Family Caregiver Relief Benefit Issuing Authority: Director General, Policy and Research Effective Date: December 9, 2015 Purpose This policy provides guidance on administering the Family Caregiver Relief Benefit. Policy Definitions 1. For the purpose of administering this policy, the following definitions apply: Activities of daily living – a set of activities necessary for self-care. The following Activities of Daily Living (ADLs) are considered for the purpose of determining if a Veteran meets the criteria set out in paragraphs 65.2(a)(ii) [i.e. daily physical assistance of another person for most activities of daily living];or 65.2(a)(iii) [i.e. ongoing direction and supervision during the performance of most activities of daily living] of theCanadian Forces Members and Veterans Re-establishment and Compensation Regulations (see paragraph 4). Mobility (considered 1 ADL): Transfers – changing the position of the body independently (e.g. positioning the body from lying to sitting; sitting to standing; lying on the back to lying on the side, etc.); and Ambulation – moving the body from one point in space to another (e.g. climbing stairs, walking, etc.) Self-care (6 ADLs): Feeding – eating and drinking of prepared foods (e.g. cutting up food, buttering bread, etc.) Washing – washing of face, trunk, extremities and hair. Dressing – putting on and taking off all pieces of indoor and outdoor clothing. Grooming/Foot Care/Personal Care – brushing of hair and teeth, shaving and make-up application; skin and nail care; cleansing and personal care associated with toileting. Toileting – continence of bowel and bladder; using toilet facilities. Taking medication – preparing and self-administering medication. Care – the provision or coordination of that which is necessary for the health, welfare, maintenance and protection of an individual who is in need of such support due to a physical, mental and/or cognitive condition. Home – means the dwelling, other than a health care facility, in which the Veteran normally resides. Informal Caregiver – a person 18 years of age or older who plays an essential role in the provision or coordination of ongoing care for that Veteran in the Veteran’s home, for which that person received no remuneration. Instrumental activities of daily living – daily activities that individuals normally do, unassisted, to live independently. The following Instrumental Activities of Daily Living cannot be used for the purpose of determining if a Veteran meets the criteria set out in paragraphs 65.2(a)(ii) or 65.2(a)(iii) of the Canadian Forces Members and Veterans Re-establishment and Compensation Regulations. However, they are considered for the purpose of determining if an informal caregiver meets the criteria set out in section 65.4 of the Canadian Forces Members and Veterans Re-establishment and Compensation Regulations (i.e. determining if the informal caregiver plays an essential role in the provision or coordination of ongoing care in the Veteran’s home (see paragraph 7). Preparing food; Managing money (e.g. banking, paying bills) Driving or accessing public transportation; Using the telephone; Running errands; Shopping; Housekeeping; Grounds maintenance Ongoing – the need for the care is continuous and unlikely to substantially improve; or the duration cannot be determined, but it is expected to last for a minimum of 12 months. Eligibility 2. Section 65.1 of the Canadian Forces Members and Veterans Re-establishment and Compensation Act provides that a Veteran is eligible to receive the Family Caregiver Relief Benefit, if he/she: a. has had an application for a disability award approved under section 45 of the Canadian Forces Members and Veterans Re-establishment and Compensation Act; b. requires ongoing care as a result of the health problem(s) for which the disability award application was approved; c. an informal caregiver plays an essential role in the provision or coordination of the ongoing care in the Veteran’s home (see paragraph 7); and d. satisfies the criteria set out in the Canadian Forces Members and Veterans Re-establishment and Compensation Regulations. 3. A Veteran is considered to need ongoing care, if his/her health problem(s) are: a. continuous, and unlikely to substantially improve; or b. the duration cannot be determined, but are expected to last for a minimum of 12 months. 4. Section 65.2 of the Canadian Forces Members and Veterans Re-establishment and Compensation Regulations provides that a Veteran is eligible to receive the Family Caregiver Relief Benefit, if he/she requires at least one of the following: a. a level of care and supervision consistent with admission to an institution; b. daily physical assistance of another person for most activities of daily living; c. ongoing direction and supervision during the performance of most activities of daily living; or d. daily supervision and is not considered to be safe when left alone (i.e Veteran poses a risk to him/herself or others if not supervised on a daily basis). 5. The phrase “most activities of daily living” is interpreted to mean a minimum of four (4) activities out of seven (7). 6. In some situations, it will be difficult, if not impossible, to separate the impact of a health condition for which a disability award has been granted from other non-awarded health conditions. In circumstances where there is a reasonable doubt or uncertainty as to whether the need for ongoing care is a result of the condition(s) for which the disability award application is approved, then the reasonable doubt or uncertainty should be resolved in the Veteran’s favour. 7. The informal caregiver plays an essential role in the provision or coordination of ongoing care in the Veteran’s home if there is evidence that: a. the Veteran relies on an informal caregiver to provide or coordinate: i. daily supervision; ii. direction and/or physical assistance with most activities of daily living; iii. assistance with completion of, or coordination of, instrumental activities of daily living; and b. the Veteran’s health and well-being would be placed at risk, and his/her ongoing care would be compromised without the informal caregiver. Excluded Groups 8. A still-serving member of the Canadian Armed Forces is not eligible for the Family Caregiver Relief Benefit. 9. A Veteran who is eligible for an Attendance Allowance under subsection 38(1) of the Pension Act (e.g. is in receipt of or has received at least a 1% disability pension or Prisoner of War Compensation) is not eligible to be paid a Family Caregiver Relief Benefit. However, a Veteran who has received a “nil” assessment under the Pension Act may be eligible if they satisfy the criteria set out in paragraph 2. 10. A Veteran who resides in a health care facility wherein the level of care provided eliminates the need for an informal caregiver is not eligible for the Family Caregiver Relief Benefit. Initial Application 11. Veterans Affairs Canada (VAC) staff will guide the Veteran through the application process in an effort to eliminate unnecessary administrative burden. Given the eligibility requirements for the Family Caregiver Relief Benefit and its relationship to the Veteran’s disability award, VAC may already have the necessary information to make a decision on the Veteran’s application, including medical, nursing and/or other assessments/records. VAC will use this information to confirm the Veteran’s health condition. Only if required, should the Veteran be asked to provide additional information to substantiate the application. Annual Renewal 12. The Family Caregiver Relief Benefit is designed so that an eligible Veteran may receive the benefit once every 12 months. In the year following initial approval of the benefit, the Veteran or, if applicable, the Veteran’s legal representative will have an expedited process to renew the benefit. 13. In order to establish the Veteran’s on-going eligibility for the upcoming 12-month period and approve the continuation of the Family Caregiver Relief Benefit, VAC must: a. confirm the Veteran’s need for an informal caregiver continues to exist; b. confirm the informal caregiver’s name and age; and c. have the Veteran attest that he/she will use the Family Caregiver Relief Benefit to provide relief to their informal caregiver. Purpose of Benefit 14. The Family Caregiver Relief Benefit must be used for any purpose that could reasonably be expected to ensure that the informal caregiver receives relief. Amount Payable 15. The annual amount of the Family Caregiver Relief Benefit is set out in Schedule 2 of the Canadian Forces Members and Veterans Re-establishment and Compensation Act (see column 2 of item 5). The amount is set at $7,238 for calendar year 2015. The amount will be indexed annually based on the Consumer Price Index. 16. The Family Caregiver Relief Benefit is not subject to income tax. 17. The Family Caregiver Relief Benefit is not payable unless a duly completed and signed application (i.e. application form plus any other pertinent information) has been made by or on behalf of the Veteran, and payment of the benefit is approved by the appropriate decision maker. 18. Only one payment may be awarded annually, regardless of the number of informal caregivers involved in providing or coordinating ongoing care for the Veteran in the Veteran’s home. Date Payable - Initial Application 19. The Family Caregiver Relief Benefit is payable on the date a favorable eligibility decision is made. The payment will be effective the date the signed application is received. The application is considered to be received on the earlier of: a. The date stamped on the application when it is received by the Department; or b. The date the application is received at the Digital Images Scanning Centre in Matane, QC. Date Payable – Annual Renewal 20. The Family Caregiver Relief Benefit is payable to an eligible Veteran once every 12 months. Termination of Benefit 21. The Family Caregiver Relief Benefit is no longer payable: a. if the Veteran no longer has an informal caregiver or a need for one; b. if the Veteran permanently relocates to a health care facility; c. if the Veteran or, if applicable, the Veteran’s legal representative fails to return a completed and signed annual renewal declaration (see paragraph 13); or d. upon the death of the Veteran. Benefit Awarded Erroneously 22. The Minister may continue the payment of a Family Caregiver Relief Benefit to a Veteran who is not entitled to it, if they meet all the following criteria: a. the amount paid to the Veteran to which the Veteran was not entitled is the result of an administrative error, or a delay or an oversight on the part of an officer or employee of the federal public administration and has been remitted under the Canadian Forces Members and Veterans Re-establishment and Compensation Act ; b. no part of the amount paid to the Veteran was the result of a misrepresentation or of concealment of a material fact on the part of the Veteran; c. the cancellation of the benefit would cause undue hardship to the Veteran; and d. the benefit had been paid to the person for five years or more. Redress 23. Two levels of review are available to a Veteran who is dissatisfied with a decision rendered in respect of the Family Caregiver Relief Benefit. See the policy entitled Review of Part 2 and Part 3.1 Decisions under the Canadian Forces Members and Veterans Re-establishment and Compensation Act for additional information. References Canadian Forces Members and Veterans Re-establishment and Compensation Act Canadian Forces Members and Veterans Re-establishment and Compensation Regulations Pension Act