How to Fill Out and Submit a Veteran Directed Care Application

To apply for Veteran Directed Care, contact a social worker in the Geriatrics and Extended Care department at your local VA medical center and ask whether the program is offered there. There is no downloadable form. The process starts with that conversation, and if you meet the clinical criteria the social worker generates an internal referral that moves you into the enrollment pipeline.¹

Before you call, it helps to know what the VA will be checking, whether the program even runs at your facility, and what you’ll be asked to decide once you’re in.

Check That You Meet the Two Eligibility Requirements

VDC has two threshold requirements. You must already be enrolled in VA health care, and a VA clinician must determine that you need a nursing home level of care.¹

That second piece confuses people. It sounds like you have to be on the verge of moving into a facility. In practice, it means you need regular help with activities of daily living such as bathing, dressing, grooming, mobility, and medication management, or with instrumental tasks like cooking, shopping, and using the telephone, especially if you live alone or your caregiver is burning out.¹

Age is not a factor. VDC is open to veterans of all ages who meet the clinical criteria, and because it sits inside the VHA Standard Medical Benefits Package, every enrolled veteran is technically eligible if the clinical need exists and the program runs locally.²³

If you are not yet enrolled in VA health care, do that first. File VA Form 10-10EZ online, by mail, or in person at a VA medical center.⁴ You cannot apply for VDC without it.

Confirm the Program Is Offered Near You

Not every VA medical center offers VDC. The decision is made at the individual VAMC level, and the facility must have a formal partnership with an approved Aging and Disability Network Agency (ADNA). That agency can be an Area Agency on Aging, an Aging and Disability Resource Center, a Center for Independent Living, or a State Unit on Aging.² If no local ADNA has completed the VA’s readiness review and signed a provider agreement, the program is not available in that area.

Two ways to check. The Administration for Community Living publishes a list of ADNAs approved as qualified VDC providers on its website. Or call your local VA medical center directly and ask to speak with a social worker in Geriatrics and Extended Care. They will know whether the program is offered and which agency handles it locally.¹

Make the Call and Prepare for the Social Worker Meeting

Contact the Geriatrics and Extended Care department at your VAMC and ask to speak with a social worker about Veteran Directed Care. The social worker will review your medical history, current functional limitations, and care needs, drawing on your existing VA records and on what you tell them directly. If you meet the clinical criteria, they generate the internal referral that starts your enrollment.¹

Come to the meeting prepared. Have your VA health care enrollment information at hand. Know what daily tasks you need help with, who currently helps you if anyone does, and whether you want to manage the budget yourself or have someone else do it. The more specific you are about your needs, the more accurately your budget will reflect what you actually require.

The Clinical Assessment Sets Your Budget

The VA does not hand every VDC participant the same dollar amount. Your budget is set using a standardized tool called the Purchased Case-Mix and Budget Tool, which your social worker administers as part of the clinical assessment. It evaluates your functional status and assigns a case-mix rate, a bundled figure covering both your spending plan and the ADNA’s administrative costs.⁵

Be honest and thorough. If the VA needs more documentation, you may be referred to the VA occupational therapy department for a separate evaluation, and its findings can increase or decrease your monthly budget.⁵ The administrative fee the VA pays to the ADNA is set by VA Central Office and varies by geographic location.

Work With Your Options Counselor

Once the VA processes the referral, the partnering ADNA assigns you an options counselor. This person becomes your main point of contact outside the VA system. The counselor meets with you, often at home, to discuss your needs, goals, and preferences, and to confirm whether VDC is the right fit.⁶ Together you develop a spending plan.

Build Your Spending Plan

The spending plan is the backbone of VDC. Every purchase must appear in the plan and be approved by the VA before you spend any money. It covers who you will hire, what you will pay them, and what goods and services you will buy. Allowable categories include homemaking and personal care, adult day care, in-home respite care, chore maintenance, safety services such as personal emergency response systems, electronic monitoring devices not covered by other benefits, caregiver education and training, and other goods and services the VA determines are necessary for you to live independently.⁷

The plan must also account for your caregiver’s wages, employer taxes, and any required workers’ compensation insurance. Your options counselor helps you run the numbers. Any change to the plan later, whether adding a service, hiring a different worker, or reallocating funds, requires your counselor’s approval before you spend.

Hire Caregivers and Clear Background Checks

One of VDC’s advantages is that you can hire people you already know and trust, including family members, friends, or neighbors, as paid caregivers.¹ You set their schedules, direct their work, and decide what tasks they handle. In the eyes of the law, you are their employer.

That employer status has requirements. All direct care workers must pass a background check before hire. The check may include a state or federal fingerprint-based criminal history search, the National Sex Offender registry, and any applicable professional registries. Anyone with a felony conviction for fraud, abuse, or exploitation of an individual is automatically disqualified.⁸ Results are reported to the VA VDC Program Coordinator, and you are notified whether the candidate passed.

As part of enrollment you will complete IRS Form SS-4 to obtain an Employer Identification Number (EIN) if you do not already have one. The EIN is required because you are hiring household employees.⁹

The Fiscal Intermediary Handles Payroll

You will not be processing payroll, depositing taxes, or filing employment reports yourself. The ADNA contracts with a Financial Management Services provider, sometimes called a fiscal intermediary, that handles the employer-side paperwork on your behalf. That typically includes:

Registering you as an employer with the IRS and state tax agencies
Processing payroll and issuing paychecks or direct deposits
Withholding and depositing federal and state employment taxes
Filing tax reports with the IRS and state agencies
Processing state and federal unemployment insurance payments
Purchasing workers’ compensation insurance on your behalf
Providing the forms and documents needed for payroll

The intermediary acts as your agent for employment tax purposes, so you are not personally filing quarterly payroll returns or dealing with unemployment paperwork.

Decide Whether You Need an Authorized Representative

If managing the budget, hiring caregivers, and overseeing a spending plan is more than you can handle, or if a cognitive or physical condition makes it difficult, you can designate an authorized representative to run the program on your behalf. That person can be a legal guardian, family member, friend, or anyone else you identify as acting in your best interest.¹⁰

Since February 1, 2024, all new authorized representative candidates must pass a background check before being formally designated, under the same standards applied to direct care workers.⁸ Decide early whether you plan to use one, because their information needs to be in the enrollment paperwork and the background check must clear before the program can begin.

How Long the Process Takes

There is no official VA-wide timeline for VDC activation. The process runs through a clinical assessment, an internal VA referral, coordination with the local ADNA, background checks on your caregivers, and spending plan approval. Each of those steps depends on local capacity and how quickly you provide the information asked of you. Realistically, expect several months from your first conversation with a social worker to the point where your caregivers start getting paid. You can move things along by identifying and recruiting caregivers while your spending plan is still under review, though no payments can be processed until the plan is approved.

After enrollment, expect a reassessment at the six-month mark in your first year, and an annual reassessment after that to update your plan and renew your eligibility. Each authorization period lasts 365 days, and services stop if the VA does not issue a renewal before it expires.¹¹

If You Are Denied

If the VA determines you do not meet the clinical criteria, you have options. For clinical decisions about your treatment or care, you can file a Clinical Appeal requesting a review. For administrative or benefit-related denials, three review pathways exist: a Supplemental Claim with new and relevant evidence, a Higher-Level Review by a more senior reviewer, or an appeal to the Board of Veterans’ Appeals for review by a Veterans Law Judge.¹² An accredited attorney, claims agent, or Veterans Service Organization representative can help you choose the right route and prepare the paperwork.

1
U.S. Department of Veterans Affairs. Veteran-Directed Care
2
Administration for Community Living. Veteran Directed Care Program
3
U.S. Department of Veterans Affairs. Veteran Directed Care
4
Veterans Affairs. VA Form 10-10EZ
5
AIM Independent Living Center. Veteran Directed Care Veteran Guidebook
6
Administration for Community Living. Veteran-Directed Care Program
7
Administration for Community Living. Veteran Directed Care – Developing My Spending Plan
8
Administration for Community Living. Background Check Guidance
9
Premier Financial Management Services. Veteran Directed Care Program Veteran Packet
10
Administration for Community Living. Veteran Directed Care Educational Webinar FAQ
11
Bay Aging. Veteran Directed Care Veteran Handbook
12
Veterans Affairs. VA Decision Reviews and Appeals