VA revamps caregivers program: Those who already qualified must reapply

A MARTINEZ, HOST:

The Department of Veterans Affairs has a very popular program that pays a stipend to those who care for post-9/11 veterans, often family members. In 2018, Congress revamped it to include Vietnam-era and older vets. But with this new law, all current caregivers must reapply to stay on the program. And they're not all guaranteed to qualify, as NPR's veterans correspondent, Quil Lawrence, reports.

QUIL LAWRENCE, BYLINE: Expanding the caregiver program to include Vietnam vets and older - that seemed more than fair to Stacy Taylor. She just never thought it would mean that she'd get dropped.

STACY TAYLOR: When you meet my husband or see it on paper, I look at his charts, it's like, well, he absolutely needs a caregiver.

LAWRENCE: Forty-five-year-old Tom Taylor served in the Coast Guard until an accident in 2014 fractured his spine.

TAYLOR: He's a C7 quadriplegic, has use of his arms but no real use of his hands - so no grip dexterity, no fine motor skills, stuff like that. So I have been his caregiver since day one.

LAWRENCE: The VA notified thousands of caregivers like Taylor that they'd need to reapply to the program. To qualify now, a veteran must need help with what the VA calls an activity of daily living, an ADL. Taylor says her husband needs help with eating, dressing, bathing and getting between his bed and wheelchair. But apparently, that wasn't enough.

TAYLOR: We had our final of the three phone and video interviews on the 28 of December. And we got the notification via phone call on the 30 of December. So it doesn't really seem like they did a very lengthy review by any means.

LAWRENCE: Taylor says that's incredibly fast by VA standards. The other way a caregiver can qualify is if the veteran needs supervision, protection or instruction. That's where Gennette Burgess figured her husband would qualify.

GENNETTE BURGESS: He trips and falls frequently. He has - his balance is really thrown off because of the injuries to his ears from the blast. But it's also thrown off by his traumatic brain injury and the fact that he's missing his right leg.

LAWRENCE: Dan Burgess lost his leg to a bomb in Afghanistan. His other leg is what's called a limb salvage, missing some muscle and skin. It's the brain injury and PTSD that Gennette worries about, though. She says he's liable to injure himself if she's not there. Just tracking her husband's health issues, she says, is a full-time job.

BURGESS: We aren't young. He was 33 when he was injured, and he's 43 now. And time is not friendly on our side right now because as he ages, the injuries are just getting worse.

LAWRENCE: Burgess says her evaluation started December 1.

BURGESS: December 14, Christmas Eve, we got two certified letters from the VA that we had to sign for. They stated in there that he did not need supervision. You are no longer needed, basically. That's how it makes you feel.

LAWRENCE: The rejection letters are generic, with no specific reasons or explanations. There is a chance to appeal, and both Burgess and Taylor say they will. But they're anxious. The VA says the law requires them to do this review. Several thousand caregivers from the current post-9/11 program probably won't qualify under the new rules, says VA's Meg Kabat.

MEG KABAT: And those caregivers are still caregivers. They're still doing caregiving. They just don't qualify for this particular program. They qualify for a lot of other programs.

LAWRENCE: For example, many of these vets still get the VA's highest level of monthly disability payment and free health care. But losing the stipend is hard, especially when caregiving remains a full-time job. Kabat says VA recognizes it may be a difficult transition. Many caregivers left behind careers. They've been out of the workforce for years. To cushion that blow, VA says no one will be removed before October this year, with an additional grace period after that before the stipend checks stop. But Kabat says the VA secretary is aware of concerns about this process.

KABAT: We continue to look at how we're implementing this particular law. And if we're not doing it well, then we're going to make some changes because certainly, our goal is to help veterans thrive.

LAWRENCE: And in some ways, it's now easier to qualify. Veterans no longer have to link their need for care specifically to a war wound. A Vietnam vet who's developed Alzheimer's, for example, could now be eligible. And the program is growing as thousands of newly eligible veterans from Vietnam, Korea or even World War II qualify. Their caregivers have been waiting decades for this kind of help.

Quil Lawrence, NPR News.

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