The Department of Veterans Affairs is pushing to expand the current caregiver program now to save money in the long run by Congress is not yet onboard.
Presently, spouses of post 9/11 veterans with severe disabilities may be eligible for living stipends worth thousands of dollars if the veteran requires around-the-clock care in the home. In 2011, Congress passed legislation to provide monetary support to spouses able to provide the care in an effort to save money on nursing home care.
The Secretary now wants to expand the benefit to other veterans and their caregivers from earlier periods that do not qualify under the existing legislation.
In the long run, the move could save VA $2.5 billion in annual costs for nursing home care in the late 2020s. But, the Congressional Budget Office says it will cost around $3.4 billion over the next five years to ramp up the enrollment program. Congress is finding the upfront cost of the expansion hard to swallow.
Congress On Caregiver Program Expansion
That sentiment aside, Congress promised more deliberations on the subject but reminded the Secretary of the agency’s present failure to process existing benefits in a consistent manner.
RELATED: Caregiver Program Investigation
For the past two years, managers of the Caregiver program at VA medical centers nationwide have begun disenrolling families or lowering tiers without following the traditional standard of care assessments to truly ensure the veteran requires the level of care consistent with the tier assignment or disenrollment.
Caregiver Program Tiers
Caregiver payments are allocated using a tier system. The higher the tier, the higher the payment amount relative to the perceived number of hours of care required:
- Tier 3 – 40 hours of care per week
- Tier 2 – 25 hours of care per week
- Tier 1 – 10 hours of care per week
Depending on the severity of the disabilities, the agency assigns a tier.
Caregivers Getting The Shaft
Lately, VA has moved caregivers off the rolls by sometimes falsely asserting the veteran’s condition improved without qualified specialists in the field having evaluated the veterans.
As an example, some administrators are claiming a veteran’s longstanding traumatic brain injuries somehow miraculously improved after 5 years with no documentary evidence suggesting any improvement was had and despite medical literature suggesting cognitive impairment will not improve statistically after 3 years.
Some caregivers speculate agency administrators are unlawfully purging the rolls using newspeak to redefine severity of known medical conditions with the end goal in mind of graduating veterans off the system even if they have not improved.
It is problems like this, the screwing of caregivers who desperately need the money, that really need some attention.
Poor Appellate Rights Of Caregivers
Tragically, when the agency makes bad decisions, a caregiver has no right to appeal the decision to the Board of Veterans Appeals as a Veterans Health Benefit claim. Instead, they are forced to appeal using the Clinical Appeals framework that only allows review at the VISN level without review and without a hearing.
How is that for due process? Or, does it sound more like the methodology used in Communist governments?