Friday, March 9, 2012

Updates for Caregivers of Wounded Warriors & Veterans

Hi all,

Today was the MOAA/Zeiders Roundtable meeting and the topic was Part II of discussing Caregiver and Family issues for Wounded Warriors and Veterans.  Leadership from the VA and DoD were present to respond to questions on care, caregiving, and benefits.  Below is much of the information gleaned from the meeting, and it’s evident that providing support for Caregivers and families is an ongoing challenge.

This meeting centered on questions raised by the group and specifically the five Caregivers or Veterans present.  Some overall themes are recurring and familiar to you:

  • Caregiver support after-hours and on weekends is problematic.  (In other words, if the FRC/RCC/CG Coordinator is not available, who do you call?)  FRC’s are not responsible for after-hours support due to their patient load, and this program receives good reviews with the 25 FRC’s assigned to seriously wounded warriors and veterans. 
  •  The onus is on the Caregiver to seek answers if dissatisfied with any aspect of care, which is very difficult when you’re exhausted and lost
  •  Peers are still the most trusted group to support other Caregivers (yep, we surely know that!)
  •  Clinical Retaliation/Repercussions often occur when Caregiver dissatisfaction is reported – which is often why it’s not reported
  •  Caregivers are frequently blocked from participation in the medical appts of their Vet, especially in emergency situations despite the change in law; some discussion centered on how to solve this with special identification, cards, or training, but this problem lingers as many of you have experienced
  • Where is the Retirement Ceremony for our medically discharged troops?  Too many casually receive a flag, a pin, and a form letter for their service. This was viewed as a fixable issue and monthly retirement ceremonies were discussed.  Hopefully this will occur soon and retroactively.

Additional questions centered on the complexity of earned benefits and being properly informed at the appropriate time to make good decisions: 
  • Fiduciary issues are often confusing due to the State vs Federal sovereign issues (who’s in charge by law) and improved coordination of the various agencies would assist in accurate information about earned benefits.
  • Questions regarding Guardian or Incompetency ratings may be resolved by the local Surrogate Court (seek legal assistance on these complexities)
  • If your Vet has a 10% or more disability rating and an Honorable Discharge, they are entitled to Vocational Rehab (a VBA Benefit) and the entitlement amount is based on the service-connected needs.
  • Volunteer work or some part-time work earning up to $850 annually does not effect your SSDI payments (Social Security payments)
  • Reduced work tolerance does not preclude receiving the full subsistence disability payment (contact the VBA for more information) 
  • For a Vet needing a Job Coach, this may be requested from Voc Rehab
  • The MEB/PEBLO (medical evaluations) are being evaluated for three criteria:  (1) Is the rating fair?, (2) Is it timely?, and (3) Is it Sevice-Member centric. There is a tension here:  the two-part evaluation permits for appeals if there is a disagreement by the Vet, but it does incur additional time; further study is ongoing at DoD.
  •   RCC’s (Recovery Care Coordinators) are now assigned to 400 Active Duty warriors.
  •  Additional RCC’s will be trained, beginning this Sunday, March 11th, and there is still poor awareness of RCC assignments.

 A holistic or comprehensive approach is needed to address thorny problems that still occur after 10 years of war, and the bigger picture of setting expectations for warriors and Caregivers to understand their benefits, financial options, educational options, employability and more is an ongoing task for those training RCC’s.  Caregiver involvement is critical and recognized by this group, while improvements in the TAP transition program is expected to improve knowledge about transition.

We continue to seek improvements in communication, parity in care across the country at medical centers, and ongoing discussions of the reality of Caregiving.  We did not hear discussion of Comprehensive Care Plans or Comprehensive Transition Plans today, but certainly you see that much was under discussion today. Please let us know your priorities and needs, and we’ll continue to add your voices to the future meetings and collaborative efforts to improve service family quality of life.

Kind regards,


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