The national director of the VA Caregiver Program will soon depart, but not before snubbing Veteran Warriors over memes posted by an organization volunteer.
Meg Kabat, national director of the VA Caregiver program, is leaving next month “to pursue private-sector employment opportunities” without an immediate replacement. The announcement came following a significant failure in processing caregiver appeals fairly.
“The National Caregiver Support Program Office is staffed by dedicated and knowledgeable employees who will ensure the efforts Meg led continue without interruption,” Veterans Health Administration Chief of Staff Larry Connell said in a statement. “VA plans to name Meg’s replacement in the near future.”
So, methinks this departure has more to do with continued failures of the Caregiver Program that have yet to be announced.
Behind VA’s Caregiver Iron Curtain
Over the past three years, the VA Caregiver Program purged veterans’ caregivers from the program. In many instances, the decision to remove the caregiver from the program was not based on facts or concrete evidence but instead on agency budgetary constraints to rein in program expenses.
The scheme was exposed last winter during a congressional hearing that also exposed that the agency failed to meet a deadline for a VA Caregiver Program client management system to help agency and congressional officials better monitor the program’s behavior.
Senator Patti Murray (D-WA) grilled agency officials about the problems within this program and the agency’s officials were ill-prepared for the grilling but agreed to stop the bad acts of VA’s Caregiver Program officials.
It was embarrassing. It was also disappointing given what the caregiver program really does.
What The VA Caregiver Program Does (In Theory)
In case you are late to the game, the program provides monetary support to caregivers of disabled veterans seriously wounded in the line of duty related to Post 9/11 service in certain situations.
That is an over-simplification, but you get the gist.
For example, the wife of a combat veteran with a severe traumatic brain injury incurred while in Iraq who was medically discharged might qualify. He might require an adult living facility but for his wife providing care in the home.
In that situation, it is cheaper and generally better for the veteran to receive support in the home versus being moved into an adult living facility or nursing home.
His spouse might qualify for caregiver compensation at the local rate of a home health aide based on the number of hours of care the veteran regularly requires:
- High Tier: Equates to a maximum of 40 hours of care
- Medium Tier: Equates to a maximum of 25 hours of care
- Low Tier: Equates to a maximum of 10 hours of care
VA provides monthly compensation to qualified caregivers to help offset the economic burden of the wife leaving the labor market to care for the veteran. The example VA provides follows:
If an eligible Veteran requires 10 hours of personal care services weekly (Tier 1) and the Caregiver’s hourly wage (including COLA) is $10 per hour, then the monthly stipend would be: (10 hours x $10) x 4.35 = $435.
This is an obvious win.
Taxpayers pay less for the overall care of the veteran and the spouse leaving her career behind gets at least a little compensation. And, the veteran is able to stay home.
Now, is the agency providing fair compensation? Not really, but the money was more than spouses previously received.
News reports have circulated for the past three years showing VA was cheating the system by “graduating” veterans out of the program resulting in the caregiver no longer being entitled to compensation.
The decision letters would say the veteran’s condition has improved such that the veteran no longer requires in-home care. Now, this might be true for certain conditions, but veterans suffering from severe traumatic brain injury generally never recover, even a little, after a few years, much less fully recover.
What we as advocates began to see was a medical fraud scheme where medical doctors or psychologists were relied on to write and push absurd medical decision letters that contradict known medical facts about the underlying conditions.
However, unlike traditional benefits decisions, caregivers adversely impacted cannot appeal bad decisions to the Board of Veterans Appeals as Health Benefits Appeals. Instead, they could only appeal by filing a Clinical Appeal at the local medical facility that previously rendered the same bad decision.
No appellate oversight or access was allowed. And, many wrongly denied caregivers were wrongly denied revenue resources in an unfair manner.
Meg Kabat = Meme-Slapped
Meanwhile, behind the scenes, the growing veteran organization Veteran Warriors was blamed for the Kabat departure. Apparently, the organization’s assertive brand of advocacy pushed Kabat to the breaking point that concluded with a sudden refusal to meet with organization officials.
Internal officials reportedly said memes circulating about her possible departure served as the straw on the camel’s back ending cooperation with the organization. Kabat was done with the weight of so many mounting failures and the obvious pressure from Veteran Warriors.
Two memes, with the second included below (the first meme was in the article’s header above), were allegedly posted by a Veteran Warriors volunteer, swiftly removed, but later cited by the agency as the basis for denying a meeting with the group just prior.
Imagine if Disabled American Veterans were denied meetings with VA for all the memes, jokes and comments posted by its volunteers or members?
Below in italics is a copy of the organization’s response about the memes and their disappointment with agency officials for refusing to meet with them.
Since when did VA officials develop such thin skin?
Letter From Veteran Warriors On Meg Kabat Departure
The departure of Ms. Kabat from the VA Central Office and managing the VA’s “Caregiver Program” brings trepidation to those of us “boots on the ground”. After spending over two years trying to engage the leadership of the program (and the VA), one would think advocates would be happy, well, we are not. We are anxious and walking blind through the maze that passes for laws, regulations and bureaucracy run amok.
During a recent Congressional hearing, Senator Patti Murray (D-WA), pushed the VA Secretary to suspend the revocations (removals) and tier reductions, until such time as the Secretary has rectified the problems (all the ones we identified). The Secretary promised that the suspension would take place and that he would “engage external stakeholders” to develop a plan to make the necessary corrections to the program.
Since that hearing, my organization has spent weeks trying to engage VA leadership, to review the culmination of our 2 plus years of work, all of which highlights the rampant dysfunction and dereliction that is exhibited throughout the enterprise.
At one point, VA leadership agreed to a meeting. They claimed to be genuinely interested in the training program we built, solely to educate every employee who works in the program. That effort alone would cure 90% of the problems we have identified. After the meeting had been scheduled, we received a message that it was “paused”.
We later were told that a “meme” posted by a volunteer (without executive approval and immediately removed AND apologized for), one that was very unkind to Ms. Kabat, was the reason our meeting was “paused”. That was a week ago. Since then, our attempts to reengage VA leadership have fallen on deaf ears. Quite literally, we have hit a stonewall.
There are literally tens of thousands of veterans and their families who 1) are eligible for this program, and 2) are being denied access to this program solely based on misconstrued laws and regulations, policies created with the intent to “graduate” veterans (in contradiction to the intent of the law) and personal agendas that have skewed and damaged the very program veterans and their families rely upon.
The use of “circling the wagons” and refusing to actually work with we “external stakeholders” will only continue to hamper the program’s existence and will be detrimental to the MISSION ACT expansion due next year. As we all await word on Ms. Kabat’s replacement, we wish her the best in this next chapter of her life and we send up positive thoughts hoping that her replacement WILL be one who wants to fix this badly broken program.
The Caregiver Red Hearing
Now, this is bad. It is really bad.
Why would VA bureaucrats think it is okay to stiff caregivers? And why is Veteran Warriors being treated differently than officials at The Big Six veteran organizations?
Nonetheless, my preliminary research on this suggests the caregiver benefits fixation is simply a red herring for a lot of veterans, at least in a sense.
I have no doubt the compensation being sought has resulted in financial hardship making this a half-red herring. But, many caregivers are focusing on the wrong benefits.
Here is what I mean.
Many veterans with caregivers have severe residuals from a traumatic brain injury while in the military. Veterans who require in-home caregivers on a regular basis may also be entitled to Special Monthly Compensation (SMC) to the tune of over $8,000.
That is around $4,000 more per month than many families receive when you combine disability compensation payouts with the caregiver payments.
Now, if you are reading this, and you believe your case may fall into this category – where the agency knows you require a caregiver but has failed to evaluate you for a higher level SMC-T – definitely hit me up for more information at my law practice.
I plan to write more about this in the future. But until then, I wanted to link to my consult page above so you would have a source for feedback.
The TBI – Caregiver Cunnundrum
A few years back, we caught VA using unqualified doctors to assess the residuals of TBI of veterans seeking benefits from the agency.
The agency regularly used family doctors or nurses to evaluate the evidence for a TBI resulting in wrongful denials of thousands of veterans. It took an IG investigation to sort out that mess and a scandal we exposed through this blog and at Kare 11 News to beat back the agency.
When you combine that kind of issue with the multi-year Caregiver Program debacle, most of us can imagine the frustration these families must be feeling in securing the compensation they need to provide care for the most severely disabled among us.