Caregiver Program Expansion

Veterans Affairs Seeks Caregiver Program Expansion To All Veterans

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.

His argument?

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.

RELATED: VA Sued For Malpractice After Veteran Death

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.

RELATED: Study Shows Link Between Marriage And Suicide Risk

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?


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  1. Early last year, Veteran Warriors provided the House Committee on Veterans Affairs with irrefutable proof that there is a systematic “culling of the herd” so to speak, of veterans from this program. After a lengthy investigation, we uncovered that over 26,100 veterans had been terminated from the program in just two years (Jan 2015 – Feb 2017). There were nearly as many that were reduced or even denied entry in the program. We found thousands of cases around the nation, where veterans were unlawfully revoked; even when their conditions had worsened. We found evidence that there appears to be an unpublished policy prescribing specific methodologies for these terminations. They include quotas, consistent language, disregard of medical evidence and even cases of fabricated and altered evidence to support these terminations.
    Over a year ago, Veteran Warriors submitted a formal request to the House Committee on Veterans Affairs for a full hearing on the VA’s “Caregiver Support Program”. In that year, despite VA leadership promises to the contrary, the terminations continue, the appeals are still being denied, and nothing has changed.

    As we watched on the sidelines again as Congressional leaders and VA officials bandied the facts and statistics. We listened as Secretary Shulkin and Ms. Margaret Kabat, (Acting Chief Consultant for the program) lobbied shamelessly for Congressional blessings for what they have been doing since 2013; gutting the program of the most eligible veterans, revoking those very veterans for whom the program was designed. All of this is being done under the guise of “expanding the program”. We believe that the use of this latest flag is to gain support by those veterans who, due to the criteria of the law are not eligible for the current program.
    While we are grateful that the Committee has taken up this fight again for us, and pleased that Chairman Roe has called for yet a second “Roundtable” to discuss the situation; we can’t help but wonder how much more “discussion” is needed to prove that (as the Secretary himself has admitted); the VA is adversarial to veterans? The time for discussion is over. It is time for action; actions that will force the VA to abide by the law and conduct this program as Congress intended.

  2. Reducing or eliminating veterans off the care giver rolls is a disgraceful but intentional act directed by Shulkin. There is no other explanation for why this could be happening across multiple VISNs, and without regard to the condition of the veteran.

    What is worse is that this is being done with the quiet approval of those in Congress. If that were not the case, it would be very easy for congress to examine the case of a veteran and their family being thrown off the rolls. That it continues proves they are in agreement with it.

    Given the VA wants to take that action, and given the caregiver program was to reduce nursing home costs as the intention, there must have been a VA program for that nursing home program. If that is the case, then families should push VA to enroll their family members in a nursing home. Once that starts to happen and the VA realizes what the cost will be, then they might realize their bluff has been called, and they will stop this nonsense.

    It is absolutely disgraceful to see veterans thrown off this program when VA continues to piss away billions on worthless IT or other contracts.

  3. Caregivers from all era’s should be getting assistance. If you can spend billions on fucked up buildings in Denver, billions on fucked up IT projects, billions on solar panels, billions on bonus’s, billions on AFGE/SES, salaries and retirement funds, and let’s not forget the billions sent over to our buddies the Iranians, just so they can produce more disabled American Veterans.

    Then you can pay those who bear the responsibility, “To care for him who shall have borne the battle and for his widow, and his orphan.”

  4. I recall contacting Ben about this topic a couple years ago, offering to provide detailed whistleblower information, to no avail. He declined to pursue the story. I’m glad to see it’s newsworthy now.

  5. “[…Depending on the severity of the disabilities, the agency assigns a tier…]”-

    Then places all tiers on respective waitlists, which also have a tired system and at the end there’s an AFGE engorged purple team member sporting only a cold crocodile tear; no tiers whatsoever.

    Notice the VA just loves to assign ‘star ratings’, ‘tiers’, anagrams and posters for them all but is usually, usually only placing very expensive lipstick on a piggy that’s only there for the bacon.

    1. To clarify: I worry that again, under the guise of “assisting veterans”, it’s really only an AFGE chess move in expanding dues-paying membership minions and yet more crony contracts and guess what? Veterans will still die because of neglect and unqualified hacks because the VA do as they always do and hire an assortment of hacks that due to legal actions in past or still pending, could not get home healthcare contracted anywhere BUT the VA. Right?

      I hope to be wrong because who the hell wants to be in a nursing home with VA hacks ignoring or poisoning you when they can do it right in your home and also rob you blind while you are duct-taped to the bed while the hack rummages through your home.

      Wait for it… (I do hope to be wrong, but I feel like shit today, what do I know?)

      1. You know nam, I’m a little surprised Little Cox missed this opportunity for forced membership expansion.

        You or others might recall several years ago, the SEIU or others were petitioning states to essentially force family members receiving state aid for caring for disabled family members in their homes to become union members. I believe Illinois was one state that let the thugs rule, so family members were essentially forced union members.

        The SEIU didn’t give a shit about those families. All they cared about was the dues that would be automatically deducted from state aid and paid to the union.

        I don’t know if that state sponsored extortion continues, but it surprises me the AFGE didn’t try the same thing.

  6. Still boils down to the bogus VA attorneys.
    They need emotional support squids at General Counsel . Fuck a duck, quack, quack!

  7. The common core here of course is precisely the same problem that has cause corruption throughout VA’s history; as a practical matter you cannot appeal to any higher authority for relief.

    In all matters of human endeavor there will be EVERY level of employee who decides to interpret the laws according to their understanding of their right to assert themselves like this and affirmed by the Oprah Winfrey Show or cousin Jeb up in Idaho. The Marine Corps puts it a bit more simplistic; everyone has two things, “opinions” and “assholes” and they ALL STINK.

    So we get around this by implementing a peaceful process of appeal and usually as a chain of command so to speak. It is this chain of command that VA breaks in the traditional appeals process.

    Most folks I ever went to school with end up at some point in life and angery say somehting like, “I will take is all the way to the the Supreme Court if I have to!” What this tells me is that America has a core belief that the chain of appeals of a government decision at least has a remote possibility of going ALL THE WAY up the chain and into our Supreme Court. In essence most Americans by Marine Corps standards are garaunteed a right to hear all of the opinions from all the assholes all the way up to the top if needs be.

    Not so at VA. All the opinions still float around in equal measure to GI tract exit points but when you disagree with them the best thing you can hope for, in a sense, is to ask the same asshole to change his opinion. There is no chain.

    In MY OPINION (a vet who received 5 Cat One PRF letters inless than 18 months) as a vet who has SEEN how the assoles routinely put forth their legal opinions based on the ham sandwich crumbs in their lunch box and then apply them to Americans liberty, property, and lives it is clear to me that the ability to comprehend even core concepts of Americana, like freedom of speech and expression, Due Process, Equal Protections, and Presumption of Good is beyond them. Trust me these people ARE NOT the brightest candles on the cake.

    As a former inpatient on a VA mental ward I have seen a lot of irrational, stupid, and frankly nut job type behaviors. Some of the patients were disturbed this way also but not NEARLY to the same degree.

    1. Appeals strategy for PRF flags in my case? Since most PRF flags are two years how can a single message recorded into a voice mail from my home have resulted in 5 PRF letters over the same thing? Because Roseburg interpretted the law to say in response to a PRF appeal that points out illegal behavior they toss the current PRF rednering the appeal moot, then rewrite a brand new PRF to address the issues of the appeal. No shit.

      Each letter became more and more nebulous about just what it was that the flag was for lolz, but they could NEVER explain why a PRF was issued for calling and leaving a message on a machine (deemed non threatening by VA police) since the PRF is ONLY authorized for behavior while on VA property. Each appeal pointed this out and my congressman had to get involved and even then for me the FINAL APPEALS process used after all other means were tried was the press. The press got the flag dropped – then VA dropped me. SO now even more people are involved. Isn’tt hat how it works though now with this crew? The appeals process involves embarassing them publicly into reconsidering poor decisions and this is a huge waste of human effort.

      If a genuine appeals process had existed for judicial review the cost savings would be HUGE.

      1. @Dennis,
        There is recourse for judicial review of this particular matter under “abuse of process” , recently affirmed by the 3rd circuit. The FTCA is the cited path for judicial review.
        Here is the quoted info #

      2. I appreciate there are methods of relief provided but my point was that the appeals process is broken and then the recourse really then falls outside of an appeals process. I mean if the appeal starts as an affimration of the legal use of the First Ammendment rights but the argument then becomes an agency abused the process then the appeal is never heard. A grievance is heard and then acted upon as a grievance but the core issue that MUST be addressed then vaporizes and the fight then becomes a he said she said sort of fight and not a this is what The People say argument.

        In America we all feel at our core that even non-Americans on our soil or anyone AT ALL deserves their day in court as it were not to decide the culpability of wrong doers really but to affirm what is and what is NOT an enumerated authority granted to a federal worker. Americans consider it an intrinsic right to clear their good names when accused and that ALL deserve an answer to the question; can the government do that to me?

        All Americans deserve to have their appeal heard on the merits of the facts within appeal and not based instead on accusations misconduct of those tasked with considering the very appeal themselves! I understand that the difference seems slight but how on Earth can a Supreme Court fulfill its role in government when appeals of federal behavior have no ultimate path to this part of our government? Vets are cut out of this chain as a practical matter but not from seeking relief – vets are cut off from Due Process and there is no relief except to restore those rights fully.

      3. They abuse the process when there is no attorney involved, but the best part of it is that they are easily rattled when you call them out on their fuckery.
        They use the normal course of trying to solve a problem as a characterization that you are repetitively calling and complaining and so on. Rather than handling the procedure the proper way.
        It is just a enticement and documentation tactic. Icalled central office once, and they already knew my name before I said anything. Go figure.
        Keep on their asses regardless!
        SEMPER FI!

      4. Exactly Dennis.

        When all my crap started I asked ALL of them if it’s in my files that I have ever been threatening, disrespectful towards staff, even the ones who deserved it and more. I asked if anyone had ever filed any complaints or flagged my folder. They all said no complaints at all about me, my manners, or courtesy. But after I got into it with a long list of PAs and idiots I don’t know what they did or claimed.

        I asked them if I had ever turned up a dirty screen, use of booze, or any issues with not following “orders” or “trying” what ever they told me to do. It was NO. Any signs of misconduct? It was no. So why treat a group of us like trash, or be hand picked to sign special contracts with them to being threatened by the VA staff and idiots at the new pain clinic and scum at the Purple Team?

        All I heard on the phone was not being ‘compliant’ and rule breaking wanting to change PCPs so often (limit is once per year), complaining about my new appointed scum healers, and merely asking questions… that I shouldn’t. To my questioning why it was taking months to hear from my new foreigner PCP, the PAs, to continue my other clinic visits and needs. Or like how they lost years long files with a couple of clinics claiming they had no record of me being a patient in their clinic. Then waiting months for my new PCP hag to do my referrals again instead of playing games. With most things told me I was being too accusatory, too rough, or using negative sounding tones in my communications with them and especially the nasty females I had to deal. And still I wasn’t being rude, cussing them, or nasty with them.

        So besides what they scrubbed from my Health E vet site the only thing they could say about me, and a few told me to do… be my own advocate, file appeals (for what) and exercise my rights. Hell, you can’t even talk to these people, stay on the major issue, or get something kicked up to a higher level for someone to actually investigate and do something instead of ignoring it all or totally side stepping the problems at hand.

        Hell. All that crap is equal to me told many times over issues with my property or town issues… “Not to waste my time to file an appeal. Won’t do you any good and you’ll lose any way.” That is how it rolls state-wide and to DC in this state. And I quote.. “you know you can’t fight city hall, LOL LOL LOL. have a nice day. lol”

  8. This whole crack down on the caregiver program is strictly about $$$. These assholes have never had to take care of a loved one with serious medical problems.
    The VA likes to have Directors in charge that have no family and has been proven to be callous in their decision making. What can go wrong ? Move to another VA.
    The VA wants these veterans to be wards of the VA to insure the VA has a place to house them.
    Look at the OIG reports on how they have a steady pattern of prosecuting family members of beneficiaries.
    VA Racketeering 101!

  9. ?Hopefully all you go here expressed your belief on the website call Helping Veterans Helping Veterans.

  10. The Caregiver program has been under attack by Shulkin for some time now. This bogus call he is claiming will increase eligibility to more Veterans is very misleading and deceptive.

    As Noted in an article on the subject from Stars and Stripes on Shulkin’s false claims of expanding the program to make more Veterans eligible. The truth is that Shulkin claims he wants to limit eligibility for the program to the most severely injured and ill veterans in order to expand benefits to veterans of all eras without inflating costs.

    We all know in real life terms that means he want to only allow anyone who has the political connections or legal resources to obtain the eligibility. As for the Average Veteran that means do not bother applying you will automatically be stonewalled and never given proper consideration for the program.



    VA considers restricting eligibility for caregivers program
    Published: February 6, 2018

    ““WASHINGTON — Department of Veterans Affairs Secretary David Shulkin is considering new restrictions to a program that provides monthly stipends and other assistance to family caregivers of post-9/11 veterans.

    Testifying before the House Committee on Veterans’ Affairs on Tuesday, Shulkin said he wanted to limit eligibility for the program to the most severely injured and ill veterans in order to expand benefits to veterans of all eras without inflating costs.

    As is, the Program of Comprehensive Assistance for Family Caregivers provides monthly stipends, medical training and access to other services, such as mental health counseling, to family members of veterans injured after the 9/11 terrorist attacks. Some advocates have fought for years for an extension of caregiver benefits to veterans injured before 9/11, describing it as an unfair disparity.”

    “Shulkin said Tuesday that new eligibility criteria would allow for an expansion without the cost.

    “We can do this in a cost-effective way and focus on who needs the benefit the most,” he said. “This is about learning how we can do this better going forward.”

    Shulkin wants to restrict eligibility to veterans who need help with at least three activities of daily living, such as eating, bathing and dressing. Veterans with cognitive dysfunction would remain eligible, he said.”

    Full Article At:


    Lets also not forget that the VA takes a lot of taxpayers dollars by placing Veterans in nursing homes as opposed to providing assistance to keep the Veteran in his, or her, own home.

    For some Veterans the VA bills Medicare as much as $700+ per-day for maintaining Veterans in nursing homes. That does not even include the money they bill for medical care for Veterans in Nursing homes.

    1. Seymore,
      You make a great point about “Shyster Shithead Shulkin”! In my opinion, he’s just trying to figure out how to get more Taxpayers Money into his “Slush Fund”, ie; his wallet!

      Plus, When was the last time we ever heard him telling the truth about what’s really going on in the VA? He’s been caught numerous times lying to Congress, Veterans and the American People!

      1. @Crazy elf – I couldn’t help noticing that you’ve extended *Shitty’s* name with another S word. Shall we make T-shirts and then sell them to his faithful followers? You know that’d be POTUS Trump too? Unless things are noticed, and interpreted as not getting better at the VA.

    2. Your point is on target. Shulkin has modified his dissertation and public speech about the CG program to fit the current agenda of expanding the program. HOWEVER…if one watched the hearing, he has no intention of doing that. He and his moral-less minion, Kabat; have been culling the numbers very systematically since he was made Under Secretary of Health. We found the PROOF that they were doing it and KABAT is at the center of it; we gave Congress that irrefutable PROOF a year ago. Ben is correct that what passes for “due process” under this program is a joke that no one is laughing at. Fake appeal boards that don’t exist. Program leaders that don’t review any appeals, they just are “signatories” (we have THAT on tape from the head of Social Work at James A. Haley VAMC) and open retaliation against the veterans and their families.

  11. Since I was a teenager, I’ve always been bothered by the following question;

    How come when a person joins or was enlisted into the military, that it is accepted that they may have to sacrifice for their Country, but yet even if they are severely wounded, and require almost around the clock care, then why does their family members have to pitch in, and bare most of the burden of taking care of them, and not the VA?

    It doesn’t add up or make sense to me.

    1. It could be because VA management is just a bunch of moral delinquents. When morality is severed from the law then we have ___________. The VA is like a Junta

    2. Now’s your chance to do something. It’s open season on fresh meat, and the recruiters are making the rounds to schools. Those wide eyed hormone-jacked confused kids gazing at shiny shoes and some dangly medals and ribbons on some strack chiseled and creased Girine. Don’t for get the flag wavy stuff either. It sells. One little poster or placard. “Don’t Do It Kid” “Ask A Veteran About the VA” “Your Country Will Betray Your Sacrifice”.

      You can be that recruiter will send that event up the chain of command. One thing the Military Industrial and Security Complex needs is fresh meat. Nothing sells a profitable war better than a dead kid.

      1. Your right, and i wish i could do more, doing all i can right now. Yep they need fresh body’s to pull those triggers don’t they. You know i wish i would have stayed on the farm forkin shit, i know i would have made out better in life. It does something to my soul when i see a veteran suffer, suffer from injustice, or in distress, so much so that i start going hyperA at times and i can’t calm down for days, weeks sometimes. Doing whatever i can, wherever i can to help a vet. Just can’t stand to see another vet suffer through the same things i had too and still do.

    3. I am sure if the VA had their way, they would house veterans needing nursing care at some dump as far away from family members as possible.

      They wouldn’t have to deal with pissed off family members showing up three times a week, and it forces a family member to choose to keep their family member at home if at all possible, and allows the VA to avoid that cost of proper care.

  12. How many Veterans approved about what is happening with our VA Caregiver Program and another Government Shut Down?

    1. @AC if a tree falls in the woods and nobody is there to see it does it make a sound? If the government shuts down and nobody is looking is it even noticed?

      1. Evidence proves that a blind man can hear a tree fall. A blind and deaf man can feel the vibration from the tree hitting the ground.

        There are lots of blind and deaf people in DC>.

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