I believe I saw another post from you about not being able to apply for Caregiver Benefits until you are out. If so, read below. I wish you the best in your health and life.
Regulations for Caregiver Program are 1. US Code 38, 1720G and 2. 38 CFR 71 (you really just need to read the 38 CFR 71 and it's only a few pages. You can google it or go to this link
https://www.gpo.gov/fdsys/search/pa...8-vol2-part71&packageId=CFR-2012-title38-vol2)
I recommend anyone interested in the VA Caregiver Program to read it, know your rights and the process. My VA Caregiver Program excludes a veteran's Primary Care Team from all aspects of the program and doesn't consult them. Actually, the Caregiver Program employees aren't suppose to be involved in the process of the Primary Care Team, read the 38 CFR 71. They are accessing veteran's medical and mental health records to include the psychotherapy notes (conversations between veteran and their mental health doctors), hold a board (only Caregiver Program employees) and make medical decisions a veteran's Primary Care Team is/are required to make.
The Social Workers that are working in the VA Caregiver Program are Licensed Clinical Social Workers (LCSW) they are not Licensed Clinical Doctors/Physician Assistants that make 'clinical evaluations', treatment care plans, deciding what type of care required and train the primary/secondary caregiver. So, don't let that Social Worker title confuse you with the word 'clinical' in it because it doesn't give them the authority to make medical and mental health care decisions for you, that's your doctors clinical duties to provide to you when you go in for treatment/care. So, when you read 'clinical determination', clinician, clinical team that means a licensed doctor, physician assistant, nurse, psychiatrist, psychologist, cardiologist, neurologist, etc...that your actually go see for care/treatment it doesn't mean the LCSW in the Caregiver Program. Now if you are being treated for a condition by a LCSW then that person can be apart of your Primary Care Team if your Primary Care Doctor deems this person needs to be a part of the team for the Caregiver Program.
Your Primary Care Team headed by your Primary Care Doctor is/are the ones to make eligibility, type of personal care services; interviews and approves primary/secondary caregiver and provides the training, determines the number of hours required for your primary caregiver, etc... The employees in the Caregiver Program employees are not involved in this process - it's total up to your Primary Care Team. You don't have to go through a c&p or a different doctor - 38 CFR 71 states these requirements are the duty of your Primary Care Team.
You can apply if you meet the following criteria of 'servicemember or veteran' according to 38 CFR 71, 71.20 states....
§ 71.20 Eligible veterans and servicemembers. A veteran or servicemember is eligible for a Primary or Secondary Family Caregiver under this part if she or he meets all of the following requirements:
(a) The individual is either:
(1) A veteran; or
(2) A member of the Armed Forces
undergoing a medical discharge from the Armed Forces.
(b) The individual has a
serious injury,
including traumatic brain injury, psychological trauma, or other mental disorder, incurred or aggravated in the line of duty in the active military, naval, or air service on or after September 11, 2001.
(c) Such serious injury renders the individual in need of personal care services for a minimum of 6 continuous months (
based on a clinical determination), based on any one of the following clinical criteria:
(1) An inability to perform an activity of daily living.
(2) A need for supervision or protection based on symptoms or residuals of neurological or other impairment or injury, including traumatic brain injury.
(3) Psychological trauma or a mental disorder that has been scored, by a licensed mental health professional, with Global Assessment of Functioning (GAF) test scores of 30 or less, continuously during the 90-day period immediately preceding the date on which VA initially received the caregiver application. VA will consider a GAF score to be ‘‘continuous’’ if there are at least two scores during the 90-day period (one that shows a GAF score of 30 or less at the beginning of the 90-day period and one that shows a GAF score of 30 or less at the end of the 90-day period)
and there are no intervening GAF scores of more than 30.
(4) The veteran is service connected for a serious injury that was incurred or aggravated in the line of duty in the active military, naval, or air service on or after September 11, 2001, and has been rated 100 percent disabled for that serious injury, and has been awarded special monthly compensation that includes an aid and attendance allowance.
(d) A
clinical determination has been made that it is in the best interest of the individual to participate in the program. (e) Personal care services that would be provided by the Family Caregiver will not be simultaneously and regularly provided by or through another individual or entity.
(f) The individual agrees to receive care at home after VA designates a Family Caregiver.
(g) The
individual agrees to receive ongoing care from a primary care team after VA designates a Family Caregiver. (Authority: 38 U.S.C. 501, 1720G(a)(2))
§ 71.25
Approval and designation of Primary and Secondary Family Caregivers.
(a) Application requirement. (1) Individuals who wish to be considered for designation by VA as Primary or Secondary Family Caregivers must complete and sign a joint application, along with the veteran or servicemember. Individuals interested in serving as Family Caregivers must be identified as such on the joint application, and no more than three individuals may serve as Family Caregivers at one time for an eligible veteran, with no more than one serving as the Primary Family Caregiver.
(2) Upon receiving such application, VA will perform the
clinical evaluations required by this section; determine whether the application should be
granted; and, if so, whether each applicant should be designated as identified in the application.
(3) An application may be put on hold for no more than 90 days, from the date the application was received, for a veteran or servicemember seeking to qualify through a GAF test score of 30 or less but who does not have a ‘‘continuous’’ GAF score available.
(b) Eligibility to serve as Primary or Secondary Family Caregiver. In order to serve as a Primary or Secondary Family Caregiver, the applicant must meet all of the following requirements:
(1) Be at least 18 years of age.
(2) Be either:
(i) The eligible veteran’s spouse, son, daughter, parent, step-family member, or extended family member; or (ii) Someone who lives with the eligible
veteran full-time or will do so if designated as a Family Caregiver.
(3) There must be no determination by VA of abuse or neglect of the eligible veteran by the applicant.
(4) Meet the requirements of paragraph (c) of this section, and any other applicable requirements of this part.
(c) Assessment, education, and training of applicants. Before VA approves an applicant to serve as a Primary or Secondary Family Caregiver, the applicant must:
(1) Be
initially assessed by a VA primary care team as being able to complete caregiver education and training. Such assessment will consider any relevant information specific to the needs of the eligible veteran,
as well as:
(i) Whether the
applicant can communicate and understand details of the treatment plan and any specific instructions related to the care of the eligible veteran (accommodation for language or hearing impairment will be made as appropriate); and
(ii) Whether the a
pplicant will be capable of following without supervision a treatment plan listing the specific care needs of the eligible veteran.
(2)
Complete caregiver training and demonstrate the ability to carry out the specific personal care services, core competencies, and other additional care requirements prescribed by the eligible veteran’s primary care team.
(d) Caregiver education and training. For the purposes of this section, caregiver training is a program of education and training designed by and
provided through VA that consists of issues that are generally applicable to Family Caregivers, as well as issues specific to the needs of the eligible veteran. During this program of education and training, family members are eligible for beneficiary travel under 38 CFR part 70. Respite care will be provided during the period of initial caregiver instruction, preparation, and training if the participation would interfere with the provision of personal care services to the eligible veteran. Caregiver training will cover, at a minimum, education and training concerning the following core competencies:
(1) Medication management;
(2) Vital signs and pain control;
(3) Infection control;
(4) Nutrition;
(5) Functional activities;
(6) Activities of daily living;
(7) Communication and cognition skills;
(8) Behavior management skills;
(9) Skin care; and
(10) Caregiver self-care.
(e)
Initial home-care assessment. No later than 10 business days after completion of Caregiver education and training, or should an eligible veteran be hospitalized during this process, no later than 10 days from the date the eligible veteran returns home, a
VA clinician or a clinical team will visit the eligible veteran’s home and assess the Caregiver’s completion of training and competence to provide personal care services at the eligible veteran’s home, to measure the eligible veteran’s well being.
(f) Approval and designation. If the eligible veteran and at least one applicant meet the requirements of this part, VA will approve the application and designate Primary and/or Secondary Family Caregivers, as appropriate.
This approval and designation will be a clinical determination authorized by the eligible veteran’s primary care team. Approval and designation is conditioned on the eligible veteran and designated Family Caregivers remaining eligible for caregiver benefits under this part. (Authority: 38 U.S.C. 501, 1720G)
So, as you can see from just some of the info pulled directly from 38 CFR 71 your Primary Care Team is required to perform all these tasks not the Caregiver Program employees.
Also, in reference to veteran's medical and mental health notes to include psychotherapy notes at my VA (I recently found out) are fully open to all VA employees who work there. Regardless who I go see for treatment, they will have access to everything in my records which is against HIPPA and the VA Privacy Policy. There isn't any protection by means of encryption/passwords/pins, no monitoring for violations, etc... I was told by the Patient Advocate that my VA goes on the 'integrity' system entrusting their employees to do the right thing. Check with your local VA to find out how they are protecting your records. You can request them to provide you with a SPAR report. Ensure you put the date frames in which you want the report to run.