By far, I am not the expert. However, after going through the initial application process, including the exams and interviews for the PCAFC caregiver’s program, not once but twice, and after six Veteran’s Health Administration (VHA) appeals in the last twenty two months, I finally won level 2 benefits at the Board of Veteran’s Appeals (BVA) on June 22, 2020.

My lovley wife, Sandra, Heidelberg Germany 1969.

I am now willing and able to share what I have learned about the caregiver’s program and how to defeat a VHA denied PCAFC decision, if you feel that you meet the eligibility requirements and you are denied, appeal. If you file a higher level revue (HLR), or a supplemental claim, those choices will send your appeal right back before the Veterans Health Administration (VHA) who have already denied you once. I would advise that instead of going with the seemingly easier routes, take your appeal to the BVA because the case will go to the Veterans Benefits Administration for adjudication, not back to the VHA. The BVA is where you will find justice.

Sandra Cripps, my loving wife of fifty four years, and my PCAFC caregiver.

I will restrain myself in the interest of professionalism on my comments herein, but make no mistake about it, the VHA put me, an R-2 veteran, through pure hell over that twenty two month period of appeals and never relented. I doubt that the VHA even knew what an R-2 veteran was. In their decision making process the VHA didn’t seem give a dam what the laws and regulations said, and they didn’t give a dam what the evidence said, they just arbitrarily denied the claim. The expert CEAT team in VISN 9 conceded that I needed help with five ADL’s as far back as February 2021, yet they still belligerently denied level 2 benefits without offering any explanation of reasons and basis for the obviously erroneous decision. The VISN 8 CEAT team, “after a compassionate and thorough review” of my medical records, along with my submitted evidence, denied my last VHA appeal in less than 24 hours after it was submitted to the VAMC Nashville Tn. Patient Advocate. Now if you buy into that crap, I have some ocean front property in Tennessee that I would just love to unload on you.

Through thick and thin!

As due to a recent court case, denied veterans and their caregivers can now ask the BVA to review denied PCAFC cases. The VHA never anticipated that one day the Board would be able to peer over their shoulder and review their work. I can only imagine the thoughts going through the BVA judges mind as he read the overwhelming evidence in my case, only to be denied six times by the VHA, so called, expert CEAT teams. As thousands of veterans and caregivers are appealing PCAFC decisions, can you imagine the backlog of PCAFC claims that is being created by the ineptness within the VHA. There will be thousands of cases, just waiting for review at the BVA.

My reason to live more of life

On the bright side, there has been a really good development of late in that the Senate Veterans Affairs Committee has finally heard the loud cries of the most disabled veterans on the planet. Senator Tester, the Chair of that committee, said that the caregiver program is the most gut wrenching thing that he has ever had to deal with in his fifteen year tenure.

Both the VBA and the VHA has admitted that my case is the first PCAFC case to be heard and granted level 2 benefits at the Board of Veteran’s Appeals.

Every dog has his day!

My 06/22/2022 BVA decision
 
Citation Nr: A22011682
Decision Date: 06/22/22	Archive Date: 06/22/22

DOCKET NO. 210903-192826
DATE: June 22, 2022