VA Says It's Trying To Improve Caregiver Program's Appeals Process

May 21, 2018
Originally published on May 23, 2018 7:18 am
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Let's follow up on a report from last year about a Veterans Affairs program for caregivers. After all of our country's wars, family members - typically, wives or mothers - have quietly done the work of caring for veterans. Often, they quit their jobs to do that. The VA has a program for post-9/11 veterans to get a stipend for their caregiver, and that may soon expand to all veterans. But last year, NPR News reported on caregivers having their stipend arbitrarily cut. The VA did a review to fix this, but as NPR's Quil Lawrence reports, many caregivers who were dropped still have not been re-enrolled.

QUIL LAWRENCE, BYLINE: In the early days of the Iraq War, troops were riding around in Humvees with almost no armor on them. There was a scandal about it, and within a few years, the trucks got thick steel plates.

GEORGE WILMOT: But they hadn't taken into account the weight.

LAWRENCE: In 2009, George Wilmot was in one of those new Humvees leaving a hilltop base in Mosul.

G. WILMOT: Some wonderful genius thought about uparmoring - good, but you got to upgrade some other stuff, too.

LAWRENCE: Stuff like the steering and the brakes.

G. WILMOT: We took a bit of small-arms fire. My driver took us off a cliff.

LAWRENCE: Wilmot was up in the gunner's turret, and he got thrown free as the Humvee tumbled, which he says was lucky. But part of the gun came off and ripped through his helmet. Another piece went through his left arm. It's now a pink-and-red patchwork, like out of a comic book.

G. WILMOT: Deadpool - nice to meet you (laughter).

LAWRENCE: The VA rates him 100 percent disabled. George gets lost easily, forgets things, like a pot on the stove, and he falls down hard sometimes without warning. His wife Jenn lists his conditions.

JENN WILMOT: Obviously, left arm limb salvage was one, then his TBI, and his back injuries and PTSD. There's, like, a bunch of little ones, and then there's couple of big ones, but yeah.

LAWRENCE: NPR first spoke to Jenn Wilmot last year because she'd been part of the VA program to be George's full-time caregiver. Vets love that program, not just for the stipend, but also the recognition of the care their families provide. Two years in, the Wilmots were dropped from the caregiver program, even though George still needs so much help that Jenn can't get a job outside the home.

J. WILMOT: But, you know, if - in order for me to leave the house, it's, like, I need to make sure somebody is at least...

G. WILMOT: She don't like leaving. Plus, I know I'm going to be stationary for whatever length of time.

J. WILMOT: A lot of times, he'll hang out in the bedroom. Like, if he knows I'm going somewhere and nobody's here, he'll hang out in our bedroom because there's a short distance right to the bathroom.

G. WILMOT: And I got a nice bed.

J. WILMOT: Yeah. That's not how you should live, though (laughter).

LAWRENCE: NPR found that eight VAs across the country were dropping caregivers off the program while most other VAs were adding. The numbers looked arbitrary from city to city. That was bad luck for the Wilmots. They go to the Charleston, S.C., VA, which dropped 94 percent of its caregivers in three years. After the NPR report last year, VA briefly paused all revocations - that is, stopped kicking people off the program - and carried out a strategic review. Meg Kabat directs the VA's Caregiver Support Program.

MEG KABAT: We were able to issue a directive. It's on the VA website, so it's there for caregivers, veterans, advocates - one policy that is followed by every medical center across the country.

LAWRENCE: So veterans like the Wilmots thought that program would be fixed. Jenn says the Charleston VA asked her to reapply, then rejected her. And those VA statistics haven't changed much. The Charleston VA had 197 caregivers on the program four years ago. Now there are only 13. Northern Arizona kept cutting. Same with Puget Sound. Fayetteville, N.C., had 570 caregivers four years ago. Three hundred and fifty have been cut, including Ashley Sitorius (ph) and her husband, William (ph).

ASHLEY SITORIUS: I thought, well, he's serving our country. You know, he'll most definitely be taken care of.

LAWRENCE: Williams served in Iraq and Afghanistan. He's also 100 percent disabled.

SITORIUS: They just said he wasn't clinically eligible anymore and he didn't need a caregiver. And honestly, he's gotten worse. I wish he was better.

LAWRENCE: Ashley says last year, after the program paused, she applied again, got rejected. She appealed to the regional office. In March, she got rejected again.

SITORIUS: Continually having to advocate and fight for his right and his benefits has been completely and utterly exhausting and outrageous. It shouldn't be like this.

LAWRENCE: The program's director, Meg Kabat, says some VAs are still correcting the error of letting way too many people in at the beginning.

KABAT: So I think it's not surprising to me that there is a group of veterans who participate in the program for a period of time and then are discharged.

LAWRENCE: That's also because once caregivers get in the program, they start using a lot of other VA services, too, so many vets improve and graduate out, which is the goal, says Kabat. But for some veterans, that goal may be out of reach. Britnee Kinard takes care of her husband, Hamilton. He survived multiple bomb attacks in Iraq, but the blasts left him with a brain injury, among other things.

BRITNEE KINARD: Let's say Hamilton's coming down the stairs, and his leg gives out, and he falls and he breaks his neck, and he's laying at the bottom of the stairs, and I'm at work because I got cut from the caregiver's - he could be dead by the time I got home.

LAWRENCE: Britnee Kinard got kicked off the program by the Charleston VA in 2014. She wants to go back to work. She had a well-paying job in banking. But her husband isn't getting better. He's deteriorating. He needs help with bathing and toileting. She's dreading taking away his car keys.

KINARD: I try my hardest not to pull his, quote, "man card." I want him to be as independent as possible. But the reality of it is is the more his health progresses, the less independent he is. And I'm trying really hard not to take that from him.

LAWRENCE: The VA says it's still standardizing the boards that evaluate applications and says last year, it audited hundreds of the cases of people removed. But some of those caregivers have been on the phone with their senators. Last month, Republican Dean Heller of Nevada and Democrat Bob Casey of Pennsylvania sent a letter to the VA. Vets kicked off before the program was improved shouldn't be abandoned, says Senator Casey.

BOB CASEY: Caregivers should not be treated differently because their case happened to come up for review a week before or a week after the time when the VA froze discharges.

LAWRENCE: The VA's acting secretary, Robert Wilkie, responded that VA is working to improve the clinical appeals process so vets and their caregivers can get back in. Sitting with her disabled husband, George, Jenn Wilmot says her last appeal was exhausting.

J. WILMOT: Does he need it? Oh, yeah. I know he does. But it's just too tiring to fight.

LAWRENCE: She might be up to it, she says, if she weren't working full time taking care of her veteran.

Quil Lawrence, NPR News, Charleston, S.C.

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