VA Caregiver Programs: Who Qualifies for PCAFC, and the 2026 Monthly Stipend in Every Locality

A VA social worker mentions "the caregiver program." A neighbor says her husband's caregiver gets a check every month. Your mother has been doing it all for your father, a 100 percent rated veteran, for free. Is there money for her, how much, and what does it take?

I'm an occupational therapist, and I've worked in home health, where the family caregiver is often the person I'm most worried about. This article is for three readers: the spouse of a veteran with a 70 percent or higher rating who wants to know what the program pays and asks; the adult child of a Vietnam-era parent who heard the program was only for post-9/11 veterans; and a caregiver already in the program who is worried about a reassessment letter. If what you need is a VA aide who comes to the house, Aid and Attendance, or the VA's long-term care copays, those are in our VA home health aide article, and I won't repeat them here.

Three kinds of statements show up below, and I'll label them. A rule is a federal regulation, 38 CFR Part 71, and I'll cite the paragraph. A VA page is the program's own description, quoted. My arithmetic is shown so you can check it. Anything labeled my suggestion is just that.

Two Programs, One Table

The VA Caregiver Support Program has two parts, and families mix them up because the names are long. The rule's purpose section, 38 CFR §71.10(a), describes both: the Program of Comprehensive Assistance for Family Caregivers, which "provides certain benefits to eligible veterans who have incurred or aggravated serious injuries during military service, and to their caregivers," and the Program of General Caregiver Support Services, "which provides support services to caregivers of covered veterans from all eras who are enrolled in the VA health care system."

The rest of this article is about the first column, because that's where the questions are. If your veteran doesn't have the 70 percent rating, skip to the section on PGCSS near the end, and read the aide article for Veteran-Directed Care, which lets a veteran hire family with a VA budget.

Who Qualifies: The Veteran

38 CFR §71.20(a) lists seven requirements, and the veteran must meet all of them. Here they are, quoted, with notes.

(1) The individual is either: (i) A veteran; or (ii) A member of the Armed Forces undergoing a medical discharge from the Armed Forces.

(2) The individual has a serious injury incurred or aggravated in the line of duty in the active military, naval, or air service: (i) On or after September 11, 2001; (ii) Effective October 1, 2020, on or before May 7, 1975; or (iii) Effective October 1, 2022, after May 7, 1975 and before September 11, 2001.

Read the three date windows together and they cover every date. The program started with post-9/11 veterans, opened to veterans of Vietnam and earlier on October 1, 2020, and to everyone in between on October 1, 2022. If someone told you it's only for the post-9/11 generation, that was true until 2020.

"Serious injury" is defined in §71.15: "any service-connected disability that: (1) Is rated at 70 percent or more by VA; or (2) Is combined with any other service-connected disability or disabilities, and a combined rating of 70 percent or more is assigned by VA." VA's stipend page adds that serious injury includes serious illness. The rating is the gate. A veteran at 60 percent is out, however much care they need.

(3) The individual is in need of personal care services for a minimum of six continuous months based on any one of the following: (i) An inability to perform an activity of daily living; or (ii) A need for supervision, protection, or instruction.

Two things to know about paragraph (3). First, "in need of personal care services" has its own definition in §71.15: the 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." In-person is the word that matters. Checking in by phone doesn't count.

Second, the activities of daily living are listed in §71.15: dressing or undressing; bathing; grooming "in order to keep oneself clean and presentable"; adjusting a prosthetic or orthopedic appliance that can't be adjusted without help; toileting; 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"; and mobility, "walking, going up stairs, transferring from bed to chair, etc." Hitting one of the seven is enough for paragraph (3)(i).

The second leg, supervision, protection or instruction, is where the rulebook and the court disagree. §71.15 still carries a definition, but §71.40 itself notes that the definition "was invalidated by Veteran Warriors, Inc. v. Sec'y of Veterans Affairs, 29 F.4th 1320, 1342-43 (Fed. Cir. 2022)," and that VA applies the statute instead. VA's stipend page gives the statute's two bases in its own words: "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." If your veteran has a brain injury, PTSD or dementia and can do the seven activities but can't be left alone safely, this is the leg to document.

(4) It is in the best interest of the individual to participate in the program.

§71.15 says this is "a clinical determination that participation in such program is likely to be beneficial to the veteran or servicemember," including whether it "significantly enhances the veteran's or servicemember's ability to live safely in a home setting."

(5) Personal care services that would be provided by the Family Caregiver will not be simultaneously and regularly provided by or through another individual or entity.

This is the paragraph to ask about if VA already sends a Homemaker and Home Health Aide for the same tasks. The rule says the family caregiver's services can't be regularly duplicated by someone else. How a particular team reads that for a particular mix of aide hours and family hours is a question for the team, and my suggestion is to ask it before you apply, not after.

(6) The individual receives care at home or will do so if VA designates a Family Caregiver. (7) The individual receives ongoing care from a primary care team or will do so if VA designates a Family Caregiver.

"Primary care team" means "one or more medical professionals who care for a patient based on the clinical needs of the patient," and it "must include a VA primary care provider who is a physician, advanced practice nurse, or a physician assistant" (§71.15). So the veteran has to be enrolled in VA health care and be a VA primary care patient, or become one.

Who Qualifies: The Caregiver

§71.25(b) sets the caregiver's side:

(1) Be at least 18 years of age. (2) Be either: (i) The eligible veteran's spouse, son, daughter, parent, step-family member, or extended family member; or (ii) Someone who lives with the eligible veteran full-time or will do so if designated as a Family Caregiver. (3) There must be no determination by VA of abuse or neglect of the eligible veteran by the applicant.

A friend, a partner who isn't a spouse, or a neighbor can qualify under (2)(ii) by living with the veteran full time. §71.25(a)(1) caps the roster: "no more than three individuals may serve as Family Caregivers at one time for an eligible veteran, with no more than one serving as the Primary Family Caregiver and no more than two serving as Secondary Family Caregivers."

Before approval, the caregiver is assessed as able to complete training, completes it, and VA visits the home. §71.25(d) lists the training's ten core competencies: medication management; vital signs and pain control; infection control; nutrition; functional activities; activities of daily living; communication and cognition skills; behavior management skills; skin care; and caregiver self-care. §71.25(e): "VA will visit the eligible veteran's home to assess the eligible veteran's well-being and the well-being of the caregiver, as well as the caregiver's competence to provide personal care services at the eligible veteran's home."

The 90-day clock. §71.25(a)(2)(ii): applicants "must complete all necessary eligibility evaluations (along with the veteran or servicemember), education and training, and the initial home-care assessment (along with the veteran or servicemember) so that VA may complete the designation process no later than 90 days after the date the joint application was received by VA. If such requirements are not complete within 90 days from the date the joint application is received by VA, the joint application will be denied, and a new joint application will be required." VA can extend the 90 days only when the delay "is solely due to VA's action." My suggestion: when VA calls to schedule training or the home visit, take the first date offered.

What Each Caregiver Gets

§71.40 is built in layers. Every General Caregiver gets paragraph (a). Secondary Family Caregivers get (a) plus (b). The Primary Family Caregiver gets all of it plus (c).

Secondary Family Caregivers get, under §71.40(b): the general benefits; wellness contacts "at a minimum of once every 120 days," with "at least one visit" in the home each year; continuing training; "ongoing technical support" for routine, emergency and specialized needs; counseling, which "includes individual and group therapy, individual counseling, and peer support groups"; and beneficiary travel when the veteran is eligible for it. They do not get a stipend, and they do not get CHAMPVA. Families sometimes plan on two paid caregivers. The rule pays one.

The Primary Family Caregiver gets, under §71.40(c), everything above plus:

• Respite. "Respite care includes 24-hour-per day care of the eligible veteran commensurate with the care provided by the Family Caregiver to permit extended respite. Respite care will be available for at least 30 days per year and may exceed 30 days per year if clinically appropriate and if requested by the Primary Family Caregiver. Respite care provided shall be medically and age-appropriate and include in-home care." (§71.40(c)(2)) Thirty days is the floor, and the rule says in-home respite is included. Our respite care article covers the rest of the respite landscape.
• CHAMPVA. Primary Family Caregivers "are eligible for enrollment in the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) pursuant to 38 U.S.C. 1781, unless they are entitled to care or services under a health-plan contract (as defined in 38 U.S.C. 1725(f))." (§71.40(c)(3)) Whether your own insurance counts as a health-plan contract is a question for the caregiver support team.
• Legal and financial planning services (§71.40(c)(5) and (6)), which §71.15 defines to include advance directives, power of attorney, simple wills, guardianship, household budgeting, debt management and retirement planning review.
• The monthly stipend, which gets its own section.

The Stipend: How It Is Calculated

Everything here is from the rule, VA's stipend page, and OPM's published pay table, with my arithmetic shown.

The rate. §71.15: "Monthly stipend rate means the Office of Personnel Management (OPM) General Schedule (GS) Annual Rate for grade 4, step 1, based on the locality pay area in which the eligible veteran resides, divided by 12." Note the address that counts: the veteran's, not the caregiver's.

The two levels. §71.40(c)(4)(i)(A): "The Primary Family Caregiver's monthly stipend is calculated by multiplying the monthly stipend rate by 0.625," and "If VA determines that the eligible veteran is unable to self-sustain in the community, the Primary Family Caregiver's monthly stipend is calculated by multiplying the monthly stipend rate by 1.00." VA's page calls these level one and level two.

Unable to self-sustain in the community is defined in §71.15. The veteran either "Requires personal care services each time he or she completes three or more of the seven activities of daily living (ADL) listed in the definition of an inability to perform an activity of daily living in this section, and is fully dependent on a caregiver to complete such ADLs," or "Has a need for supervision, protection, or instruction on a continuous basis." Three activities, fully dependent, every time; or continuous supervision. That's the line between the two levels, and it's decided at the evaluation and at each reassessment (§71.30(a)).

The arithmetic, once. OPM's 2026 salary table for the Rest of U.S. locality area, which covers every address not inside a named metropolitan area, puts GS-4, step 1 at $36,409 a year. So:

• Monthly stipend rate: $36,409 ÷ 12 = $3,034.08
• Level one: $3,034.08 × 0.625 = $1,896.30
• Level two: $3,034.08 × 1.00 = $3,034.08

Those figures are mine, from the rule's formula and OPM's table. I did not find a VA page that publishes 2026 dollar amounts, so I can't cross-check against VA's own number. Treat the table below as a close estimate of what VA deposits, not VA's statement of it. VA's stipend team takes questions at 1-833-930-0816, weekdays.

No employment. §71.40(c)(4)(iii): "Nothing in this section shall be construed to create an employment relationship between the Secretary and an individual in receipt of assistance or support under this part." I'll stop there on what that means for taxes and benefits, because no VA page I read says more.

The 2026 Stipend, Locality by Locality

OPM divides the country into locality pay areas: named metropolitan areas, two statewide areas for Alaska and Hawaii, and "Rest of U.S." for everywhere else. The areas are defined by county, and a county an hour outside a city can be inside that city's area. OPM's 2026 locality pay area definitions list every county by area. Find the veteran's county, then the row.

Every figure below is my arithmetic from OPM's 2026 GS-4 step 1 annual rate, as above, rounded to the nearest dollar. The annual rates incorporate the 1 percent General Schedule increase for 2026.

The spread is narrower than people expect: level two runs from $3,034 in the Rest of U.S. to $3,793 in the San Jose-San Francisco area, a difference of about 25 percent. The bigger jump is between levels. Going from level one to level two adds 60 percent at every address.

When the Money Starts, and When It Changes

Back to the application date. This is the paragraph families don't know. §71.40(d) says the stipend, CHAMPVA and beneficiary travel "are effective on the latest of the following dates," and for a first application the three that matter are: "(1) The date the joint application that resulted in approval and designation of the Family Caregiver is received by VA. (2) The date the eligible veteran begins receiving care at home. (3) The date the Family Caregiver begins providing personal care services to the eligible veteran at home." The rule lists four more dates for a replacement Primary or Secondary caregiver, a caregiver reapplying with the same veteran, and an application resubmitted after a denial (§71.40(d)(4) to (7)). If the veteran is already home and you are already caring for them, the stipend runs from the day VA received the application, even though designation can take up to 90 days. Everything else in §71.40(b) and (c), such as training and counseling, starts at designation.

OPM raises. "Adjustments to stipend payments that result from OPM's updates to the General Schedule (GS) Annual Rate for grade 4, step 1 for the locality pay area in which the eligible veteran resides take effect prospectively following the date the update to such rate is made effective by OPM." (§71.40(c)(4)(ii)(A)) The January pay raise flows through; there is no back pay for it.

Moving. "Adjustments to stipend payments that result from the eligible veteran relocating to a new address are effective the first of the month following the month in which VA is notified that the eligible veteran has relocated to a new address. VA must receive notification within 30 days from the date of relocation." Miss the 30 days after a move to a lower-paying area and VA "will seek to recover overpayments" back to when the change should have taken effect (§71.40(c)(4)(ii)(B)). Tell the caregiver support team about a move within the month.

Reassessment. §71.30(a): the veteran and caregiver "will be reassessed by VA (in collaboration with the primary care team to the maximum extent practicable) on an annual basis to determine their continued eligibility," including "whether the eligible veteran is unable to self-sustain in the community for purposes of the monthly stipend rate." An increase from a reassessment "takes effect as of the date of the reassessment." A decrease takes effect no earlier than "60 days after VA provides advanced notice of its findings" (§71.40(c)(4)(ii)(C)(1)). Skipping a reassessment or a wellness contact is grounds for revocation (§71.30(d), §71.40(b)(2)).

That is the rule. VA's practice right now is different, and VA says so on its reassessment page: "We're suspending annual reassessments during a review of current eligibility criteria for those enrolled in the Program of Comprehensive Assistance for Family Caregivers. However, we will continue to initiate reassessments for Veterans and family caregivers who request to be considered for an increase in stipend level or if there is evidence of an increased need for personal care services. We will not remove anyone from the program or decrease any support based on reassessments." A reassessment you ask for, to move from level one to level two, is still available. The page gives no end date for the suspension, so my suggestion is to confirm it with the caregiver support team before you count on it.

How You Can Lose It, and What Keeps Paying

§71.45 separates revocation, which is for cause, noncompliance or VA error, from discharge, which is everything else. The date benefits stop and how long they continue afterward depend on the reason.

Two things in that table matter most in practice. After a veteran's death, the Primary Family Caregiver's stipend and CHAMPVA continue for 90 days, and §71.45(e) says VA "will, if requested and applicable, assist the Family Caregiver in transitioning to alternative health care coverage and mental health services," with bereavement counseling available. And VA must be told of a death or institutionalization "as soon as possible but not later than 30 days."

The Legacy Cohort, in One Box

If the veteran's caregiver was approved before October 1, 2020, or the application was received before that date and approved after it, the rule calls the veteran a "legacy participant" or "legacy applicant" (§71.15). Three things apply to that group and no one else:

• Eligibility is protected through September 30, 2028. §71.20(b) and (c) make them eligible "for eight years beginning on October 1, 2020." VA's final rule of September 29, 2025 "will further extend the transition period for the legacy cohort through September 30, 2028," effective September 30, 2025. A discharge of a legacy caregiver for not meeting the current criteria takes effect no earlier than 60 days after October 1, 2028 (§71.40(c)(4)(ii)(C)(2), Note 1).
• The old three-tier stipend still applies to them when it pays more: 1.00, 0.625 or 0.25 of the monthly stipend rate by the old clinical rating, and VA pays "whichever is higher" of the old and new calculations (§71.40(c)(4)(i)(B) and (C)).
• A floor. A legacy participant's stipend "is not less than the amount the Primary Family Caregiver was eligible to receive as of the day before October 1, 2020," as long as the veteran stays at the same address (§71.40(c)(4)(i)(D)). Move, and the floor goes.

Legacy status ends if a new joint application is approved for the same or a new Primary Family Caregiver (§71.15). Think twice before re-applying to swap caregivers.

If VA Says No, or Says Level One

Options depend on when the decision was issued. VA's appeals page says to start with VA Form 10-305, which explains the choices, and that VA Form 20-0998 "is not the designated form" for PCAFC decisions.

For decisions on or after February 19, 2019, VA lists four routes: the VHA Clinical Review Process through the facility's Patient Advocate; a Supplemental Claim (VA Form 20-0995) "if you have new and relevant evidence that was not part of the record"; a Higher-Level Review (VA Form 20-0996), where "You can't submit additional evidence"; or an appeal to the Board of Veterans' Appeals (VA Form 10182). For decisions before February 19, 2019, the Board appeal uses VA Form 10-307. VA says it "is unable to provide an exact timeline" for reviews. The Caregiver Support Line, 1-855-260-3274, can tell you where a request sits in the process, and an accredited representative, attorney or claims agent can help with the forms.

My suggestion for a level-one decision you think should be level two: the definition is three or more of the seven activities, fully dependent, every time, or continuous supervision. Before you file, write down which activities, how often, and what happens when no one is there, and ask the veteran's VA primary care team to put the same facts in the chart.

The Proposed Rule

In December 2024 VA proposed amendments to Part 71 that it says would expand access: a broader definition of serious injury, telehealth home visits during emergencies, fewer reassessments, and new criteria for the six-month personal care need. The comment period has closed. As of this writing the Federal Register lists no final rule adopting those changes, and VA's page still describes them as proposed. Nothing in this article relies on them. If a final rule publishes, the eligibility and reassessment sections above are the ones to re-read.

The General Program, for Everyone Else

If the veteran is enrolled in VA health care but doesn't have the 70 percent rating, the Program of General Caregiver Support Services is open. VA's page: "This program may be right for you if all these descriptions are true for you: You care for a Veteran who is enrolled in VA health care, and You provide personal care services to the Veteran, and You want to connect with other caregivers, get more support from a professional care team, or grow your skills as a caregiver." It adds: "You don't need to be a relative or live with the Veteran to be considered a general caregiver."

What it offers, in VA's words: "Peer support mentoring, Skills training, Coaching, Telephone support, Online programs, Referrals to available resources." Under the rule, General Caregivers also get respite for the veteran "that is medically and age appropriate for the eligible or covered veteran (including 24-hour per day in-home respite care)" (§71.40(a)(4)) and counseling connected to the veteran's treatment under §71.50. No stipend, no CHAMPVA.

To enroll, VA says to "Contact the caregiver support team or the caregiver support coordinator at your nearest VA facility," or ask the veteran's VA team for a referral; "The Veteran must agree to receive care from you and have you listed as their caregiver in their health care record."

How to Apply, and What I'd Have Ready

VA's application page: "You and the Veteran will need to apply together," both signing and dating VA Form 10-10CG. Online at VA.gov; by mail to the 10-10CG Evidence Intake Center, PO Box 5154, Janesville, WI 53547-5154; or in person with the caregiver support team at the nearest VA medical center. "Don't send medical records along with your application." A representative signing for the veteran needs a power of attorney, guardianship order, or one of the VA forms the page lists. The stipend is paid by direct deposit only, through VA's customer engagement portal.

My suggestions, not rules:

1. Confirm the rating and the enrollment first. The 70 percent must be a service-connected rating, alone or combined, and the veteran must be enrolled in VA health care with a VA primary care provider. Getting disability pay is not enrollment.
2. Write the care down before the evaluation. For each of the seven activities: does the veteran need hands-on help every time, sometimes, or never? If the need is supervision, what happens in the hour no one is home? The level-two definition is specific, and a vague "needs help with everything" scores worse than a precise list.
3. Take the first training and home-visit dates offered. The 90-day clock denies the application if the steps aren't done, and only VA-caused delay extends it.
4. Keep the date VA received the application. That is the day the stipend starts under §71.40(d). If the first deposit doesn't reach back to it, ask.
5. Report a move within 30 days, and a death or institutionalization within 30 days. Both are rule deadlines with money attached.
6. If VA already sends an aide, ask the team how paragraph (5), no simultaneous and regular care by someone else, applies to your hours before you apply.

If the veteran is also on Medicare home health, or about to be, Find an Agency lists the Medicare-certified agencies that serve the ZIP code, and our guide to who qualifies for home health care covers that benefit, which runs alongside the VA's and is paid by a different rulebook.

Frequently Asked Questions

How much is the VA caregiver stipend in 2026?

It depends on where the veteran lives, not the caregiver. The rule sets the monthly stipend rate as the Office of Personnel Management's General Schedule annual rate for grade 4, step 1, in the veteran's locality pay area, divided by 12. Level one pays 0.625 of that rate and level two pays 1.00. Using OPM's 2026 tables, that is about $1,896 a month at level one and $3,034 at level two for the Rest of U.S. area, and about $2,371 and $3,793 in the San Jose-San Francisco area, the highest. Those are my calculations from the rule and OPM's table, not VA-published figures, and VA's deposit can differ by a few dollars.

Who qualifies for the VA Program of Comprehensive Assistance for Family Caregivers?

The veteran must have a service-connected disability rated 70 percent or more, alone or combined, from service in any era; need in-person personal care for at least six continuous months because of an inability to perform an activity of daily living or a need for supervision, protection or instruction; get care at home from a VA primary care team; and VA must find the program in the veteran's best interest and that no one else is regularly providing the same care. The caregiver must be at least 18 and either the veteran's spouse, son, daughter, parent, step-family member or extended family member, or someone who lives with the veteran full time. That is 38 CFR 71.20 and 71.25.

Does the VA pay family caregivers of veterans who do not have a 70 percent rating?

Not through this program. The stipend, CHAMPVA and the 30 days of respite belong to the Program of Comprehensive Assistance for Family Caregivers, which requires the 70 percent rating. Caregivers of any enrolled veteran can join the Program of General Caregiver Support Services, which provides training, coaching, peer mentoring, telephone support and referrals but no payment, and does not require the caregiver to be a relative or live with the veteran. Veteran-Directed Care, a separate VA program, gives the veteran a budget to hire workers who can include family.

When does the VA caregiver stipend start, and is it paid back to the application date?

For a first application, the rule makes the stipend effective on the latest of three dates: the day VA received the joint application, the day the veteran began receiving care at home, or the day the caregiver began providing personal care at home. VA has 90 days from receiving the application to finish the evaluations, training and home assessment and designate the caregiver, so a stipend approved at day 80 covers the months back to the application date. That is 38 CFR 71.40(d) and 71.25(a)(2)(ii). The rule adds later dates for replacement caregivers and reapplications.

Can the VA reduce or stop the caregiver stipend?

The rule allows it. VA reassesses eligibility and stipend level, normally once a year, and a decrease or a discharge for improvement takes effect no earlier than 60 days after VA gives advance notice. Benefits continue for 90 days after the veteran dies or enters an institution, and 30 days after a caregiver or veteran asks to end the designation. Separately, VA's reassessment page says annual reassessments are suspended during a review of the eligibility criteria and that VA will not remove anyone or decrease support based on reassessments. Families who joined before October 1, 2020 are protected through September 30, 2028.

Sources

Rules (Cornell LII, current eCFR text):

• 38 CFR §71.10, Purpose and scope
• 38 CFR §71.15, Definitions
• 38 CFR §71.20, Eligible veterans and servicemembers
• 38 CFR §71.25, Approval and designation of Primary and Secondary Family Caregivers
• 38 CFR §71.30, Reassessment
• 38 CFR §71.40, Caregiver benefits
• 38 CFR §71.45, Revocation and discharge of Family Caregivers
• 38 CFR §71.50, Counseling, training and mental health services for family members
• Extension of PCAFC Eligibility for Legacy Participants and Legacy Applicants, final rule (September 29, 2025)
• Amendments to the PCAFC, proposed rule (December 6, 2024)

VA pages:

• The Program of Comprehensive Assistance for Family Caregivers (VA.gov)
• PCAFC Monthly Stipend (VA Caregiver Support Program)
• PCAFC Reassessment Update (VA Caregiver Support Program)
• PCAFC decisions: options for further review and appeal (VA Caregiver Support Program)
• Proposed changes to the PCAFC (VA Caregiver Support Program)
• The Program of General Caregiver Support Services (VA.gov)

Pay tables (OPM, public domain):

• 2026 General Schedule pay tables, complete set of locality pay tables (PDF)
• 2026 locality pay area definitions