VA Family Caregiver Program: Who Qualifies and How to Apply

The VA Family Caregiver Program, formally the Program of Comprehensive Assistance for Family Caregivers (PCAFC), pays a monthly stipend and provides training, health coverage, mental health counseling, and respite care to family members who care at home for Veterans with serious service-connected conditions. To qualify, the Veteran generally needs a service-connected disability rated at 70% or higher and a documented need for personal care or supervision lasting at least six months, and the caregiver has to be an adult who can safely deliver that care and complete VA training. Veterans from every service era are now eligible.¹

Which Veterans Qualify

Under 38 CFR § 71.15, the Veteran must have a “serious injury”: a single service-connected disability rated at 70 percent or higher, or a combined service-connected rating of 70 percent or more. The injury has to have been incurred or aggravated in the line of duty during active military service.²

Beyond the rating, the Veteran must need in-person personal care services for at least six continuous months, based on either an inability to perform activities of daily living or a need for supervision or protection to stay safe.³ The VA looks at seven daily activities:

Dressing or undressing
Bathing
Grooming to maintain cleanliness and appearance
Adjusting prosthetic or orthopedic devices that cannot be managed without help due to the disability
Toileting
Feeding, where there is coordination loss, weakness, inability to swallow, or need for non-oral nutrition
Mobility, including walking, climbing stairs, and transferring between bed and chair

A Veteran who can handle some of these tasks may still qualify if neurological or cognitive impairment means they need continuous supervision, protection, or instruction because a functional impairment directly threatens their personal safety on a daily basis.⁴ Every functional limitation has to be tied in the medical record to the Veteran’s service-connected conditions, and a clinical team reviews those records to confirm the link.

Who Can Serve as the Caregiver

A caregiver must be at least 18 years old. Under 38 CFR § 71.25, eligible people include a spouse, son, daughter, parent, step-family member, or extended family member. Someone with no family relationship can also qualify if they already live with the Veteran full-time or agree to do so once designated.⁵ Any history of abusing or neglecting the Veteran will disqualify an applicant.

Before approval, the VA evaluates whether the applicant can communicate effectively, follow the Veteran’s treatment plan, and perform the care tasks without supervision. The applicant then completes a VA-provided training program covering the Veteran’s specific care needs and must demonstrate they can perform the required tasks. Failing to complete training or show proficiency results in denial.⁵

Each Veteran can have one primary caregiver and up to two secondary caregivers. That distinction controls benefits: only the primary caregiver receives the monthly stipend and can access CHAMPVA health coverage. Secondary caregivers get training, mental health counseling, and certain travel benefits.⁶

What the Program Pays and Provides

The Monthly Stipend

The primary caregiver’s stipend is calculated from the Office of Personnel Management’s General Schedule pay table, using the GS-4, Step 1 annual salary adjusted for the locality where the Veteran lives. The VA divides that annual figure by 12 for a monthly rate, then applies a multiplier based on the Veteran’s care level.

Level 1 pays the monthly GS-4 Step 1 locality rate multiplied by 0.625, for Veterans who need help with daily activities or supervision but can still function with moderate support.
Level 2 pays the full monthly GS-4 Step 1 locality rate, for Veterans the VA determines are “unable to self-sustain in the community.”⁷

A Veteran qualifies for Level 2 if they are fully dependent on a caregiver for three or more of the seven activities of daily living, need continuous supervision because of neurological impairment, or require regular and extensive instruction without which daily functioning would be seriously impaired.⁷ Because locality pay varies, the actual dollar amount depends on where the Veteran lives.

The stipend is not taxable for federal income tax purposes under the Caregivers and Veterans Omnibus Health Services Act of 2010.⁸ It does count as unearned income for Supplemental Security Income, however, which can reduce or eliminate SSI benefits for a caregiver who receives them. The $20 general income exclusion applies, but if you rely on SSI, work through the math before you enroll.⁹

Other Benefits

Both primary and secondary caregivers receive training tailored to the Veteran’s condition, mental health counseling, and reimbursement for eligible travel when accompanying the Veteran to VA care, including regular transportation, parking, tolls, and pre-approved meals and lodging.¹⁰

Primary caregivers also receive:

The monthly stipend at the Level 1 or Level 2 rate.
CHAMPVA health coverage, but only if the primary caregiver has no other health coverage. Family members of the caregiver are not covered.¹¹
At least 30 days of respite care per year, during which the Veteran receives professional care while the caregiver takes a break.⁶
Free legal and financial planning assistance related to the Veteran’s needs.
Military commissary and exchange access.

The CHAMPVA rule catches people out. If you already have Medicare, employer-sponsored insurance, or TRICARE, you cannot get CHAMPVA through the caregiver program.¹¹

How to Apply

The application is VA Form 10-10CG. Both the Veteran and each prospective caregiver provide a Social Security number or tax identification number, date of birth, current address, and phone number, along with the name of the VA medical center where the Veteran receives or plans to receive care. If someone signs on behalf of the Veteran, attach a document showing legal authority, such as a power of attorney or guardianship order.¹²

Include recent medical records that describe the Veteran’s functional limitations. Focus on which daily activities need help, how often, and what supervision is required for safety. Better documentation moves the clinical review faster.

You can file Form 10-10CG three ways: online at VA.gov, by mail to the Program of Comprehensive Assistance for Family Caregivers at the VA Health Eligibility Center, or in person with a Caregiver Support Coordinator at a VA medical center. Check every required signature before you send it. Missing signatures cause avoidable delays.

After the VA receives the application, a clinical team reviews the Veteran’s health history and completes an assessment to verify medical necessity. A home visit follows to evaluate the caregiving environment and observe how the caregiver and Veteran interact. The VA aims to issue a decision within 90 days of receipt. If approved, support services begin based on the date the application was received.

Staying Enrolled After Approval

Enrollment is not permanent. The VA reassesses annually to confirm the Veteran and caregiver still meet program requirements, including whether the Veteran remains “unable to self-sustain in the community” for the higher stipend tier. Reassessments can include a home visit. The VA can conduct them more often when it documents a reason, or less often if it determines yearly review is unnecessary.¹³

Refusing or missing a reassessment leads to removal from the program. This is one of the most common ways families lose benefits, and it usually has nothing to do with the Veteran’s medical status. Missed scheduling and unanswered VA outreach are enough.

The VA can also remove a caregiver for fraud, abuse or neglect of the Veteran, unresolved safety concerns, or refusing to provide care or arrange coverage during absences. Removal also happens under less adversarial conditions, including the Veteran no longer needing the program, institutionalization or death of the Veteran, the caregiver requesting removal, or the Veteran requesting a different caregiver.¹⁴

If You Are Denied or Removed

If you disagree with a PCAFC decision, whether a denial, a tier reduction, or a revocation, you have several review options for decisions issued on or after February 19, 2019:

Supplemental Claim on VA Form 20-0995, when you have new and relevant evidence that was not part of the original record.
Higher-Level Review on VA Form 20-0996, in which a senior decision maker in the Caregiver Support Program reviews the case. No new evidence is allowed.
Board Appeal on VA Form 10182, which takes the case to the Board of Veterans’ Appeals.¹⁵

A VHA Clinical Review Process is available regardless of the decision date. Ask the Patient Advocate at your local VA medical facility about that route. For questions on any of these forms, call the VA Caregiver Support Line at 1-855-260-3274, Monday through Friday, 8 a.m. to 8 p.m. Eastern Time. Accredited representatives, attorneys, and claims agents can also help prepare an appeal.¹⁵

1
U.S. Department of Veterans Affairs. Program of Comprehensive Assistance for Family Caregivers (PCAFC)
2
eCFR. 38 CFR 71.15 – Definitions
3
eCFR. 38 CFR 71.20 – Eligible Veterans and Servicemembers
4
eCFR. 38 CFR Part 71 – Caregivers Benefits and Certain Medical Benefits Offered to Family Members of Veterans
5
eCFR. 38 CFR 71.25 – Approval and Designation of Primary and Secondary Family Caregivers
6
U.S. Department of Veterans Affairs. Program of Comprehensive Assistance for Family Caregivers
7
U.S. Department of Veterans Affairs. Program of Comprehensive Assistance for Family Caregivers (PCAFC) Eligibility Criteria Fact Sheet
8
U.S. Department of Veterans Affairs. Information for Caregivers – Community Care
9
Social Security Administration. POMS SI 00830.317 – VA Caregivers Payments
10
U.S. Department of Veterans Affairs. File and Manage Travel Reimbursement Claims
11
U.S. Department of Veterans Affairs. CHAMPVA Health Care Benefits for the Primary Family Caregiver
12
U.S. Department of Veterans Affairs. Apply for the Program of Comprehensive Assistance for Family Caregivers
13
eCFR. 38 CFR 71.30 – Reassessment of Eligible Veterans and Family Caregivers
14
eCFR. 38 CFR 71.45 – Revocation and Discharge of Family Caregivers
15
U.S. Department of Veterans Affairs. PCAFC Decisions – Options for Further Review and Appeal