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Got a letter from the VA

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  • #16
    I am very persistent. It can be exhausting though. Once you reach the right person it is worth it.


    • #17
      Two separate programs. One is for any veteran with a disability that impairs their ability to provide their own bowel and bladder care. This is for both SC and NSC, regardless of era. It provides very limited hours (generally up to 4-6/day) and is funded locally out of the local VA. The social worker at the local VA in the SCI clinic should be very familiar with this one, and how to apply. Most will pay a family member vs. using an agency, but this varies by location.

      From the VHA Handbook 1176.1 (SCI Services)
      Fee Basis Services
      (1) Bowel and bladder care for certain veterans with SCI are considered supportive medical services due to the possibility of medical complications. The clinic of jurisdiction, or medical center, authorizes such care under the fee-basis program to eligible veterans dependent upon others for their bowel and bladder care while residing in their community.
      (2) Provisions of M-1, Part I, Chapter 18, are applicable to SCI veterans requiring home-care services. Adverse determinations of entitlement are not to be made without considering recommendations from the nearest SCI Center. When bowel and bladder care is not desired or cannot be procured through a skilled licensed provider, any individual employed by the veteran as a home health attendant, when trained and certified as competent by VHA personnel, may receive reimbursement for provision of this care. A relative (by blood or marriage) of a veteran in the fee basis program is not to be excluded from treating the veteran for a fee, as long as professional and/or training requirements are met. Reimbursement does not exceed the hourly rate paid to nursing assistants employed at a VA facility. Reimbursement is to be consistent with the hourly rate set by the local or state guideline in which the SCI veteran resides. In no instance shall fee-basis bowel and bladder care be authorized for a veteran who can perform this function unassisted. Bowel and bladder care at VA expense may be authorized for all veterans based on clinical need, including those receiving Aid and Attendance benefits.

      The other caregiver program is new and ONLY available for those who served in OEF/OIF (ie, post 9/11) on active duty and who are service connected. That program pays a family member, and allows more categories of care needs, including supervision for those with TBI, etc.:\

      Here is some additional information:

      The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.