Well, let’s qualify that. Everything you’ll need to know about the questions you’ll be asked if you wish to apply for PCAFC. PCAFC stands for Program of Comprehensive Assistance for Family Caregivers. I think they should just call it VHA A&A. Or How about A&A Type II? VA is already an utter miasma of acronyms. To the uninitiated, it could drive you to tears listening to VA litigators discourse using all these terms. I find a new one every day in VBMS trying to decypher VA Rater’s notes.
Anyway, here’s the document that I refer to above. I hope it informs and aids any of you in your pursuit of caregiver benefits.
WorkshopSession3_VA PCAFC Veteran Functional Assessment Instrum
On another note, I recently had a Veteran approach me and ask for advice on their SMC aspirations. I gave him a Padawan’s introduction to SMC using Breniser v. Shinseki. George Breniser’s case is a wonderful stroll down SMC Lane and explains what you need to prevail and proceed to the higher levels of O, R1, R2 and T.
The thrust of Breniser is simple. Pyramiding was the primary argument in the Georgemeister’s appeal. He wanted A&A for his loss of use (LOU) of his legs. He lost because you only get one L, M or N coupon for each “condition”. He legitimately had LOU of the lower extremities and was awarded LOU under §3.350(b)(1). All well so far. The appeal hinged on George’s interpretation of how this SMC gig works. The key phrase is incorporated in §3.350(e)(1)(ii)- i.e., “no condition considered twice”. The Georgester reasoned that because he had a condition (lou), he was thus entitled to a&a because he couldn’t do shit like all the rest of us.
So, where do we get this laundry list of ‘conditions’? Why §3.350(b). SMC L inaugurates a Veteran into the higher levels of SMC. SMC K and S are minor awards in the financial scheme of things. You can’t “build” higher SMCs off of them. The five conditions entitling you to SMC at the L rate are:
1) loss of use of lower extremities (feet)
2) lou of a foot and a hand
3) blindness at 5/200 or 5 degrees or less of concentric field of vision.
4) the need for aid and attendance of another
5) Bedridden
And that’s all she wrote. If you have two of these conditions and they are not related to the same “disability”, then you are in high cotton. If one is for a&a, then you’re really on Bucks Boulevard.
In the case of the gentleman asking me about his entitlement, he had been awarded a&a for his cardiomyopathy which caused him to have shortness of breath and a host of other goodies. VA might call this the index disease-that which is so severe it provoked the need for the a&a of another in and of itself. At 100%, this definitely entitled him to the a&a under §3.350(b)(3) back in 2019.
Fast forward to last month and the LOU of his lower extremities due to service connected DM II peripheral neuropathy. So, the DM II is an endocrinological issue under §4.119 DC 7913. The PN is a neurological side effect of the DM II under §4.124a DC 8520 but it’s not separate and distinct to be truthful. The cardio is under §4.104 under DC 7020. So, two different anatomical different body functions. Get it?
My inquiring Veteran also has a high-powered and well-known law dog who disagrees with him (and me) on whether he has enough of these Breniser conditions. The law dog maintains he was granted a&a for all his disabilities but it doesn’t work that way. The actual decision awarded the a&a strictly for the cardio and, in a rush to disenfranchise him of of any future SMC at the O rate, and the jump up to R1, graciously gave him the “bump” under §3.350(f)(4) to SMC M based on the 100% rating for lou of his feet. Poof. There went the R1. That’s VA FM for you.
The actual 2019 decision granting a&a said the 1/2 step bump was specifically for his other disabilities which were separate and distinct from the heart condition- including… (wait for it) his bilateral 40% ratings for his lower extremities. Note this was declared separate and distinct and attributed to the DM II. So, it had nothing to do with the a&a and the heart issue (read a&a condition).
So, our boy has two awards between L and N, no condition being counted twice. Bingo. SMC O. And, since one of the conditions is a&a, under §3.350(h), he should advance to R1 automatically. Mr. Big JD attorney says no- the loss of use of the feet has been “used up” by the 40% bilateral lower extremity PN disability. Here’s the error in that logic. You can’t award a&a for a loss of use condition. If you have lou, you have loss…of…use. Sound it out like Phonics™. Plain and simple. Sure, the lou may make doing certain everyday things like getting on and off the toilet dang near impossible but getting on and off the toilet is not a loss of use of anything. It’s an inability to do something.
A&A is awarded because you cannot accomplish one or more activities of daily living. It will never have anything to do with lou. Impairment, yes but not lou. If you’re lou, you can’t be given a&a in lieu of it. If the a&a preceded the lou, and the lower extremity PN was separate and distinct and used for the §3.350(f)(3) bump, then you get another L separate and distinct from your a&a L. You have acquired a new condition. Sure in the VA world, they’d probably say “Okay, ya gotta cough up the 1/2 step because your 40% turned into 100% and that would be pyramiding. So we’re gonna give you an M instead of the L 1/2 for the extra 100% for the DC 5110 LOU”. Yeah, but the combo of two Ls takes you way past L 1/2 or M to O so that whole argument becomes moot on its face.
Think conditions. Think no condition counted twice. That’s the whole secret to this. Remember, it’s not the degree of disability but the extent of your functional loss. If you have a heart attack and you’re boobs up, then you need a&a. And if the COPD gets so bad you need oxygen to make it to the shitter, then you need a&a for that, too. Two different conditions. Don’t let anyone ever tell you that a 40% rating for a leg under DC 8520 (or even bilaterally) is “used up” or tantamount to lou under §3.350(b)(1). It isn’t. It’s 40% for DC 8520 which is a far cry from 100% under DC 5110 for lou of the lower extremities (LEs).
SMC is a jungle full of possibilities. How you assemble them is the key to whether you’ll advance. If you’re not careful, a lot of disabilities will be combined that could be exploited individually to reach another a&a award. And because every case is horribly unique, each Veteran will need to be mighty careful in how he or she allows VA to bag ’em and tag ’em. Cheating you out of SMC S is often the worst example. VA will combine everything you have to give you a combined 100% rating when they could grant you one 60% or 70% as a stand alone TDIU and then combine the balance to attain SMC S.
In closing, I’m going to discuss the absolute insanity of seeking advice at a Veterans Help site. It’s akin to buying week-old sushi at a 7-11. Imagine our boy, now with all the ammo for R1, sashays over to VBN-the Peggy-loving pink site and asks for advice on whether his SMC calculations are correct. Hold on to your hats. Considering not a single one of them is accredited or possesses so much as a law degree, virtually every one of the Grand Poobahs pooh-poohed the idea that R1 was for application. Read some of this drivel. “Do you realize the dissent is not what is president [sic] here?” I think he was trying for precedent. “I worked for 30 years for VA and I know this shit.” No, sonny. You let the M 21 figure out your shit for 30 years. Garbage in, garbage out. Seeking good advice for your claims-especially SMC claims- in the absence of a claims file or access to the Vet’s VBMS efolder would be like entrusting your claim to the village idiot. Imagine a hearing for SMC with a VLJ and you saying you know you’re not entitled to SMC _____. The Judge asks you why not. You say because a VA claims expert named Rotor Head told you so…
Here’s another one. These chowderheads almost talked this ol’ boy out of pursuing his R1. Who, in their right minds, would try to help defeat a fellow Veteran? The concept is so alien, it defies the imagination. Worse, they laughed about it.
Considering VA has a 74% documented error rate, a VA employee, former or otherwise, dispensing advice lacks that Je ne sais quoi I’d expect to encounter. Not a single one of these Poohbahs have any legal training. Most haven’t litigated much more than their own claims. Cupcake said the dead giveaway is no one is using his or her real name. So how would you check Cruiser’s bona fides? You can’t. He could say he was a Veterans Law Judge or Winnie the Pooh for 30 years and be equally credible. I noticed a lot of the big guys also put up montages of their medals. I’m surprised there aren’t a lot more MOHs up there with all the bravado.
To be credible in this business you need a name, rank airspeed and tail number. You need truth-not braggadocio. Vets need a curriculum vitae they can use as a measuring stick. We use real world examples here. I offered advice using asknod until I became accredited in 2015. I don’t need to hide behind it any more. I’m now 20-year protected and bulletproof. You can find me on the VA’s OGC accreditation list. Granted, that doesn’t make me smart. It just makes me accountable and trusted to do VA claims.
This is how it’s done. Game. Set. Match. There simply is no mystery to this nor is there any Voodoo involved.
And that’s all I’m going to say about that.
asknod
Bethanie Spangenberg
kcraveiro
robinhoodesqvetsatty
Wesley McCauley
Veterans Claims Help 
Commenting about PCAFC again.
A year ago in November 2022 just prior to Thanksgiving, my husband and I applied for the Caregivers’ Program (PCAFC). We received notification in December 2022 that we were denied to be admitted into PCAFC. We appealed to BVA on December 30, 2022.
BVA responded by March 7, 2023. BVA Remanded our case. In the Remand, the Judge was notebly upset. His irritation of being upset came through his choice of words. The judge referenced the fact my husband was a war veteran thereby certain factors are already assumed as indicating factual evidence of being in need for PCAFC. The judge referenced “Duty to assist” was additionally not adhered. The judge pinpointed specific responses of PCAFC indicative of the fact, they, too, were aware of my husband’s needs while, yet, simultaneously denying the Program to him. The judge stated the decision made by PCAFC was an erred decision. Therefore he was remanding the case with the direction that errors be corrected and explanation/justification of their determinations. Consequently, the judge’s articulated expectation was that a new decision be rendered.
In May 2023, PCAFC responded to us to state they were working on our case appealed to BVA.
We haven’t heard back from them since.
I called the national office and they agreed we should have heard back from the local office by now. They gave me the local office number and suggested I call the local office. I began calling them back in the early fall of the year.
I left detailed messages with all defining “call back”information. I once got through to talk to one social worker. She was originally flippant in her tone and demeanor. She stated that had we appealed through their process, they are compelled to respond in 45 days. However, since we had gone through BVA to appeal, PCAFC is under no obligation to respond to our appeal within a certain timeframe…..”It can be whenever”.
Upon noting my response of shocked indignant disbelief that she would be so nonchalantly cavaleer about a serious matter, she adjusted her attitude. She, tried to become more accommodating. She gave me the contact information of the social worker in charge of appeals. I called numerous time and left comprehensive detailed messages for the social worker in charge of appeals to call me back. We have not received any call back calls or written information to date. This process of applying for PCAFC began a year ago to include a timely response from BVA; but, not from PCAFC.
Shout out to James Cripps for his sharing of facts that BVA is a possibility of appealing a PCAFC case as well as being a superior route for appealing PCAFC.
Sincerely,
Cheryl
There is no end to abuse. Good that you are a lioness. Thanks for the update.
This story really triggered me too>
INVESTIGATIONS
Will the VA stop thousands of veterans from losing their homes?
UPDATED NOVEMBER 16, 2023
HEARD ON MORNING EDITION (4 min)
https://www.npr.org/2023/11/11/1211855956/veterans-va-loans-foreclosure-covid-forbearance
I’ve contacted my Congresspeople and gov. to intervene. Don’t know who else to complain to.
LOL I was just going to post about my successful HLR for R-1 at VBN and it says :”This users name is permanently BANNED”. Fuckem if the cant take a joken…
Well, the consolation prize is you may get to post it at Hadit but if you keep mentioning my name or “Former Member”, they’ll give you your walking papers there too. Funny thing about censorship, David. It’s like these sites deliberately want to misinform Veterans yet their whole, stated metric is aimed at helping them.
Yeah Alex, you must be good buds with T-Bird or now Rattler over there. I mentioned your name in praise and instead of your real name, which I typed in, a blue link popped up as “Former Member” that took me here! :0
Please make note of the new shorter address for my website. vatheredneckway.com
Well Alex, after reading this thread, I don’t feel so bad about the referal that brought so much crap down on your head. You seemed to have not only have handled the situation, but at the same time, used the experience in a way that is going to benefit the many. I can only imagine how disruptive it has been down at the “Presidents Club”. God’s speed Alex, and keep up the spot on good work.
Alex,
I sent you an email telling you people with psych conditions have MTHFR mutations. They cause low Folic Acid, Vit B12, Vit D and high Homocysteine (which is toxic). You need those vitamins to recycle homocysteine and make SAMe….which you need for vital processes including making neurotransmitters. In other words, it screws up methylation.
And SSRIs and antipsychotics lower the same vitamins and more. That’s what causes suicide. So it’s not suicide, it’s homicide.
Yes, I’m sure. I can prove it. Read my email.
Alex, is this the new criteria for PCAFC assessment that is about to be applied to new applicants as well as existing participants, or is this the same criteria that was used before the halting of discharging veterans from the program?
You got me there, James. As far as I know, they are handcuffed right now on kicking anybody out. That will change. I saw this coming when the benefit was extended to all Vets. Too much $$$ going out. They had to staunch the cashflow. WWP got this for post-9/11/ 2001 Vets only in 2010. We NOVA members were just briefed on this in Orlando back in April at our conference. We can do the claims but will have to create a private contract to do it with a reasonable set fee-not a percentage of the retro.
DAMN! My lawyer’s firm took on my case but NEVER said ANYTHING about a private contract! Snakes!
So, does qualifying for PCAFC equate rising to a higher SMC?
My husband is 100% disabled; TDIU; and receives Aid & Attendance. I don’t know what level. I believe he’s above K, though.
My husband is a Vietnam Agent Orange exposed Purple Heart Veteran (80 years old). My husband had Colorectal Cancer (denied in 2011 as not being AO related). Lost sphincter wears Ostomy bag. PTSD (50% granted in 2018) upon appealing for higher rating. He was originally low balled at
30 %. Diagnosed with Prostate Cancer in 2015….rating went up to 100%. An Hormone shot every 6 months keeps prostate cancer in abeyance with a lowered PSA. However, suffers chronic incontinence.
Loss of use of right hand in 2017; neurology stated loss of use due to a type of gradual wasting away of muscle in forearm
and hand. Falling under the Motoneuron disease as in ALS.
Monomelic Amyotrophy.
It is a Motor neuron (MND) disease that is the umbrella covering all type Motor neuron diseases and variants. To which ALS/ Amyotrophic Lateral Sclerosis and variants falling under the same umbrella as being classified as Motor Neuron Disease (MND). As exhibited in cases of muscle loss: Monomelic Atrophy.
ALS causes degeneration of nerve cells in the brain and spinal cord that leads to muscle weakness, muscle atrophy, and spontaneous muscle activity. The VA Doctors pondered whether my husband had ALS or MS. Yet, the Neuromuscular Head/Chief Physician, conceded that Veteran’s illnesses was an ALS variant because his illness fell under the umbrella of Motor Neuron Diseases as did ALS……is a Motor Neuron disease.
Other complicating issues:
*Spinal issue (S Curve of spine)
*Multi focal motor neuropathy associated with Diabetes 2 is a part of the mix/entwined as well.
Deterioration. Of bones on vertebra
Spondylosis…inflammatory arthritis
Acts like spinal cord injury.
However, most severely is the inability of identifying the exact reason for the monomelic atrophy.
Appointment with Neurology later this week……especially since the loss of mobility due to increased chronic falling; inability to stand and walk without falling.
More recently experiencing increased chronic falling due to weakness and muscle loss in both legs/feet-loss of use. Uses cane; waiting on a walker.
We applied for PCAFC in November 2022. We were denied in December 2022. We appealed to BVA. BVA remanded in March 2023 because the Judge stated errors were made in denying PCAFC. The Judge denoted all the errors made in denying PCAFC. The Remand directed that errors were to be corrected for making a new decision. This week we received communication from Janesville dated May 23, 2023 stating they were working on our case. Feeling apprehensive about Janesville……seems like never good news when landing at Janesville.
So, back to my original question. Does qualifying for PCAFC equate rising to a higher SMC?
<<>>
Sadly, no Cheryl. It is a two-tiered caregiver stipend from the VHA rather than the VBA. But, by operation of law, you can receive both a&a as well as the PCAFC at the same time.
As I am unsure what your husband’s current VA rating status is, I would surmise he should be at R1 at a minimum. I’m booked out until the end of time but I’d be happy to refer you to a fellow NOVA attorney or agent who could ensure your husband is remunerated properly.
I’d also strongly suggest you don’t seek meaningful advice at some of the above-mentioned Veterans help sites unless you relish having abuse and ridicule piled up at your front door.
Thank you Alex.
What’s up with Janesville? Is it a “stand in or substitute for local?
Hey “Former Member”! Being that Hadit is TU would you mind if I left a link for this post on the VBN? I know they would LOVE this! Well, some maybe, others not so much… 😉
PS I am honored… 🙂
Feel Free, sir. I’m sure it may offend certain overinflated egos there and get you booted. You probably won’t get to “set a president” though.
Well, I really don’t like my choices for presidents at the moment! Hell, they even locked my thread over there cuz they didnt like what I was saying! Jokem if they cant take a f*****!
On another note, I have an appeal through my “lawyer” for our past 3, well actually our first, denied applications for PCAFC. But through all 3 of our applications and interviews we NEVER saw a form like the Veteran Functional Assessment Instrument you have linked above! WTF?
Now not only did they lock my thread they have now totally locked me out! I should consider this a blessing! I dont want all that ate up with the dumb shit rubbing off on me. Maybe too late! :0
Oh! and don’t call me “Sir”! I worked for a living! 😉
You may not be a JD but you are much smarter than most people I know with JD’s. Love to read all you write. Making my plan of attack to progress past the award of “S” when I applied for A&A. Had ducks in a row with 1 SC at 100% for 20years and a boat load of other SC’s for another 150%. But I guess they thought in giving me “S” I would just say shucks and walk away! Wrong! I will fight these shit birds till my last fucking breath. It is a real shame all the fucking gutless asswholes at the VA who make us fight for all we earned by fighting for our country. We already earned compensation!!! I will never rest.
SF & Hooya!
RAC
I suggested using “real” names on a site I used prior and was voted off the island. Then I got banned. Recently I have been getting emails to join, however, I can’t even visit the site. It says I am “Banned”.
LOL,
Carl Bacon
I got banned once for using the name “Nursey”. They said it implied I was an “expert”. I finally got tired of being banned for stupid reasons and the next time I got banned I went back and stole all their members.