VA overhauls application process for caregiver support program after court ruling

Veterans Affairs officials are overhauling their application process for caregiver benefits while simultaneously fighting a court ruling that would force them to allow a legal review for individuals rejected for the program.

The move follows an order last month from a panel of U.S. Court of Appeals for Veterans Claims judges, which ruled that families rejected by the Program of Comprehensive Assistance for Family Caregivers should have an opportunity to appeal those decisions to the Board of Veterans’ Appeals, which handles other VA benefits disputes.

But VA officials have opposed that idea, arguing instead that keeping program decisions within the clinical side of department operations will produce better health care options for veterans and less complexity for families.

“We believe that participation in this program is part of a veteran’s overall medical care plan,” said Meg Kabat, senior advisor on families, caregivers and survivors at VA. “These clinical and medical decisions being thrown into the litigation process is not what is best for veterans.”

On Monday, VA asked the full veterans claims court to revisit the April decision. At the center of the case are concerns over how applications to the caregiver program are handled. For veterans who need significant home care from a spouse or family member, the program awards up to $2,300 a month in stipends and access to additional support services.

About 25,000 veterans are participating in the program today, and another 27,000 applications are pending. Currently, leaders from individual VA medical centers review applications and make decisions on who receives the benefit.

That has led to complaints about inconsistency and a lack of transparency with the application process from a number of veterans advocates, and formed much of the basis of the recent lawsuit.

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Kabat said those applications will now go to clinical teams at each of the department’s 18 Veterans Integrated Service Networks. More than 200 new medical professionals are being hired for the work.

Veterans who are rejected for the program by the new review panels will be able to appeal to a different VISN twice if they believe the decision was made in error. VA officials said the new process will allow families and outside advocates to better understand the reasons for the decisions, and ensure that similar applications across the country are handled in a similar way.

But the new process will likely do little for families rejected in the past who could be in line for a substantial financial payout under the appeals court’s April order.

In that case, Jeremy Beaudette, a Marine Corps veteran who left legally blind and suffering from traumatic brain injury after multiple combat tours in Iraq and Afghanistan, was rated as 100 percent disabled by VA officials because of his wounds.

But when his wife, Maya, applied for benefits through VA’s caregiver program she was rejected. Multiple appeals to department officials were also denied.

Thanks to their court victory, the couple can appeal the decision to the Board of Veterans’ Appeals, which could award back benefits as well as new eligibility for the caregiver program.

Nothing in the new application process unveiled by VA Monday would award back pay to veterans previously rejected for the program. In a statement, Amanda Pertusati, supervising staff attorney at Public Counsel (which brought the lawsuit against the department), said officials are still reviewing the changes.

“We look forward to implementing the courts order to ensure that all caregiver program claimants have the ability to seek appellate review, as well as to obtain the benefits that they are entitled to,” she said. “It is unfortunate that the parties and the court will now have to be distracted by VA’s attacks on the court’s decision, rather than focusing all efforts to implement it.”

The court ordered VA to develop an implementation plan for the retroactive appeals by June 3. VA officials said they will follow that order, even as they fight the lawsuit.

Meanwhile, outside advocates say they are watching both the legal fight and program reforms closely.

“We commend VA for its commitment to comply with the lower court’s decision and we strongly encourage them to continue collaborating closely with the [veterans] community on communications, planning, and strategy moving forward,” said Steve Schwab, CEO of the Elizabeth Dole Foundation

“We await the full court review of this case, but EDF is committed to working with the VA on a more equitable and transparent appeals process that provides all caregivers with a chance to access the benefits they have earned and deserve.”