“Heartbreaking”: Caregivers Being Denied PCAFC Benefits When Veterans Die During Appeals
CCK Law: Our Vital Role in Veterans Law
When a veteran dies while a caregiver appeal is pending, the Board of Veterans’ Appeals (Board) has been denying the caregiver’s claim outright, without deciding whether the caregiver qualified. As a result, they get no retroactive compensation. Two former caregivers, represented pro bono by Chisholm Chisholm & Kilpatrick (CCK Law) and the National Veterans Legal Services Program (NVLSP), have asked a federal court to stop that practice.
Here is what is happening:
- Caregiver benefits come from the Veterans Health Administration (VHA), not from the side of VA that handles disability compensation. VHA is ill-equipped for adjudicating these types of claims, often leading to erroneous denials.
- Caregiver appeals can take years, partly because VHA and the Board do not share one electronic record.
- If the veteran dies during these long appeals, caregivers cannot continue the claim for retroactive compensation, unlike in other VA compensation cases.
- A bill pending in Congress would address the situation by statute rather than by litigation, but the likelihood of passage is currently unclear.
What Is PCAFC? (Caregiver Benefits)
VA’s Program of Comprehensive Assistance for Family Caregivers (PFAFC) is authorized by 38 USC § 1720G and implemented at 38 CFR Part 71. For an approved primary family caregiver, the program provides a monthly stipend, health coverage, training, respite care, and counseling. For a family member who left a job to provide full-time care, the stipend is often the only income replacing that paycheck.
Hundreds of thousands of caregivers have filed claims for these benefits since the program was created. VA’s own records as of June 2026 give a glimpse of the challenges facing caregivers:
The Caregiver Support Program office receives roughly 10,000 applications every month, with an average national approval rate of 31 percent. Though there was an influx of applications in process when PACT Act benefits were announced, this number now remains steady at 10,000. In terms of reviews and appeals, CSP has resolved 3,170 Legacy Notices of Disagreement, 3,592 VHA Higher Level Reviews, and 7,227 VHA Supplemental Claims, but VHA has granted fewer than 5 percent of those reviews or appeals.
Why Do Caregiver Claims and Appeals Take So Long?
A main reason is that records are scattered. The Veterans Benefits Administration built a single electronic claims folder for disability compensation claims, but VHA never built the equivalent for caregiver applications.
Caregiver records sit in different VHA systems, and none of those systems is the one the Board uses. VHA staff, medical center patient advocates, and Board attorneys are therefore looking at different documents when they decide the same application. So the Board frequently remands the case — sends it back to VHA — to collect records the Board cannot see.
Each remand adds months or years.
Caregiver advocates, including the Elizabeth Dole Foundation and the Quality of Life Foundation, have reported repeatedly that inconsistent VHA guidance and training cause applications to be denied in the first place. Denials generate appeals. Appeals generate remands. Remands generate delay. And delay, for a family caring for a seriously ill veteran, can lead to injustice.
What Happens to a Caregiver’s Appeal When the Veteran Dies?
The Board denies it. And the denial is not based on the merits. According to the class filings, the Board has reasoned that benefits under PCAFC depend on being admitted to the program. A veteran who has died cannot be admitted going forward; thus, no retroactive stipend is payable, no matter how much care the family member actually provided.
The care itself is not in dispute in these cases. The Board has decided the criteria do not matter: the bathing, the feeding, the medication schedules, the nights without sleep. The only reason that the Board denied these appeals was that the veteran did not live long enough for VA’s bureaucracy to reach a decision.
How Is This Process Different Than Disability Compensation Claims?
Death does not automatically end a disability compensation claim. Under 38 USC § 5121A, a survivor who is eligible for accrued benefits may ask within one year of the death to be substituted for the deceased claimant and carry the claim or appeal through to a decision. Put more simply: the family can finish what the veteran started, and past-due benefits can still be paid.
That is small comfort for a grieving family. But it means the years of waiting are not erased.
Caregivers who appeal a PCAFC denial have not been getting that result. The Board’s position in these cases has been that the program requires admission, admission cannot happen after death, and so the appeal ends there.
Example: Presley and Bolton-Pellerin
Sharon Presley and Shyrl Bolton-Pellerin are two clients being represented on a pro bono basis by CCK Law and NVLSP.
Sharon Presley cared for her father, an Army combat veteran who served in Vietnam. Late in his life, he needed help with many of the ordinary tasks of a day. They filed a joint PCAFC application together. VA’s Caregiver Support Program denied it.
With his Board appeal, the Veteran submitted a letter from his VA primary care physician stating that his cancers had progressed to the point that he needed almost complete and total care. He died of liver cancer about four months later. The Board then denied the appeal because he had died while waiting for a decision.
Shyrl Bolton-Pellerin cared for her husband, an Army Veteran of the Vietnam era with service-connected cancer. Their application was denied too. They appealed through VHA’s clinical appeal process, and VA indicated that they were in fact eligible. VA began processing them for final approval. Ms. Bolton-Pellerin completed the required caregiver training in anticipation of being approved as a primary family caregiver.
Her husband died before the approval was finished. VHA denied the appeal, and the Board reached the same conclusion it had reached in Ms. Presley’s case.
She had done everything VA asked of her. The only step left was VA’s own.
What Are CCK Law and NVLSP Asking the Court To Do?
In August 2025, the two caregivers filed motions at the U.S. Court of Appeals for Veterans Claims (CAVC) asking the Court to certify a class (i.e., start a class action) and to order VA to decide these appeals on their merits. The proposed class covers caregivers whose appeals were denied solely because the veteran they cared for died while awaiting a decision.
The right to appeal a PCAFC decision to the Board is itself recent. It came from Beaudette v. McDonough, decided by CAVC in April 2021 and unanimously upheld by the U.S. Court of Appeals for the Federal Circuit in February 2024. The current case argues that a right to appeal means little if the appeal is dismissed on a technicality before anyone reads it.
How many caregivers are affected is not publicly known. NVLSP’s director of litigation has estimated that dozens may be affected each month.
A class certification hearing has been held, and as of the date of this article, the Court has not issued a ruling.
CCK Law has been involved in over 117 cases before the Court of Appeals for Veterans Claims and the Court of Appeals for the Federal Circuit that have set precedent rectifying situations like this. We firmly believe that this is a serious injustice violating the spirit and intent of the VA benefits system. We hope the Court makes the right decision for Ms. Presley, Ms. Bolton-Pellerin, and an untold number of other caregivers who have cared for veterans without benefits that we believe the law clearly indicates are rightfully theirs.
Is Congress Considering a Fix?
Yes. Companion bills introduced in 2025 — H.R. 3833 in the House and S. 2055 in the Senate, both titled the Veterans’ Caregiver Appeals Modernization Act of 2025 — would address the problem directly. According to the House committee summary, the legislation would do three things:
- Require VA to build one digital system that every VHA and Board employee deciding caregiver applications can access.
- Clarify that caregivers may be eligible for past-due stipends when an application is granted on appeal after the veteran has died.
- Require consistent guidance and training for the VHA employees who decide these applications.
Neither bill has become law. Legislative text and status for H.R. 3833 and S. 2055 are available on Congress.gov.
What Should Caregivers Do if VHA Incorrectly Denies Their Claim?
Nothing here is legal advice about a specific case. But a few practical steps could help caregivers in this unfortunate position.
- Appeal rather than start over. A new application generally establishes a new date from which your past-due stipends are calculated. An appeal preserves the original one.
- Keep every document. Denial letters, training completion records, physician letters, and correspondence all become evidence, and VHA’s records are not consolidated.
- Watch the deadlines. Appeal periods are short and are stated in the decision letter.
- Do not assume a denial after a death is final. Both the pending litigation and the pending legislation could change that outcome, so preserve the file.
- Consider help from a VA-accredited representative who is familiar with caregiver appeals, which follow different rules than compensation claims. CCK Law offers free case evaluations.
Frequently Asked Questions
Is this the same case as Beaudette v. McDonough?
No. Beaudette won caregivers and veterans the right to appeal PCAFC decisions to the Board. This newer case argues that VA is undercutting that right by refusing to decide appeals once the veteran has died.
Can a caregiver join the proposed class?
The Court has not certified a class, so there is nothing to join yet. Caregivers who believe they fit the description should keep their records and their denial letters in case notice is later issued.
Also: continue to appeal. Caregivers who believe they are owed retroactive PCAFC benefits should continue the appeal process, either to the Board or to the Court of Appeals for Veterans Claims. This is because if someone just gets a denial-because-of-death decision and lets a year lapse — either after a VHA decision or a Board decision — they may not be able to get retroactive benefits if the Court does not certify a class.
What happens if the veteran was already approved in PCAFC and then died?
That is a different situation with different rules, and stipend continuation after a participant’s death is handled separately from a denied appeal.
Does the caregiver or the veteran file the PCAFC application?
Both. PCAFC applications are filed jointly by the veteran and the proposed family caregiver, which is part of why the veteran’s death complicates the appeal.
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