A triple amputee Veteran will have his full-time caregiver services reinstated after the Tennessean reported Wednesday that the Nashville VA initially decided to deny the level of his caregiver's benefits.
Staff Sergeant J.D. Williams lost his right arm and both legs while deployed with the 101st Airborne Division in Afghanistan in 2010.
He was discharged and sent home, where his wife, Ashlee Williams, was assigned and paid by the VA to be his caregiver.
But after six years, she wrote on Facebook on Nov. 17, the VA decided to lower her husband to the lowest tier of the program, determining that he no longer needs a full-time caregiver.
She claimed that the VA assumed that the care she provided her husband, including helping her husband with applying prosthetics and lifting him into a wheelchair about 10 times a day, was part of her "spousal duty."
"...should have been included on the marriage certificate according to the VA," Ashlee Williams wrote in a post that was shared more than 25,000 times on Facebook by Wednesday morning.
Williams wrote in a separate post that while she still has caregiver designation, being dropped to the lowest tier in the program has been a "pattern" she has seen in other VA caregiver cases.
"I'm just a minuscule part of this MUCH Larger problem," she wrote.
Nashville VA is part of the Tennessee Valley Healthcare System. When asked by the Tennessean to comment on the case, the VA said they will reverse their action Wednesday.
"In this case, the reassessment process was handled incorrectly, and VA is taking steps today to reinstate Mr. Williams’ caregiver benefits to their original level," said Chris Vadnais, a TVHS spokesman.
He said Williams' occupational therapy assessment responses were not fully considered by the team assessing his benefits, leading to an "improper reduction."
"The goal of all VA health care programs is to help Veterans achieve their highest level of health, quality of life and independence," said Vadnais.
The Williams did not respond to requests for comment.
Caregiver details the VA's process
According to Ashlee Williams, when a caregiver is dropped to the lowest tier, they're given an opportunity to appeal. But the appeal is reviewed by the same clinical eligibility team that made the decision to change caregivers' status, and the appeals are most often denied.
Then the caregiver is removed.
The practice of dropping the caregiver's to a lower tier before the appeal and dismissal helps ensure the VA pays the cheapest rate, Williams said.
"The VA now only has to pay them the 3 months at the lower tier. It is a SIGNIFICANT difference," she wrote. "THIS is why I'm speaking out. No-one deserves this. I will appeal my decision to be lowered and fight for every other caregiver going through this too."
Williams noted that she had made six attempts to reach the VA Caregiver Support Coordinator on Friday before posting, but ultimately went public due to the VA’s inaction.
An OB-GYN at the VA hospital made the decision, according to her post.
Vadnais said the provider was a primary care physician who works in a women's clinic, not an OB-GYN.
VA to establish clearer assessment
The VA MISSION Act gives the VA the ability to make these changes to participants of the Program of Comprehensive Assistance for Family Caregivers, while expanding the program to those who care for Veterans.
The VA, Vadnais said, periodically reassesses participants to ensure that Veterans and caregivers have everything they need to continue progressing toward improved health and wellness.
"Eligibility for VA’s caregivers program is complex, and determinations are often made by multidisciplinary teams, including primary care doctors, rehab professionals and mental health clinicians," he said.
The VA, he said, is working to establish clearer, more objective eligibility criteria for consistency in these determinations.
"In the meantime, VA is ensuring that all facilities understand better how to differentiate Veterans undergoing positive changes in their needs and capabilities from those who require a consistent or greater level of care," he said.
'A hundred ways I could have died'
J.D. Williams was on his second tour in Afghanistan when he led a small six-person team into a village "that had a great deal of resistance," he wrote in a blog post for Retiring Your Boots.
As they approached, an IED detonated directly beneath him.
"My whole life started flashing through my head and I could feel an ice-cold tingling sensation all over my body," he wrote.
When he checked himself for injuries, he saw that his right arm and legs were gone.
"I (laid) back down and started thinking about life. Chaos going on all around me, I’m laid there thinking I may never see my family, friends, or Montana ever again," he wrote.
Williams said his team risked their own lives to get him to safety and get him a medical evacuation within 20 minutes, all while exchanging gunfire with the Taliban.
"As soldiers, we faced the horrors of war and never backed down... I take pride in our country and the brave men and women who defend it. I can honestly say that I would do it all again. I can think of a hundred ways I could have died the day I stepped on that IED but I’m here and I’m extremely thankful for that," he wrote.