Veterans

Former SEAL, not-for-profit sue VA over new rules restricting caregiver benefits

A former Navy SEAL and a veterans not-for-profit are suing the Department of Veterans Affairs for restricting disabled veterans’ access to benefits and caregivers.

Andrew Sheets, a former petty officer second class who saw 33 combat missions in Afghanistan from 2003-2004, and Veteran Warriors, Inc. alleged in a complaint filed Monday that the Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA Mission Act of 2018, more commonly known as the Final Rule, “is arbitrary and capricious and exceeds VA authority.”

The VA caregiver program, established under the Caregiver Act in 2010, currently provides thousands of dollars a month to the caregivers of nearly 20,000 veterans who separated from the military after Sept. 11, 2001. The Final Rule was designed to expand these benefits, first to veterans who served before May 1975 and then to those who served between 1975 and 2001.

Officials said the expanded benefits of the Final Rule, which went into effect on Oct. 1, 2020, could reach an estimated 41,000 individuals in the coming years.

The Final Rule also changed the caregiver program’s eligibility requirements, meaning current recipients would be reevaluated and possibly removed from the program.

Rather than mandate a specific disability rating for eligibility, the initial Caregiver Act was open to veterans who could not perform at least one activity of daily living as defined by the act or needed supervision, protection or instruction.

Among its many revisions, the Final Rule reduced the number of benefit tiers from three to two and required a disability rating greater than 70 percent and in-person care services to be eligible.

“The VA’s Final Rule creates such a high standard of eligibility for our vulnerable veterans and caregivers that either by design or default thousands of veterans would now be left without critical assistance,” said Bart Stichman, executive director of the National Veterans Legal Services Program. “During a pandemic and at a time when the VA is attempting to reduce veterans suicides, the VA should be ensuring that needy veterans have access to vital caregiver services rather than limiting their access.”

The NVLSP and law firm Sidley Austin LLP are representing Sheets, his wife and Veteran Warriors pro bono. Of Veteran Warriors’ nearly 5,000 veteran members, approximately 70 percent participate in the VA’s caregiver program. Many of these members face imminent harm due to the changes made by the Final Rule, the organization said in a press release.

“The VA’s adoption of the Final Rule is not only unlawful, it would cut off veterans and their caregivers from a program of benefits and services they desperately need,” said Lauren Price, founder and managing director of Veteran Warriors. “The Final Rule is doubly cruel for veterans and caregivers who are in critical need of assistance because the Final Rule not only restricts the number of veterans who qualify for benefits, but also the amount of benefits for those who do qualify.”

Price also said that the legacy veterans eligible for caregiver benefits under the rule would be the most likely to suffer from it.

The VA initially awarded Sheets, who separated from the Navy in 2006, a 70 percent disability rating for post-traumatic stress disorder with anxiety, panic attacks, secondary depression, and episodic alcohol abuse in sustained remission. He was also diagnosed with mefloquine toxicity for adverse neuropsychiatric effects of the antimalarial drug including paranoia and hallucinogenic dreams. Including a number of other disabilities, his total combined disability rating in 2006 was 90 percent.

The VA later increased Sheets’ disability rating to 100 percent in October 2011 and accepted him and his wife into the caregiver program.

Now, the Final Rule has put the benefits Sheets and his wife receive at risk of being reduced or withdrawn.

“I can’t imagine not being able to be a part of this program anymore,” Kristie Sheets, Andrew Sheets’ wife and primary caregiver, told Military Times. “I don’t want to see this program go away. It’s helped us; I know it’s helping others.”

Kristie Sheets was the first approved caregiver in Northern California when she and her husband were accepted in 2011. After quitting her job the year prior to care for her husband and their three children full time, the health insurance provided by the program alone was vital.

“It’s more than 9-5, it’s more than 40 hours a week,” she said of caring for her husband. “There’s a lot of stuff that we have to navigate and we have to navigate together, which leaves me little time for other things in life.”

Without the caregiver program, Kristie Sheets said her husband’s VA disability wouldn’t be enough to provide for their family of five. She’s also worried about the lack of VA funding for mental health support outside of the caregiver program.

“They’re eroding the mental health part of it from the program, and that seemed to be covering this huge gap that is needed in the VA system,” she said.

Until Andrew Sheets is reevaluated by the VA, the family is unsure whether or not they will remain eligible for benefits under the caregiver program, a situation many other disabled veterans and their caregivers find themselves in.

Editor’s note: This story has been corrected to reflect the tax status of Veteran Warriors, Inc.

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