What is VA Form 10-10CG used for To apply for VA s Program of Comprehensive Assistance for Family Caregivers. VA will use the information on this form to assist in determining your eligibility a clinical assessment will also be required. An eligible Veteran may appoint one 1 Primary Family Caregiver and up to two 2 Secondary Family Caregivers. Complete this form to apply Veterans and Servicemembers who do not meet the criteria for VA s Program of Comprehensive Assistance for Family Caregivers...
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What is VA Form 10-10CG used for?

The VA Form 10-10CG is the US Department of Veterans Affairs Form, officially called an Application For Comprehensive Assistance for Family Caregivers Program. Veterans or servicemembers should file this form when applying for VA's Program of Comprehensive Assistance for Family Caregivers. VA will require the information given on this form to consider the applicant’s eligibility. By filing this form, a Veteran may appoint one Primary Family Caregiver and up to two Secondary Family Caregivers. Each time it is necessary to appoint a new Caregiver, a new Form 10-10CG must be completed.

Is the VA Form 10-10CG accompanied by any other documents?

In case the applicant is not enrolled in the VA’s health care system or is currently undergoing a medical discharge, they should submit VA Form 10-10EZ "Application for Health Benefits" as a supporting document to the VA 10-10CG form. Enrolled Veterans may submit the Health Benefits Renewal Form (VA 10-10EZR) with their filled out VA Form 10-10CG in order to provide information updates.  

If the form is not being completed by the applicant themselves, it is mandatory that the Power of Attorney or equivalent Representation Documents be attached.

How long does it take to fill out the VA 10-10CG Form?

It should take about 20 minutes to complete the application including the time allotted for reading instructions, gathering the necessary facts and then filling out the form.

What information should be provided on VA Form 10-10CG?

  • Personal details about the applying veteran or servicemember (full name, SSN, DOB, gender, place of last treatment, signature, date of completion),

  • Information about the primary family caregiver (full name, SSN, DOB, gender, address, relationship to veteran, health insurance, signature)

  • Information about the secondary family caregiver (the same details as for the primary caregiver).

Where to send the filled out VA Form 10-10CG?

When fully filled out, the Application Form should be delivered to the following address: Program of Comprehensive Assistance for Family Caregivers Health Eligibility Center

2957 Clairmont Road NE, Ste 200, Atlanta, GA 30329-1647, or it can be brought in person to the local VA Medical Center Caregiver Support Coordinator (CSC)

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- WE DO WHATEVER WE NEED TO FOR HER. I'D RATHER BE HOME WITH PEOPLE THAT LOVE AND CARE ABOUT HER. THEN I KNOW IF SHE'S GOING TO BE TREATED RIGHT. - JUST BEING AT HOME, HE'S IN A FAMILIAR SURROUNDING. I THINK THAT'S GOOD FOR HIS MENTAL HEALTH. - JUST KNOWING THAT HE'S HERE AND THAT WE CAN STILL SPEND OUR LIFE TOGETHER, I WOULD RATHER HAVE THIS CAREGIVER'S ROLE THAN NOT HAVE HIM AT ALL. - IT'S A BLESSING TO ME TO BE ABLE TO STAND UP AND WORK FOR MY DAUGHTER. - CAREGIVERS DO A WIDE RANGE OF DIFFERENT THINGS. IT CAN RANGE FROM ACTIVITIES OF DAILY LIVING TO SOMETIMES MORE COMPLEX, COGNITIVE TYPES OF ACTIVITIES, SO HELPING SOMEBODY MANAGE THEIR FINANCES, MAKE APPOINTMENTS, MANAGE MEDICATION REGIMENS, PREPARE FOOD, DO SHOPPING. - HEY RICK, LOOK. - OH, THAT'S AN AWARD CEREMONY WHERE WE GOT THE UNIT CITATION. WITH CATHY, I TRY TO PUT MYSELF IN HER PLACE, TOO. IF I WAS HER, YOU KNOW, WOULD I WANT HER TO DO THIS FOR ME? DO I NEED HER TO DO THIS FOR ME? WOULD I WANT TO BE A LITTLE BIT MORE INDEPENDENT? AND WE GET THE APPOINTMENTS, WE MAKE THE APPOINTMENTS, WE WALK HER FROM THE HOUSE OUT TO THE TRUCK, WE GET IN, WE GET TO THE HOSPITAL, AND WE GO TO HER APPOINTMENT. - WHEN YOU VISIT HER, WHAT PROGRESS YOU'RE HAVING, WHAT PROGRESS SHE'S HAVING-- WE HAVE TO REPORT THAT TO STAY LEGALLY HER GUARDIAN. AS FAR AS CONSERVATORSHIP, YOU HAVE TO DEAL WITH ALL BANK STATEMENTS. ALL ACCOUNTS GOT TO BE BALANCED. THAT'S VERY DIFFICULT WHEN YOU'RE DEALING WITH 3 OR 4 DIFFERENT ACCOUNTS. THIS IS A TYPICAL DAY IN MY LIFE: TRYING TO GET STUFF SITUATED AROUND FOR HIM, ESPECIALLY WITH PHARMACY. ONE OF THE BIGGEST CHALLENGES FOR ME IS TO KNOW WHEN TO PULL BACK. SOMETIMES BRIAN NEEDS HELP AND SOMETIMES BRIAN DOESN'T NEED HELP, AND JUST FIGURING OUT WHERE THAT EVEN KEEL IS, AND THAT'S NOT BECAUSE OF BRIAN. SOME OF THAT HAS TO DO WITH ME. YOU'VE GOT--SUNGLASSES ARE IN HERE. - HEY, GOOD MORNING, MR. EDDIE. - GOOD MORNING. - HOW ARE YOU? - PRETTY GOOD. HOW YOU DOING? - I'M ALL RIGHT. HOW WAS YOUR NIGHT? - IN ORDER TO ACCOMMODATE HIS IMMOBILITY, THE VA INSTALLED A HORCHER LIFT. WE PUT HIM IN A SLING, ATTACH IT TO THE HANGER, AND USE A REMOTE CONTROL TO GET HIM FROM BED TO HIS WHEELCHAIR, FROM HIS WHEELCHAIR TO THE TOILET, TO THE SHOWER. ONE OF THE WAYS THAT WE CAN PROVIDE A BREAK FOR A CAREGIVER IS TO SEND A HOMEMAKER/HOME HEALTH AIDE INTO THE HOME, AND WE PROVIDE 10 HOURS A WEEK OF HOMEMAKER/HOME HEALTH AIDE SERVICES FOR THIS VETERAN AND THE CAREGIVER. THESE ARE FOLKS WHO COME INTO THE HOME AND HELP THIS VETERAN WITH HIS BATH AND HELP DO HIS LAUNDRY AND CHANGE THE BED LINENS AND SO FORTH, WHICH REALLY CAN TAKE A SIGNIFICANT BURDEN OFF OF THE FAMILY CAREGIVER. WE SEND OUR HOME-BASED PRIMARY CARE TEAM INTO THE HOME, SO THE VETERAN HAS HOME VISITS BY PHYSICIAN, SOCIAL WORKER, NURSES, PHYSICAL THERAPIST. - WE TAKE ADVANTAGE OF ALL THESE PROGRAMS. THERE'S A PROGRAM FOR A MOTORIZED WHEELCHAIR, WHICH THEY GAVE US. IT'S AN EXPENSIVE WHEELCHAIR. IT'S ONE THAT SHE CAN ACTUALLY HIT A BUTTON AND...