my hands, this time it was about solely the ability to dress myself. It just did not feel right. Is anyone else having this experience with the reassessments?

[USNDW]

Very late reply.

Yes.

We have been in the program since 2011.

In April we had a clinical evaluation, three days later we got the letter stating we were being removed from the program. Mail moves fast with bad news.

Took 2 weeks to get an answer as to why, the clinical report. I went back and looked at my healthy vet medical records and found the assessment.  Went back and looked st PCAFC criteria, and we met the criteria for having at least 4 areas of daily living where I need help, and it was unsafe for me to live alone???

Sent in a request for review. Denied. Sent in the formal appeal. Denied. Even after we pointed out the page and paragraph where the assessment noted I met the criteria. Our only issue with the clinical report was the nurse wrote mobility or walking issues were short term. Even considering that we still qualified, but my mobility issues have existed since before I was medically retired, in fact that is why I was retired.

We contacted our Senators office and they made an inquiry, and within 24 hours they called. When I asked how they could deny and remove when the clinician clearly noted I could not live alone and needed help with 5 of ADL listed in the PCAFC criteria. Crickets

We got a letter stating we could request another review instead of the next step, the BVA, and followed with another letter stating the VA was reviewing the criteria, because they are kicking off 90% of legacy participants with their new criteria.

My point,  if you can roll over in a bed by yourself they will deny or remove, that is sick. I asked if they want to pay to put me in a nursing facility because that is what the clinicians report contained. Help bathing, grooming, walking, putting on orthopedic appliances, and dressing.

[blahsaysme2u]

On 4/24/2022 at 9:58 AM, john999 said:

I think the caregiver program is a hoax. You  have to be bedridden to get the program.  I tried to get it for my wife and the program people were hostile and dismissive.  Me and the wife can be pretty ornery at times.  We both felt insulted.

i feel the same....my wife is the best caregiver in the world...my memory issues from my tbi, i rely on her for everything...im not an invalid or bedridden, but she makes sure i eat, take meds, sort meds, order meds, make appointments, do basic hygiene etc...i dont go anywhere without her! my PTSD and anxiety issue keep my home mostly....she does all shopping etc..

we applied and the lady was very............obnoxious to be nice about it- telling us this program is not for veterans that can feed themselves....so we gave up...she told us to appeal if we felt the decision was wrong but i already have enough of imposter syndrome- i dont need to be forced to feel like i dont deserve something else..(well really my wife-bc its really to help her!)

Edited August 30, 2022 by blahsaysme2u (see edit history)

[john999]

My wife handles my meds as well.  She helps with my insulin shots.  VA seems to be saying that unless you are a candidate for a nursing home you can't have a caregiver that gets paid.  They talked to my wife like dirt and that was the end of that.  She don't play dat!  It is not good because she deserves the money for doing the VA's job.  However, can you imagine how long we would last in some VA approved nursing home?  It is a death sentence.

[blahsaysme2u]

Exactly...or how long I would last without my wife...we all have saints for spouses

[USNDW]

Just in the last 2 weeks the VA is extending benefits for PCAFC to those who are still eligible for review, meaning, if you still have the options of a Higher Level review or BVA after being dismissed, you have a 3 year extension.

I have not yet received any letter from VHA but I read the instruction and verified with VISN 19 Administrator.

I had wrote a letter of dissatisfaction with their clinical review and she returned my call.  She verified that yes, the PCAFC is reviewing their decisions and guidance due to all the feedback from Veterans, Caregivers, and Senators and Congressmen/women.

Don't know how long until notifications are being sent out, but if you were recently dismissed within the last year, you should be extended and they will be doing reassessment after they correct their guidance and criteria.

 

In my case,  they stated I did have a functional impairment that would exist for 6 months or more. I am rated 100% P&t with SMC K and S, so I asked how in the hell is that not a functional impairment? There is no answer, they were just kicking people out to reduce costs because ALL veterans are now eligible.

[blahsaysme2u]

just called to find out if we were able to appeal- was told the computer system is down and they have no way to check...i cant find the claim on VA.gov(claims are so disjointed there- labeled wrong or just says "comp claim" with no indication what the claim was for etc)

guess ill try again tomorrow

[USNDW]

Check your letters.

When were you notified you are being dismissed from PCAFC??

They give specific time periods for clinical appeals, usually 1 year for Higher Review and same for BVA following a Higher Review decision

VISN 19 also stated we can reapply. I use private health care and am going to get an IME from my PCM and get that into my VA records

Remember that VHA and VA compensation sides are 2 different animals. VHA cannot see veterans C file records, only health records

[blahsaysme2u]

has there been any updates to this post? anyone tried re-applying? i searched hadit and not much out there in recent months...

thanks

[john999]

That caregiver thing is a hoax and a racket.  It is really a fraud done by the VA to be seeming to help us.  I am sure the big wigs at the VA go to congress and brag about their Caregiver system.  What lying dogs.

[jamescripps2]

The way to win is to submit a completed VAF 10182 and ask the BVA to take a look at your case. ((.((% it will be remanded back to the VHA with an expedited status ordered by the BVA judge with speciffic instructions on the readjudication of the claim. A win will produce backpay. That is how I won on June 22, 2022.