Citation Nr: A22018776 Decision Date: 09/14/22 Archive Date: 09/14/22 DOCKET NO. 220427-240407 DATE: September 14, 2022 ORDER Entitlement to benefits under the Program of Comprehensive Assistance for Family Caregiver (PCAFC) is granted. FINDING OF FACT The Veteran has been unable to perform an activity of daily living for a minimum of six months. CONCLUSION OF LAW The criteria for entitlement to benefits under the PCAFC have been met. 38 U.S.C. § 1702G; 38 C.F.R. §§ 71.15, 71.20, 71.25, 71.30. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from October 1966 to December 1969. In the March 2022 VA Form 10182, Decision Review Request: Board Appeal, the Veteran elected the Evidence Submission docket. Therefore, regarding the issue addressed in the March 2021 notification of denial issued by the Agency of Original Jurisdiction (AOJ), the Board may consider only the evidence of record at the time of the March 2021 decision, as well as any evidence submitted by the Veteran or his representative with the VA Form 10182 or within 90 days of receipt of the VA Form 10182. 38 C.F.R. § 20.303. Entitlement to benefits under the PCAFC Eligibility under the PCFAC program requires a finding that an eligible Veteran is in need of personal care services for a minimum of six continuous months from an eligible caregiver because of: An inability to perform an activity of daily living, a need for supervision or protection based on symptoms or residuals of neurological or other impairment or injury, or a need for regular or extensive instruction or supervision without which the ability of the veteran to function in daily life would be seriously impaired. 38 U.S.C. § 1720G(a)(2); 38 C.F.R. § 71.20(a); see Veterans Warriors, Inc. vs. McDonough, 29 F.4th 1320 (Fed. Cir. 2022). "In need of personal care services" means that the eligible Veteran requires in-person personal care services from another person, and without such personal care services, alternative in-person caregiving arrangements (including respite care or assistance of an alternative caregiver) would be required to support the eligible Veteran's safety. 38 C.F.R. § 71.15. "An inability to perform an activity of daily living" means the individual requires personal care services each time he or she completes one or more of the following: (1) Dressing or undressing oneself; (2) Bathing; (3) Grooming oneself in order to keep oneself clean and presentable; (4) Adjusting any special prosthetic or orthopedic appliance, that by reason of the particular disability, cannot be done without assistance (this does not include the adjustment of appliances that nondisabled persons would be unable to adjust without aid, such as supports, belts, lacing at the back, etc.); (5) Toileting or attending to toileting; (6) Feeding oneself due to loss of coordination of upper extremities, extreme weakness, inability to swallow, or the need for a non-oral means of nutrition; or (7) Mobility (walking, going up stairs, transferring from bed to chair, etc.). Id. An "eligible veteran" is a member of the Armed forces undergoing a medical discharge, or an individual who had a serious injury incurred or aggravated in the line of duty during active service. See 38 C.F.R. § 71.20(a). "Serious injury" means any service-connected disability that is rated 70 percent or more by VA, or is combined with any other service-connected disability or disabilities, and a combined rating of 70 percent or more is assigned by VA. 38 C.F.R. § 71.15. Service connection is in effect for interstitial lung disease, status-post transplant with a rating of 100 percent. Therefore, the Veteran is an eligible veteran for the PCAFC. See 38 C.F.R. §§ 71.15, 71.20(a). The Veteran and his spouse had a VA caregiver functional assessment in March 2021. The evaluator found that the Veteran's primary deficits involved lack of safety with upright mobility, decreased fine motor skills in his right hand, and decreased activity tolerance. Although capable of doing so independently, the spouse reported assisting him with dressing and undressing, particularly with pants, as the Veteran had difficulty and pain with buttoning, and putting on shoes and belts. The Veteran also required supervision while bathing or utilizing the toilet because he was at a high risk for falling and once having fallen, had issues getting back up. His fall risk was not limited to movements in the bathroom. Generally, the spouse monitored the Veteran's movements because he had issues with falling due to left leg numbness and sudden buckling. For example, in the prior year, the Veteran fell unexpectedly in the kitchen and was injured with a big gash on his head. Additionally, the Veteran was incapable of the act of bending down, and consequently, could not retrieve things he had dropped. The record shows that the Veteran is unable to stand for longer than a 10 minute period or walk distances greater than 25 feet because he only had one lung. The Veteran exercised with light weights and a recumbent bike in attempts to strengthen his lung and legs. The Veteran said that his disabilities required him to utilize a cane, rollator, bathtub that is a stepover, shower chair with grab bars, chairlift, and raised toilet seat. The spouse also monitored the Veteran's medications. He estimated that his regiment consisted of over 26 prescriptions which could change every three weeks depending on the results of his blood lab work. Regarding self-presentation, the examiner felt that the Veteran had the judgment and physical ability to cope, make appropriate decisions, and take action in a changing environment or potentially harmful situation. However, it was also noted that the Veteran had an inability to manage medications. The Veteran was only left alone when the spouse went to the store, and within that short time span, he required sticky notes to remind him about his medication and meals. The record shows that the Veteran is unable to dress or undress himself or perform activities without assistance due to his high-fall risk and low activity tolerance. Further, he had extreme difficulty getting back up after a fall. As a result of his disabilities, he received extensive assistance from his wife every time he performed any activity. Therefore, the Veteran has an inability to perform two of the enumerated activities of daily living. See 38 C.F.R. § 71.15. The record also shows that this was continuous for at least six months. The Veteran is therefore entitled to benefits under the PCAFC due to an inability to perform an activity of daily living, and the claim is granted. See 38 U.S.C. § 1720G(a)(2); 38 C.F.R. § 71.20(a). L. M. BARNARD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Lee The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.