Points of new awareness about the
VA Caregiver Program:
Please be certain to research
beyond private, secret, and open Caregiver Communities on social media. Rumors can spread like
wildfire, even when the information is not accurate. Rising anxiety levels within the family rarely does anyone good. Find out the facts first. Note that VeteranCaregiver goes directly to
the VA Central Office with questions raised on specific processes, caregiver
law, and changes. The answers are not always clear and often raise more questions -- but these are direct responses from Caregiver Program Leadership.
Something one Caregiver Support
Coordinator tells you does not always confirm national guidance. Each VISN has the
flexibility to implement the program (*within the parameters of the Caregiver
law*) differently. We already posted the
official response to new phrases used in 2016 regarding “short-term recovery
program”, “graduation”, and the significant reductions in Tier 3
caregiving. According to the VA, there
are no quotas, no changes in eligibility requirements, and no changes in ADL
measurement. Note possible discrepancies to the law, with date, person, VAMC, requests for clarification in writing and attach a Read Receipt to the short message.
ADL’s still form the basis for eligibility,
as do safety and protection elements. Here is an excellent example of the detail
you may need to explain about only a single ADL: bathing independently. See below and other questions and responses
may be found on www.VeteranCaregiver.com’s
website in the “Ask Questions Here” section on the Homepage:
I’M CONFUSED ABOUT ADL’S. JUST USING BATHING AS AN
EXAMPLE, MY WW HAS DIZZINESS, BALANCE, LIMITED RANGE OF MOTION THROUGH BACK AND
UPPER BODY WITH CHRONIC PAIN. HE CANNOT WASH BY HIMSELF, YET THE CGC SAYS SINCE
HE SITS IN THE SHOWER BY HIMSELF, HE CAN BATHE WITHOUT HELP. NOT TRUE! HE
CANNOT WASH HIS HAIR SINCE HE CANNOT RAISE HIS ARMS. HE CANNOT WASH HIS BACK,
BUTT, OR BACKS OF LEGS SINCE HE FALLS OFF STOOL IF HE RAISES ONE LEG TO REACH
THE OTHER. HOW IS THIS NOT NEEDING ASSISTANCE?
This is a great example of when detail explains
what the needs are. If you haven’t already, write all this down, since if the
questions are not asked about detail, then assumptions are made. What you
describe fits the definition of needing assistance with bathing, but if the
right questions aren’t asked, or the vet glosses over his not wanting to say
personal details, there is a chance that this will be overlooked. Write this up
and ask that the evaluator/RN/PCM add it to his medical records.
If you need to appeal a VA
decision, you will need to know the precise reasons to address points specifically
in your appeals documentation. Appeal justification is best explained using language similar to the clinical language provided to you as the reasons for the caregiver program change in status. Specific points, evidence, and documentation is best delivered in a succinct document, and excess emotion removed. Abusive language is not advised even if you feel it is warranted.
Appeals timing of document
submission will vary from VAMC to VAMC, but will be shared with you upon
request.
Also ask specifically for "confirmation of the receipt of the documents
for appeal", and again request "confirmation that the Appeals Panel reviewed the
materials prior to their decision" in writing. Note
the timing of decision letters and the receipt of documents.
There are separate VA non-medical
databases that contain feedback on the caregiver and veteran. This information may
not be available to those reviewing appeals, and request copies of both
the Patient Advocate Tracking System (PATS) notes, and any Caregiver Application
Tracking System (CATS) notes. (This may mean a FOIA request.) The noted information
may be used for decisions and unless you’ve verified the information is
correct, or that information is missing, your status may be adversely affected. It appears that access to this information varies per VAMC.
The specific reasons for
Caregiver Program reduction or termination" will be explained to you in a
transparent, understandable manner" per VACO. It’s best to receive this in writing, and we
have seen only a single VA do this in the status change letter.
You may request to record a Skype call if you’re far from the VA and a meeting is
offered, and you may request to tape a meeting for an in-person meeting. We recommend responses in writing so you can
review and compare to your veteran’s needs, the responses used for the
decision, if records were changed or missing, and to determine your response.
Trust, but verify information.
It is very possible to receive a VA response that is accurate, but literal. If you don’t receive direct
answers to questions, rephrase them politely in an email and request clarification of the
response. It should not be necessary when direct responses and transparency would be more efficient, but ... Make use of an outside advocate (AW2, Legion, AMVETS, etc.) when in doubt.
Please stay informed, use trusted
resources and advocates, and know how absolutely vital caregivers are to the care
of our nation’s wounded, ill, and injured.
We will continue to post direct VACO Caregiver Program responses to your questions for your increased
awareness.
Linda Kreter & the
VeteranCaregiver Team
