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Appealing Denials of Benefits-VA Family Caregivers Program

Sadly, in the VA health care system, family caregiver program denials are treated as clinical decisions vice a denial of disability compensation or pension benefits; thus, your appeal process is through the VHA instead of the VBA.  This means that you are not entitled to the full range of higher-level review and appeal options that you would have with a traditional disability or pension claim. Instead, as a clinical decision, you must file a written appeal with the local VA Medical Center that denied your application or revoked a previous authorization. If that appeal is rejected, then you must file an appeal with the Veterans Integrated Service Network (VISN).  Your appeal will then be processed by the Office for Quality, Safety, and Value on the VISN level.  To help you better understand this very dysfunctional review process, I have attached a copy of the applicable policy guidance- VHA Directive 1041- and would be glad to answer any questions that you may have on this topic. vhadirective1041

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