Military Caregivers = Service Humans

When I talk to others about military caregivers, or caregivers in general, they often confuse military caregivers with clinical caregivers.

Military caregivers, just like family caregivers, are not clinical caregivers.  We are not!  We are more closely related to service dogs than nurses, doctors, or social workers, but it’s almost impossible to change the visual in someone’s head when they are picturing someone in medical scrubs.

The Free Dictionary defines a clinical caregiver as a “physician, nurse, or social worker, who assists in the identification, prevention, or treatment of an illness or disability” (https://www.thefreedictionary.com/caregiver).  That is not me!

Maybe if I wore a vest that said Service Human the similarity to service dogs would be a little clearer.  It would give others an indication to ask, “What does your service human do for you?”.  In my son’s case, he would say, “She knows my medical history, manages my medications and finances, and is my voice when life gets too complex”. 

My son has a service dog named Fenris.  Everyone recognizes that Fen is a service dog, not a clinical caregiver.  They understand that when Fen is not in service, he’s probably chewing on a bone or lounging with our other dogs in the backyard, with one eye, always, focused on my son. Fenris has learned to provide a task for my son that replaces something he lost during his time as a soldier; I do the same.  When I am not providing that task, I’d love to hang with my peers, continue my career, or go back to “normal”, but I’m not the same anymore—part of me has one eye on my son, too.

Societies function on language, that is how we share our joys, sorrows, information, history….  Words create clarity or confusion, and I’m really tired of being confused with someone who wants to work for Visiting Angels.   Johns Hopkins defines a family caregiver as “a person who tends to the needs or concerns of a person with short- or long-term limitations due to illness, injury or disability”.  Every person in the world fits this description at one point in their life or another, as noted by former first lady Rosalyn Carter, “There are only four kinds of people in this world: those who have been caregivers, those who are currently caregivers, those who will be caregivers and those who will need caregivers. Caregiving is universal.” (https://rosalynncarter.org/) 

It’s no wonder the public does not understand what it means to commit to a person with a disability—fully… 24/7.

For those caregivers who commit to replacing a function of another person’s life, service dogs, as defined by ADA service dog policy, more closely resembles our lives: “dogs that are individually trained to do work or perform tasks for people with disabilities.”  (https://www.ada.gov/resources/service-animals-2010-requirements/#how-service-animal-is-defined). 

ADA service-dog policies are focused on the needs of the disabled person, not on the dog.  They don’t care if the dog is a mutt or bred specifically for service.  They don’t care if the dog was with the person when they were injured, how they came into their lives, who trained them, or when they might be replaced.  Service dog policies ensure that an individual who is diagnosed with a disability can get the support they need, with access to that support 24/7, no matter where they go.   And ADA policy tells the public how to accommodate that service dog.  How many of you know how to accommodate a caregiver?  If I say I’m a service human, do you have a better idea of my life and how you might be accommodating?  Hmmm… maybe that’s another blog post!

Dogs don’t choose to be service dogs and neither do service humans.  We become something that we didn’t choose to be, because someone we love needs us.  I’ve run from an uncomfortable situation on many occasions, saying, “this is not me”, and I’ve listened to countless others share their moments of frustration.  Most of us, in time, learn to step into the voids created by combat injuries, but it’s a long time before any of us feel comfortable in this role.  And no matter how long I support my son, there is always that part of me saying, I’m still a technical writer, a mom, a wife… I do not wear medical scrubs and I am not a clinical caregiver!  I’m a service human!

Life Insurance deadline for Service-connected Disabled Veterans

Deadline: December 30, 2022

Service-connected Disabled Veterans who were awarded a NEW Veterans Benefits Administration (VBA) disability rating within the last two years can apply for Service-Disabled Veterans Insurance (S-DVI), until December 30th of 2022. 

Why should Veterans care about life insurance deadlines?

Disabled service-members qualify for great, inexpensive life insurance when they exit the military, but most don’t know about it or don’t understand how difficult it will be to get life insurance when the deadline to register for post-military life insurance has passed.  One option for a small policy is S-DVI, which provides $10,000 to $30,000 in life insurance to disabled Veterans, and has premium waiver for 100% disabled Veterans, but it is being replaced with VA life insurance on January 1st, 2023.  VA life insurance is guaranteed acceptance for disabled Veterans, but there is no waiver of premiums offered.

If you apply for and are approved for S-DVI, you can keep it, even after VA life insurance is active.  If you miss the deadline, your only option is VA life insurance.

Why is life insurance important for disabled Veterans and their families?

In a recent study performed by the Oklahoma City VA Health Care System, researchers found that the lifespan of a service-connected, 100%-disabled female Veteran is 22% less than her non-veteran counterpart, and the lifespan of a service-connected, 100%-disabled male Veteran is 11% less than his non-veteran counterpart.  The widow or widower of these Veterans might qualify to receive a portion of the Veteran’s disability pay through VA Dependency and Indemnity Compensation (VA DIC) or a few other programs, but each program has a stringent set of rules and only provides a portion of the Veteran’s disability pay.  With no life insurance, the likelihood of a disabled Veteran leaving their family financially destitute is high. $30,000 isn’t going to help much, but it’s better than nothing.

Why don’t disabled Veterans have access to good life insurance?

I can’t say for sure, but from this mom’s perspective, I’d say that missing deadlines for the really good life insurance is related to how a Veteran transitions from the military and whether they have visible or invisible wounds. 

Take, for example, a combat Veteran who doesn’t look injured, we’ll call her Stacy.  Stacy deployed to a few combat zones, she saw things that would make many of us melt into a puddle, she felt the blast of an explosion on multiple occasions, and she landed a little too hard while exiting a helicopter.  Stacy looks fine.  She finished her four years of service and discharged.  Stacy is twenty-five, single, and doesn’t look injured.    

Stacy wasn’t given a traumatic brain injury (TBI) evaluation, her post-traumatic stress disorder (PTSD) evaluation consisted of a few questions when she returned from deployment, and her back pain was treated with a few visits to the chiropractor.  On her exit-medical exam, the examiner told her to head to the VA in her hometown to deal with her headaches, back pain, and anxiety. 

Stanley is a Veteran who lost his left leg in combat.  It is obvious that Stanley was injured.  He was sent to a wounded warrior program, where he recovered from his injury.  After recovery, he was guided through the convoluted process of acquiring benefits that will support him outside of military life.  Stanley is twenty-five, single, and was well advised about his life insurance options before he was handed his DD-214. 

Why didn’t Stacy take care of herself?

Stacy knows what an injury looks like because she saw plenty of them in combat.  In her opinion, combat injuries look bloody and often include missing body parts.  She knew that she needed to head to her local VA when she got home, but finding an apartment and looking for a job came first. 

Six months later, she applies for benefits, gets through her exams for compensation and pension (C&P), and a year later she is awarded a service-disability rating for TBI, PTSD, degenerative-disc disorder, sleep apnea, and a few other random issues.  Her friends say, “Girl, you look fine!”, and they are right, her wounds are invisible, but Stacy is 100% disabled and will never get an inexpensive life insurance policy to protect her family. 

How could they not know?

I’ve spent the last 8 years filing paperwork and juggling medical documentation for my son who is 100% disabled.  In all of those 8 years, not one person or organization ever said,  “Hey, he’ll never be able to get civilian life insurance, but if he adds a new disability to his rating, he can apply for S-DVI and request a waiver of fees”.  Nope, not one of them ever said that. 

So, why are we sharing this information now?

Caregivers support other caregivers and the Veterans we care for.  A few months ago, quite a few military caregivers were asking if anyone had heard about the new VA life insurance program.    

I hadn’t, but I was excited to think that my son might be able to qualify.  I looked into it, and… huh, there it was, a deadline for a program I’d never heard of.  Funny how that works. 

Now you know why the deadline is important. 

The VA, FINALLY, includes all military caregivers in PCAFC

On October 1, 2022, ALL individuals who live with and care for a Veteran can apply to participate in The Program of Comprehensive Assistance For Family Caregivers (PCAFC) and/or the VA’s general caregiver program. For eligibility and an online application, go to: https://www.caregiver.va.gov

Messy but they try

One of the best and worst programs for military caregivers is the Program of Comprehensive Assistance for Family Caregivers (PCAFC). 

PCAFC is a program that supports individuals who care for a wounded, ill, or injured servicemember, after that servicemember is discharged from the military.  There is an application process to participate in PCAFC, and, once approved, caregivers receive a stipend, based on the level of care they provide.  

Why are family caregiver important?

Think of Iron Man and the suit that keeps him safe.  We want that suit for all our servicemembers, and we are close, but not close enough.  With the progression of military technology, the majority of post-9/11 combat injuries do not end in death, but the incidence of long-term damage from wounds, illness, and injury has increased.  Crunching numbers from the Congressional Research Services and the Department of Veteran Affairs data on America’s Wars, Post 9/11 survival rate from wounds is about 98%, which is 29% higher than all previous wars. 

These statistics show that many young men and women returned from Iraq and Afghanistan with injuries that would have killed their fathers and grandfathers.  This is the group of Veterans that need some level of care.

Difficulty in transitioning

For servicemembers who were not medically discharged, the first stop in getting medical and mental health benefits is the Veterans Benefits Administration (VBA). 

Per an article in Workplace Health & Safety, The Unique Health Needs of Post-9/11 U.S. Veterans, “The “signature” illness of post-9/11 veterans is polytrauma”; a combination of pain, post-traumatic stress disorder (PTSD), and persistent post-concussion syndrome (PPSC) – basically a combination of head trauma, mental trauma, and pain.  Before getting help, injured servicemembers are required to navigate a maze of VBA forms, then try to explain the complexities of their injuries to a medical provider who may or may-not have any military experience.  Many just walk away—unless they have a caring family who helps them through the maze, a caregiving family.

Has the program always existed?

Prior to 2011, military caregivers were called mom, dad, wife, husband, sister, brother, or any label that connected the servicemember to the person who took on the role of caregiver. 

But in 2011, Senator Elizabeth Dole began the groundwork that would become an enormous movement to support America’s military caregivers.  In 2012, Senator Dole commissioned a RAND study, Hidden Heroes, America’s Military Caregivers (2014), and the study found that there were over 5.5 million military caregivers in the United States.  Five-and-a-half million caregivers had little support, financially or emotionally; they were caring for our wounded military without so much as a thank you.

Findings from the Rand study went to Capitol Hill, and not so quickly or easily, PCAFC was born. 

Government programs rarely get it right the first time

As with many programs that are born on Capitol Hill, there were problems.  The biggest problem was the exclusion of Veterans who served prior to 9/11.  PCAFC was launched with the promise that wounded, ill, and injured Veterans who served prior to 9/11 would be included… later. 

The Mission Act and PCAFC

In 2018, Congress passed the Mission Act, which expanded PCAFC to all caregivers, but the implementation of that expansion was placed in the hands of the Department of Veteran Affairs.  As you might expect, they fumbled the expansion when they changed the eligibility criteria to a crazy-restrictive, you must be on deaths door, type of program.  And they decided that they would only evaluate the needs of Veterans who served prior to May 7th, 1975 (the end of the Vietnam era). 

A big gap between service eras

“Veterans who fall in the gap will be included, soon”, so said the VA, but their new rules were so bad that in 2022 they had to pause, again.  During the pause, Capitol Hill stepped in and say, “Whoa!!! What happened here?  We never told you to change the rules.”  So… the new rules are, again, are under construction. (Discussion for another post). 

Finally!

Even though the rules are still under construction, on October 1st, 2022, the Department of Veterans Affairs FINALLY made ALL Veterans eligible for PCAFC. It may be a messy program, but they are working on it, and we (the caregivers of all eras) are in the same boat.

The Infographic

The infographic (the shareable image at the top of the blog) is something you can share with anyone you think might benefit from the information.  And now you have a little background on why this tiny fact is important.