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When wounded troops come home from the battlefield, they often need full-time care. And more often than not, that comes from a family member. The VA has been giving these caregivers a stipend to help offset the costs for families. But now some vets are getting kicked off the program, vets like Matt Lammers, who lost both his legs and an arm in the Iraq War back in 2007. Recently the government decided that he and his wife no longer qualify for support, in part because of Matt's behavior. As NPR's Quil Lawrence reports, their story brings up questions like which veterans deserve support and how long should they get it?
QUIL LAWRENCE, BYLINE: At times, Matt Lammers looks like he doesn't need anyone's help.
UNIDENTIFIED ANNOUNCER: In the No. 1 position, Matt Lammers, from the Army.
LAWRENCE: This summer at the Pentagon's Warrior Games in Tampa, Lammers competed in sitting volleyball, swimming and indoor rowing.
UNIDENTIFIED ANNOUNCER: The results of round one.
LAWRENCE: He rigged a brace to hold down the stumps of his legs while he hauls with his one remaining arm, flinging his whole torso backward against the rowing machine.
UNIDENTIFIED ANNOUNCER: Final results.
LAWRENCE: He won his race, and at the end of the games, the U.S. Army gave him the Heart of the Team Award. It's a title you could also give to Matt's wife, Alicia, who he says did what it took to get him here.
MATT LAMMERS: I'd honestly say - not to be smart, but - the question's more, what doesn't she do? Because she does so much.
LAWRENCE: Back at their hotel room, Matt Lammers makes a list.
M LAMMERS: She helps me shower, in all honesty. Clipping my nails. That's a huge one. I - we don't like saying the word can't in our family. However, that's something that I really can't do with one arm. She helps me transfer my wheelchair, drives me to my appointments.
ALICIA LAMMERS: It's a way to support each other. His goals became my goals.
LAWRENCE: Alicia Lammers has been her husband's caregiver for much of the past eight years with a stipend from the VA. And Matt can be difficult. He's tough to take care of.
A LAMMERS: Not just the physical disability. We're talking about the mental disabilities, too, that is very challenging. It's an everyday - it's a constant change.
M LAMMERS: Reminding me of why we're still in the fight, why we still go on. Why we never give up. She does a lot. Without her, I don't know where I'd be at this point, just after all of my mistakes in the past.
LAWRENCE: And he has made mistakes. He's had trouble with drugs. He's abused his wife and others, sometimes physically. He's mistreated VA staff. He's no poster child, except maybe for survival, and for how much worse it could be without the help of a spouse willing to make taking care of him a full-time mission. Caregivers say the VA program validates their sacrifice. That's why it was so devastating last December when VA kicked Alicia off the program. In a letter, the VA in Fayetteville, N.C., said Matt had made no significant improvements since 2011 and hadn't consistently engaged in treatment.
A LAMMERS: I feel, like, a stab in the back - like what I do is not worth it in their opinion, like I'm not part of their team like I thought I was.
LAWRENCE: They're not alone in their frustration. The caregiver program has been overwhelmed by applications from its creation in 2011. It's been administered inconsistently with some VAs purging huge numbers from their rolls. Media coverage by NPR and others has driven the VA to freeze all removals twice in the past two years, most recently, in December, after Senator Patty Murray pressed VA Secretary Robert Wilkie at a hearing.
(SOUNDBITE OF ARCHIVED RECORDING)
PATTY MURRAY: We're hearing that this is a continuing problem in the VA's management of this program.
ROBERT WILKIE: I am going to do everything I can to make sure everybody stays in the program. It's that important to me, personally.
LAWRENCE: Following that hearing, Secretary Wilkie halted all removals from the program. That was December 20, six days too late for Matt and Alicia Lammers. They had just moved from Arizona to near Fayetteville. A letter from the Fayetteville VA dated December 14 kicked them off the program. Fayetteville also denied their appeal in the spring and then rejected Alicia's brand-new application on June 28. Her response...
A LAMMERS: I'm not leaving. I'm still with him, and I'm still going to do what I do.
LAWRENCE: The Fayetteville VA told NPR that the program was, quote, "no longer in his best interest. He refused to follow his care plan, seriously endangering his health and that of those around him." The bottom line appears to be Matt Lammers' past abusive behavior. That's what drove the Fayetteville VA to drop his wife, Alicia, from the program. The Lammers' case, says Sherman Gillums with the group AMVETS, highlights a faulty assumption from the start of the caregiver program.
SHERMAN GILLUMS: That VA would argue sometimes it was never meant to be a permanent program. Well, amputations and paralysis are permanent conditions.
LAWRENCE: Gillums is a former Marine who's paraplegic. He's on the VA's advisory board for the caregiver program. He says it was created as a short-term, recovery-based intervention, and that's not the reality for some vets.
GILLUMS: It's not about recovery. It's about sustaining your life. That person is going to be a part of the caregiving function for that individual for the rest of his or her life in some way, shape or form. Even if they're cut off from the program, they're still needing that care.
LAWRENCE: Gillums says the program needs to accept the reality that catastrophically injured vets may always need help.
GILLUMS: So when you hear about a triple amputee who's not going to the hospital or keeping appointments, and that's the standard by which you judge whether caregiver support will be given, I think it's wrong.
LAWRENCE: VA told NPR it understands that some program participants may always need a caregiver, but even those veterans need to stick with their treatment plan. For now, VA has reached out and encouraged Matt and Alicia Lammers to follow their care plan and then reapply in six months. And they say they will, but it still hurts that the VA said Matt hasn't improved in eight years.
M LAMMERS: All three of my limbs are still amputated, as they were June 10, 2007. Those have not grown back.
A LAMMERS: I still have to help him. I still have to drive him. I still have to take him to appointments.
M LAMMERS: And I wouldn't change anything for the world. I'm not complaining, and I don't get hung up on injuries.
A LAMMERS: I'm still going to do it, even if you pay me or not.
M LAMMERS: But what exactly do they expect from us triple amputees, single amputees, paras? I can't really comprehend that.
LAWRENCE: They agree Matt is doing better right now than he has in years. But the Lammers say that's not the point. At his best and at his worst, it shouldn't matter. They've earned it, and they need the help.
Quil Lawrence, NPR News, Tampa.
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