Program of Comprehensive Assistance for Family Caregivers (PCAFC) decision letters issued as of September 28, 2021, include a notice of updated review and appeal rights: VA Form 10-305: Your Rights to Seek Further Review of Program of Comprehensive Assistance for Family Caregivers (PCAFC) Decisions.
If you received a PCAFC decision prior to September 28, 2021, VA will be mailing a letter notifying you of your Board appeal rights. These notices will be issued in phases.
How Veterans and caregivers appeal or ask for a review of PCAFC decisions
Your options depend on the date VA issued your PCAFC decision. If you disagree with a PCAFC decision issued before February 19, 2019, you can now appeal to the Board of Veterans’ Appeals (Board). You can also seek review through the VHA Clinical Review Process (also known as the VHA Clinical Appeals Process).
If you disagree with a PCAFC decision issued on or after February 19, 2019, you can utilize the following options: Supplemental Claim, Higher-Level Review or appeal to the Board. You can also seek review through the VHA Clinical Review Process.
How to get help
If you have questions about forms to request review of or appeal a PCAFC decision, you can call VA’s Caregiver Support Line (CSL) at 1-855-260-3274.
An accredited representative, attorney or claims agent can also help you. To identify an accredited representative, contact your local VA regional office for assistance or visit https://www.va.gov/disability/get-help-filing-claim/.
Review options for decisions issued prior to February 19, 2019
If you disagree with a PCAFC decision issued before February 19, 2019, you can now appeal to the Board. You will need to submit a completed VA Form 10-307, Program of Comprehensive Assistance For Family Caregivers (PCAFC) Notice of Disagreement (NOD) to:
Veterans Affairs Evidence Intake Center
P.O. Box 5154
Janesville, WI 53547
You can also seek review through the VHA Clinical Review Process. Please contact the Patient Advocate at your local VA medical facility for more information on the Clinical Review Process.
Review options for decisions issued on or after February 19, 2019
If you disagree with a PCAFC decision issued on or after February 19, 2019, you can utilize the following options: Supplemental Claim, Higher-Level Review or appeal to the Board. You can also seek review through the VHA Clinical Review Process.
Like the Clinical Review Process, a Supplemental Claim or request for Higher-Level Review will be conducted by VHA.
Supplemental Claim
- If you have new and relevant evidence that was not of record when VA made its PCAFC decision, you can file VA Form 20-0995, Decision Review Request: Supplemental Claim.
Higher-Level Review
- If you want your decision reviewed by a higher-level decision maker within the Caregiver Support Program and do not have additional evidence you want considered, you can request a Higher-Level Review using VA Form 20-0996, Decision Review Request: Higher-Level Review.
Submit your completed VA Form 20-0995 (Supplemental Claim) or VA Form 20-0996 (Higher-Level Review) to:
Veterans Affairs Evidence Intake Center
P.O. Box 5154
Janesville, WI 53547
Appeal to the Board
- To appeal a PCAFC decision to the Board issued on or after February 19, 2019, you will need to submit a completed VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) to:
Board of Veterans’ Appeals
P.O. Box 27063
Washington, DC 20038
Fax: 844-678-8979
The VHA Clinical Review Process (also known as the VHA Clinical Appeals Process) is still available for all PCAFC decisions
The VHA Clinical Review Process is still in place for Veterans and caregivers who want to seek a review of their PCAFC decisions. To better serve Veterans and caregivers, VA has improved this process. The average VHA Clinical Review Process takes approximately six weeks to complete.
Contact the Patient Advocate at your local VA medical center or your Caregiver Support Coordinator for more information.
If you received a PCAFC decision prior to September 28, 2021, VA will be contacting you
Over the coming months, VA is proactively contacting individuals to inform them of their right to appeal PCAFC decisions to the Board.
VA will be mailing these notices over a period of several months, so not everyone will be receiving notices at the same time. This phased approach is being used so that VA can be as responsive as possible to questions and requests for reviews of decisions.
Questions? Reach out to us
If you have questions about PCAFC, the Caregiver Support Line is available to assist toll-free at 1-855-260-3274.
Find your Caregiver Support team or Caregiver Support Coordinator using the facility locator.
Please visit www.caregiver.va.gov for more information on the Caregiver Support Program and any updates.
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Yes Frank.
My wife has been made to feel humiliated and she does not understand why she was denied to the program.
She has psychosis with Schizophrenia caused by her service in the Army.
She is 100% total and permanent service connected and she truly requires instruction, supervision and protection from the hazards inherent in the environment….and that includes those would take advantage of the vulnerable.
She has mental unsoundness and has chronic Schizophrenia, but I can see how she would feel somehow punished and marginalized. It’s almost too bad that she has all her limbs in that that would make her disabilities appearant.
As her caregiver my experience with this program is that the matter was a forgone conclusion with the finders of fact within the program. The clinician even went so far as blaming us for the technical problems during the evaluation stating, “This only happens when YOU are recieving texts or phonecalls.”
No one was texting or calling us during that time.
Also it appeared that the criterion he used to determine our acceptance or denial was a sort of moving goalpost and was very capricious and arbitrary. The denial letter states that the Veteran did indeed require personal assistance but that the level required did not meet the program requirements. Funny thing about that statement is that there is no clear mark that indicates reaching a certain level or threshold to supercede or rise above.
Also the so called clinical appeals process was and is a complete waste of time and effort as well.
The second denial letter is nearly as vague and ambiguous as the first. No concrete anything other than vague pronouncements about “experts with the program’ and other such unclear information and nonsense.
In fact when her doctor walked over to the office of the program and asked whether he should document his clinical recommendation or assessment….they flat out told him no…not to.
Hmmmm…? ( I have the letter he wrote to me stating these matters)
I can’t go to work in any normal capacity as my wife safety is of the highest priority and none would argue that she could not be able to live independently without my assistance and help.
It’s absolutely incredible that the program would deny her this clinical benefit from the VHA.
I strongly believe that when a Veteran is found to be 100% disabled, be it mental or otherwise, there should be no denial on a Caregivers Claim.
Especially when both the Veterans Administration and Social Security (disability) Administration find the Veterans completely Totally and
permanently disabled. It is an injustice to a Caregiver, to be denied a stipend, a total disregard of her service and Hard work thru the Years. We should not have to beg for what the V.A. knows Caregivers deserve, that is why the program came to be. Let it be known that Caregivers have saved the Federal Government millions of dollars. We should not be humiliated, because of the changes in the new policies that govern the program. Please know that every dollar that a Caregiver receives, has been paid by the Veterans Service to this Great Country we so much Love. Now is the time for the V.A. to care for the Veterans and also the Caregiver, the Caregiver who for some has been a 50 years+ commitment. God Bless this Country and all our Veterans.
Where is my reply…?
No fault of mine my disappeared comment is absolutely verifiable true.
They have deleted the original reply to this post.
For Shame.
There were no swear words…nothing vulgar…nothing untrue…nothing other than a concise account of our experience with the program detailed here.
If the medical records do not indicate all that the veteran is medically going through and requires a caregiver to get approved for PCAFC, make a home visit and see the necessity out there for our military heroes. Approve the applications.
I have been denied twice! My husband is rt leg ampute above the knee, lost a left kidney and part of his stomach. His one lef that he has got pins and wires in the knee and is unable to walk at all now. Also he has COPD and he requires assistance with everything. He served his country in Vietnam and is currently 74 yrs old. I also agree that the process is extremely complicated also. And ever time you try to reach someone on the phone it always go to vmx.
If the VA would just take a harder look at getting it right the FIRST time when programs become available, they would stop making so much extra work for themselves in the appeals process. Seems so obvious! How is this still allowed to go on? What a waste for money!
Can my wife be a caregiver?
The VA is a joke. This combat infantry vet has fought to get my broken back linked to a Bradley tank falling 20 foot off in a nose dive in to the ground. They cancel appointments all the time n say you did it. Go pull your medical records, everyone will have stuff in theirs of their drs undermining them.
It’s sad vets serve n get hurt or dead n the VA doesn’t give a sht. It’s a huge joke. It’s a disgrace and so is our government.
VA needs reform next on the countries agenda. Then father’s right in family court.
Thank You for the information. We are in need of this program & have been refused. God Bless You for sharing!
We have filed 2 appeals, been denied and are now in the Supplemental Review process. VBA is next.
This is without a doubt the most confusing and difficult program we have ever tried to navigate with the VA. Seems we’re not alone. Tons of appeals being filed. The VA really dropped the ball on this one. Good luck!
Sure wish they would include GULF WAR Vets and caregivers.
more bull sht from the VA