Citation Nr: A25035471 Decision Date: 04/17/25 Archive Date: 04/17/25 DOCKET NO. 220103-506882 DATE: April 17, 2025 REMANDED Eligibility for benefits under the Department of Veterans Affairs (VA) Program of Comprehensive Assistance for Family Caregivers (PCAFC) is remanded. REASONS FOR REMAND The Veteran had active service from July 2011 to November 2014. See DD 214. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2020 administrative decision of the VA Veterans Health Administration. In the January 2022 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the September 2020 agency of original jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801. The Board notes that the Veteran's caregiver also filed an identical VA Form 10182 on the same date as the Veteran. The Board notified the appellants that the forms had been received on the same date. See Notification Letter, dated August 23, 2021 (indicating the claims are identical). As the nature of a PCAFC appeal encompasses the Veteran and caregiver, was identical, and filed on the same day, they were docketed as one claim. Thus, the Board proceeds to the merits. 1. Eligibility to PCAFC is remanded. The Veteran, and his Caregiver, contend that the Veteran is eligible for the PCAFC program. See January 2022 VA Form 10182. More specifically, the Veteran reported he relies on a caregiver daily due to posttraumatic stress disorder (PTSD), traumatic brain injury, and other disorders, which are 100 percent disabling. The claim was denied in a September 2020 decision because the Veteran "did not meet the clinical eligibility criteria for this program. Specifically, the functional level and need for daily caregiving assistance and not substantiated by the Veteran's medical record." VHA PCAFC File, received April 20, 2022, pg. 87. The denial was based on a January 2018 VHA Centralized Eligibility and Appeals Team (CEAT) decision on the basis that medical records did not support that he is in need of personal care services from another individual (caregiver) for a minimum of six continuous months. See VHA File, pg. 23. The Board notes that the notification letter currently in the claims file is legally inadequate. Under 38 C.F.R. § 20.802(a), the Board may remand for correction of any error by the Agency of Original Jurisdiction in satisfying a regulatory or statutory duty if correction of the error would have a reasonable possibility of aiding in substantiating the claim. 38 U.S.C. § 1720G(a)(12). PCAFC requires the Department of Veterans Affairs (VA) to notify individuals who apply for the program of decisions affecting the furnishing of assistance with notice as described within 38 U.S.C. § 5104. Generally, notice under 38 U.S.C. § 5104 (b) must include the following: (1) identification of the issues adjudicated; (2) a summary of the evidence considered by VA; (3) a summary of the applicable laws and regulations; (4) identification of findings favorable to the claimant; (5) in the case of a denial, identification of elements not satisfied leading to the denial; (6) an explanation of how to obtain or access evidence used in making the decision; and (7) if applicable, identification of the criteria that must be satisfied to grant service connection or the next higher level of compensation. 38 U.S.C. § 5104 (b). Notice must also set forth the right to a hearing, the right of representation, and the right to appeal to the Board of Veterans' Appeals. 38 C.F.R. § 3.103(b)(1). In this case, the notification letter did not meet the applicable requirements. As the copy of the decision letter contained in the file does not provide legally adequate notice of the decision and does not sufficiently explain to the Veteran the criteria necessary for eligibility for PCAFC benefits and does not meet the criteria, as required by 38 U.S.C. § 5104. Remand is needed to cure this due process deficiency. Correction of these errors by the AOJ is necessary to satisfy a statutory duty under 38 U.S.C. § 5104 and a duty-to-assist error that occurred prior to the decision on appeal. See 38 C.F.R. § 20.80(a); see also 38 U.S.C. § 1720G(a)(12). The matters are REMANDED for the following action: 1. Issue a notice of the decision on the issue of entitlement to eligibility for PCAFC benefits as described in 38 U.S.C. § 5104. The notice shall include but is not limited to, a summary of the evidence; a summary of the applicable laws and regulations; identification of findings favorable to the claimant; and identification of elements not satisfied but necessary for establishing eligibility for PCAFC benefits under 38 C.F.R. § 71.15-71.25. Notice must be sent to the Veteran and the Caregiver-Applicant. Cory M. Picton Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. McKenzie, Counsel 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.