VA Caregiver Support Programs: PCAFC Stipend, PGCSS and How to Apply

The VA Caregiver Support Program runs 2 programs. Most of the confusion online comes from mixing them up.

The Program of Comprehensive Assistance for Family Caregivers (PCAFC) is the one with money attached. It was created by the Caregivers and Veterans Omnibus Health Services Act of 2010 for post-9/11 veterans, opened to all service eras by the VA MISSION Act of 2018 in 2 phases (October 1, 2020 and October 1, 2022), and rewritten in October 2020 into the 2-level structure that applies today. The rules are in 38 CFR Part 71.

The Program of General Caregiver Support Services (PGCSS) has no stipend and no rating requirement; it is open to the caregiver of any veteran enrolled in VA health care.

Source: https://www.va.gov/family-and-caregiver-benefits/health-and-disability/comprehensive-assistance-for-family-caregivers/ and https://www.caregiver.va.gov/care_caregivers.asp, current as of September 2026.

If you are not sure which fits, start with PGCSS; the same Caregiver Support Program team handles PCAFC applications.

The veteran may be eligible if all of these are true, per VA's PCAFC page:

• "The Veteran has a VA disability rating (individual or combined) of 70% or higher," and
• The veteran was discharged from the military or has a date of medical discharge, and
• "The Veteran needs at least 6 months of continuous, in-person personal care services," and
• The veteran is enrolled in VA health care.

The 70% rule comes from the definition of "serious injury" in 38 CFR 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." A veteran at 60% does not pass this test, no matter how much care they need. Every service era counts. The VA disability guide explains how combined ratings work, and the rating estimator runs the math. If the veteran's condition has worsened, the increase guide covers that process.

The personal-care test decides most applications. Under 38 CFR 71.20, the veteran must need personal care services "for a minimum of six continuous months" because of at least 1 of these:

• An inability to perform an activity of daily living (ADL). 38 CFR 71.15 lists 7: dressing or undressing, bathing, grooming, adjusting a prosthetic or orthopedic appliance, toileting, feeding, and mobility. "Inability" means the veteran needs another person's help each time, or
• A need for supervision, protection or instruction. The regulation defines this as "a functional impairment that directly impacts the individual's ability to maintain his or her personal safety on a daily basis." A veteran with a brain injury, dementia or severe mental health symptoms who can physically dress and bathe may qualify this way.

The care must be provided at home, and the veteran must get ongoing care from a VA primary care team.

The caregiver's side. Under 38 CFR 71.25, you may be approved as a Family Caregiver if you are 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 or will if approved. A veteran can have 1 Primary Family Caregiver and up to 2 Secondary Family Caregivers.

Watch out: "Personal care services" means in-person help. Driving, cooking and paying bills do not count on their own. VA looks for hands-on help with the 7 listed ADLs, or daily supervision the veteran cannot safely go without.

The old 3-tier stipend ended in October 2020. Today there are 2 levels, both tied to a federal pay grade rather than a fixed dollar figure.

38 CFR 71.40(c)(4) sets the stipend as a share of the "monthly stipend rate," which 38 CFR 71.15 defines as the Office of Personnel Management (OPM) General Schedule annual rate "for grade 4, step 1, based on the locality pay area in which the eligible veteran resides, divided by 12."

• Level 1 is the monthly stipend rate times 0.625, or 62.5%.
• Level 2 is the monthly stipend rate times 1.00, or 100%. It applies when VA finds the veteran "unable to self-sustain in the community": needing personal care for 3 or more ADLs with full dependence on the caregiver, or needing continuous supervision, protection or instruction.

Because the GS-4 rate changes with locality pay, the same level pays more in San Francisco than in rural Kansas. The examples below are VA.org arithmetic from OPM's 2026 tables: the annual GS-4 Step 1 rate divided by 12, times 0.625 or 1.00. VA does not publish a locality table on the pages opened, so treat these as estimates and confirm your area's figure with your Caregiver Support Coordinator.

Source: OPM 2026 General Schedule locality tables (https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2026/RUS.pdf and the DCB, HOU, NY and SF tables), effective January 2026; formula from 38 CFR 71.15 and 71.40.

"Rest of U.S." covers every county outside OPM's named metro areas, so it is the figure most families will see. The stipend is paid to the Primary Family Caregiver, not the veteran, and VA says it "will no longer issue PCAFC paper checks," so you will need direct deposit.

How the stipend interacts with other benefits. The stipend is paid to the caregiver, not the veteran, so it does not reduce the veteran's disability compensation, Special Monthly Compensation (SMC) or Aid and Attendance. What VA will not do is pay PCAFC when the same personal care is already provided and paid for by another program, such as a Medicaid-paid caregiver; 38 CFR 71.20 requires that the care not be provided at the same time by another person or entity.

The Primary Family Caregiver's package under 38 CFR 71.40(c) has 5 more parts:

• CHAMPVA. The Civilian Health and Medical Program of the Department of Veterans Affairs covers the Primary Family Caregiver who is not already covered by another health plan. The spouse health care guide explains CHAMPVA's deductible and cost share.
• Respite care. Temporary care of the veteran so you can rest. It "will be available for at least 30 days per year and may exceed 30 days per year if clinically appropriate," and can include 24-hour-a-day care. The respite care guide covers in-home, adult day and short-stay options.
• Mental health counseling. Individual and group therapy, counseling and peer support groups for the caregiver.
• Beneficiary travel. Travel benefits under 38 CFR Part 70 when you go with the veteran to VA appointments.
• Legal and financial planning services, provided through VA contracts.

Secondary Family Caregivers receive training, counseling and beneficiary travel, but not the stipend, CHAMPVA or respite entitlement. Both get ongoing training "to maintain or improve the personal care services provided to the eligible veteran"; the caregiver training guide covers the curriculum.

The Program of General Caregiver Support Services defines a General Caregiver as "a person who provides personal care services to a Veteran enrolled in VA health care who: needs assistance with one or more activities of daily living or needs supervision or protection." There is no rating requirement, no 6-month rule, no home visit and no application form. A caregiver whose veteran is rated 30%, or not rated at all, can use it.

PGCSS offers:

• Building Better Caregivers, "an online six-week workshop that helps caregivers reduce stress and anxiety, manage difficult behaviors and emotions, and improve physical and mental health."
• Peer Support Mentoring, pairing newer caregivers with experienced ones.
• Skills training, one-on-one coaching, group support and REACH VA coaching.
• Respite care referrals when a caregiver needs a break, and referrals to community resources.

To enroll, contact the Caregiver Support Program team at your veteran's VA medical center ("each VA medical center has a caregiver support team"), or ask the veteran's provider for a referral, then complete an intake assessment. The VA Caregiver Support Line at 855-260-3274, staffed Monday through Friday, 8:00 a.m. to 8:00 p.m. ET, can route you to your local Caregiver Support Coordinator; the number is on the caregiver.va.gov home page. The family member programs page lists other VA services for spouses and dependents.

VA Form 10-10CG is the Application for Comprehensive Assistance for Family Caregivers Program. 38 CFR 71.25 requires a "joint application": the veteran and each proposed caregiver sign the same form.

1. Confirm the basics. The veteran should be enrolled in VA health care and rated 70% or higher. Without both, the application will be denied.
2. Decide who applies. 1 Primary Family Caregiver and up to 2 Secondary Family Caregivers can be listed. VA says "a new form submission is required each time a different caregiver is appointed."
3. Complete VA Form 10-10CG. The veteran and each caregiver fill in and sign their own section.
4. File it 1 of 3 ways. Online at VA.gov (VA's preferred route); by mail to the 10-10CG Evidence Intake Center, PO Box 5154, Janesville, WI 53547-5154; or in person with the Caregiver Support Program team at any VA medical center.
5. Keep a copy and note the date. The 90-day clock in 38 CFR 71.25 starts when VA receives the application.

The family caregiver program guide walks through each section of the form and the documents that help.

VA's PCAFC page says: "We'll assign you as a caregiver no later than 90 days after we get your application." Within that window 38 CFR 71.25 requires 4 things to happen. VA's caregiver site tracks them as pending intake, in queue for assignment, assigned and under review, and decision issued.

1. Veteran assessment. A VA clinical team checks the 70% and personal-care tests and which ADLs or supervision needs apply. This decides Level 1 versus Level 2.
2. Caregiver assessment. VA checks age, relationship or living arrangement, and whether you can carry out the care plan.
3. Caregiver training. Core training covers medication management, vital signs and ADL care. It must be completed before approval.
4. Home visit. VA staff visit the home to confirm the care plan works there. A February 13, 2026 final rule removed the pandemic-era telehealth option, so expect an in-person visit.

VA mails the decision letter and says to allow 10 to 14 business days for it to arrive. If the steps are not completed within 90 days, the application is denied and a new one is required, so answer scheduling calls quickly.

After approval. Under 38 CFR 71.40, VA makes wellness contacts "at a minimum of once every 120 days," with at least 1 home visit a year. Under 38 CFR 71.30, VA reassesses eligibility and stipend level annually, or less often when it documents that annual review is not needed.

Watch out: Missing wellness contacts is a ground for revocation under 38 CFR 71.40. Reschedule rather than skip.

Legacy status. If the veteran's caregiver was approved before October 1, 2020 (a "legacy participant"), or the application was received before that date (a "legacy applicant"), a final rule published September 29, 2025 keeps those families in PCAFC "through September 30, 2028" and protects them from a stipend decrease based on reassessment, with limited exceptions. VA extended the deadline because its December 6, 2024 proposed rule to change eligibility drew 842 comments and could not be finalized in time. As of September 2026 that proposal, which would broaden the serious injury definition and reduce reassessments, remains proposed, per VA's proposed changes page. Check that page before acting on any claim that the rules have changed.

A PCAFC denial, discharge or drop from Level 2 to Level 1 is a Veterans Health Administration decision, so the review routes differ slightly from a compensation claim. VA's family caregiver decision review page lists 4 options for decisions dated on or after February 19, 2019:

• Clinical Appeal. Ask your VA medical center's chief of staff to review the decision, with the chance to add new medical evidence about the veteran's care needs.
• Supplemental Claim, for "new and relevant evidence that we didn't consider before."
• Higher-Level Review, "if you believe there's an error with the decision," within 1 year of the decision date.
• Board Appeal, for review by a Veterans Law Judge, within 1 year of the decision date.

New evidence goes to a Supplemental Claim or Clinical Appeal; an error on the existing record goes to Higher-Level Review. You can get free help with any of them from a VA-accredited representative.

Discharge timing. Under 38 CFR 71.45, a discharge for lost eligibility takes effect "no earlier than 60 days after VA provides advanced notice," your window to appeal. Benefits continue 30 days after a discharge the caregiver or veteran requests, and 90 days after the veteran's death or move into an institution.

State caregiver help is thinner than state benefits for the veteran, but it exists. Some states run caregiver respite grants through the state veterans affairs department or unit on aging, and state Medicaid programs may pay a family member for personal care when the veteran's income qualifies (VA will not pay PCAFC for the same care). Some states offer caregiver tax credits or paid family leave, and most offer property-tax relief keyed to the veteran's rating. Select your state to see what applies.