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Witness Testimony of Sarah Wade, Wounded Warrior Project, Coordinator, Family Issues and Traumatic Brain Injury

Chairman Hall, Ranking Member Lamborn, and Members of the Subcommittee:

Thank you for inviting Wounded Warrior Project to testify on VA’s Fiduciary Program.  Through our long work with severely-wounded veterans and their family caregivers, many of whom are fiduciaries, Wounded Warrior Project brings a unique understanding to the operation, and shortcomings, of VA’s Fiduciary Program.  As a caregiver myself of a severely wounded veteran of Operation Iraqi Freedom who sustained severe traumatic brain injury, and as one who has worked with many other caregivers of severely wounded warriors, I believe I can offer a helpful perspective.

WWP appreciates the important responsibility vested in VA’s Fiduciary Program to safeguard the benefits of veterans who are unable to manage their own affairs.  That program unquestionably has a critical mission and performs vital work.   But we are gravely concerned that in managing the program, VA does not take account of, or even recognize, the unique circumstances of family members who have devoted themselves to the full-time care of severely wounded veterans, and who also serve as their fiduciaries.  Parents and spouses who have made great sacrifices – often giving up careers and depleting savings -- to care for their loved ones hardly pose a risk of misusing the veteran’s benefits, and in fact should be free to apply part of their loved one’s benefits to help maintain a household that they share.  We welcome this opportunity to document the critical need for VA to revise its policy and practice with respect to caregiver-fiduciaries who have demonstrated their dedication to the veteran’s well-being. Adoption of the recommendations we will be discussing would end the often shameful and arbitrary treatment that too many families have endured.

Let me reiterate.  WWP recognizes that the risks the VA fiduciary program is designed to counter are certainly real, and appropriate oversight is needed.  In that regard, we appreciate the Government Accountability Office’s (GAO) emphasis in its February report on the importance of improving VBA compliance with Fiduciary Program policies. 

Importantly, those policies recognize that all fiduciary cases do not require the same degree of attention and supervision, and that field examiners should consider the unique circumstances of each case.  Unfortunately, there appears to be wide variability in examiners’ exercise of that judgment with respect to many of the fiduciaries with whom WWP works – family members who are not only fiduciaries for severely wounded veterans, but also their full-time caregivers.

GAO makes an important observation in stating that VA’s fiduciary case management system does not provide sufficient information to managers and staff about their cases.  That statement highlights that VA is not sufficiently aware of, and not sufficiently attuned to, the unique circumstances of these caregiver-fiduciaries.

The many, many caregivers of wounded warriors whom I’ve known and with whom I’ve worked over the years have made great personal sacrifices to provide daily care to their loved ones.  They’ve chosen to give up, or indefinitely suspend, careers or career plans.  These family members have put their own lives “on hold” to be caregivers.  Many have been appointed fiduciaries.  I can assure you that their love and dedication to their wounded spouses and children did not change in any way by virtue of taking on new responsibilities as a fiduciary.

Yet, in dealing with caregivers who serve as fiduciaries, the Veterans Benefits Administration (VBA) too often fails to recognize their sacrifice.  Instead, parents and spouses who over time have surely proven their dedication to their loved one, too often encounter a VBA system marked by its rigidity, intrusiveness, and unreasonableness when it conducts oversight of those caregivers in their role as the veteran’s fiduciary. 

Let me illustrate my point by way of examples:

  • A VBA field examiner imposing a summer-vacation expenditure limit for a profoundly wounded warrior, his wife and two children;
  • A mother/caregiver having to explain to a VBA examiner why she allowed her wounded-warrior son to spend “too much” money on Christmas gifts;
  • The spouse/caregiver of a traumatically brain-injured veteran having to get permission from a VBA field examiner to purchase a couch;
  • A devoted mother-caregiver to her minimally-conscious son being required to pay back money for toilet paper purchased for the home with the veteran's funds;
  • A family’s being questioned about expenditures for gasoline when the wounded warrior does not drive or own a car, but the fuel was used to transport the veteran;
  • Several instances of mothers, who are full-time caregivers to wounded veterans, being required to pay rent to the veteran rather than residing in the home for “free;”
  • A field examiner denying a mother-caregiver’s request to replace the (now-wheelchair bound) veteran’s eight year-old high-mileage truck that she uses to transport him in a rural, snowy part of the country; and
  • A mother-caregiver having to relinquish her role as a fiduciary because she had had to declare bankruptcy after leaving her job to care for her wounded warrior son.

Let me assure you – from personal knowledge -- that these families do not deserve to be treated in the demeaning, petty and hurtful manner reflected in these examples.  At the same time, we would acknowledge that VBA examiners have not universally been as unreasonable as these examples suggest.  Yet these specific illustrations are not isolated problems, or remote outliers.  Further compounding these problems is that as these caregivers have looked to one another for clarity in understanding the often-inexplicable workings of VA programs, what becomes apparent is the stark variability in VA oversight across the system.  The impression, frankly, is of a program marked by arbitrary and capricious decision making.  

It should be recognized that a family member or members residing with the veteran may have no income – and may well have depleted some of their own assets – to become the veteran’s caregiver.  We see no basis whatsoever for precluding such families from drawing on the veteran’s benefits to pay for the family’s living expenses!  VA Fiduciary Program policy should make that abundantly clear.  But even more fundamentally, a devoted family member who provides daily care for a severely wounded veteran should not be treated as an object of VA suspicion – either in terms of rigid management of their budgeting or intrusive home visits -- simply because the individual serves as the veteran’s fiduciary.  We believe these families are owed a presumption of honesty, and should be treated with dignity.    

Over the past year we have discussed these concerns with officials in the Veterans Benefits Administration, offered to work with them on these issues, and arranged for them to meet with a family caregiver-fiduciary to appreciate better these families’ experiences under the program with the hope that necessary modifications could be made.  But more than half a year since first raising these concerns with VA, it remains unclear whether promised remedial revisions to Fiduciary Program policies will ever come to fruition.

Separate from the issues of inconsistent oversight and arbitrary requirements, VA has acknowledged a need for more training, consistent with GAO’s findings.  WWP strongly agrees.  But VA must not only provide more training for its fiduciary program staff, it should better inform family members of their responsibilities in agreeing to serve as fiduciaries.  These steps would be helpful, but certainly would not go far enough.  VBA must substantially revise its policy and practice to reflect far greater balance and understanding as it relates to caregiver-fiduciaries whose sacrifices have surely demonstrated that they do not pose significant risk.

Given the resource and staffing problems GAO described in reporting on the Fiduciary Program, it is particularly difficult to understand devoting resources to close scrutiny of family caregiver-fiduciaries who have proven themselves over time.

Indeed, the caregivers are well known to VA.   Each has worked closely with a Federal Recovery Coordinator and/or case-managers in connection with their veteran’s care.  In the isolated instance in which there is some indication of a problem concerning a caregiver, caseworkers in the Veterans Health Administration, and often care-coordinators in other VA offices, become aware of it.  From the caregivers’ perspective, “VA” is a single entity, and they have every reason to believe VA knows they are reliable and have integrity.  So imagine how confusing it is for a caregiver who has worked closely, and developed relationships of trust, with other VA staff to encounter VBA personnel whose fiduciary-requirements convey fundamental mistrust.   It does not seem too much to ask that VBA and other arms of the Department work more closely together to share information relating to caregiver-fiduciaries, rather than requiring these dedicated individuals to prove themselves yet again.

In short, Mr. Chairman, devoted family members who have clearly made great sacrifices to care for their loved ones hardly pose a risk of misusing the veteran’s benefits.  VA Fiduciary Program policies and practices must be revised to draw distinctions among categories of fiduciaries.   A devoted family member who provides consistent, high-quality daily care for a severely wounded veteran should not be treated as an object of VA suspicion simply because the individual serves as the veteran’s fiduciary.  We believe these families are owed a presumption of honesty, and should not be subjected to rigid budgeting and ongoing intrusive scrutiny without substantial cause.  Finally, VA must work to achieve more uniform standards and greater consistency in its application of fiduciary oversight policy.

Mr. Chairman, we look forward to working with the Subcommittee staff in addressing these concerns regarding the VA’s Fiduciary Program.

That concludes our testimony.  I’d be pleased to address any questions you may have.