This form is a sample of an agreement between an elderly or disabled client and a Caregiver who operates as an independent contractor and provides personnel to assist Client to live at home and to have as much control over the home environment and life as possible under the circumstances. Caregiver's personnel also assist Client with the activities of daily living, scheduling medication, assistance with mobility, accompanying Client on errands and appointments, and such other services as agreed between Client and Caregiver.
In this agreement, Client waives damages for simple negligence of Caregiver, but not gross negligence or misconduct that is intentional or criminal in nature. Courts generally will not enforce waivers of this type of misconduct since such a waiver would be deemed to be against public policy because it would encourage dangerous and illegal behavior.
Caregiver Form Application With Va In Nassau
Category:
State:
Multi-State
County:
Nassau
Control #:
US-00458BG
Format:
Word;
Rich Text
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FAQ
Caregiver Support Program (CSP) The program's mission is to promote the health and well-being of family caregivers who care for our Nation's Veterans, through education, resources, support, and services. Find Your Local Caregiver Support Team located at every VA facility .
When applying for PCAFC, a Veteran may appoint one (1) Primary Family Caregiver and up to two (2) Secondary Family Caregiver applicants on the VA Form 10-10CG application. Decisions made by VA may have impacted one or more individuals listed on the VA Form 10-10CG application.
Call the Caregiver Support Line at 855-260-3274 ( TTY: 711 ) and ask for help filling out the form. Find a Caregiver Support Team Coordinator at your nearest VA health facility. Go to our Caregiver Support Program Teams directory. Get help from an accredited representative, like a Veterans Service Organization (VSO).
If you are filing a supplemental claim (a claim after an initial claim for the same or similar benefit was previously decided) and have new and relevant evidence ... please complete and submit VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits.
Need Help? To assist you with enrolling in these programs, contact your local VA facility CSP Team/Caregiver Support Team, or call the VA Caregiver Support Line(CSL) at 1-855-260-3274. Subscribe to receive email updates and information about VA Caregiver Support Program services.
