When Coast Guard rescue swimmer Dave Riley lost all four limbs to a rare bacteria in 1997, his wife, Yvonne, gave up her career and freedom to become his full-time caregiver.

He said he wouldn’t be able to survive without her help, even for everyday tasks like eating, putting on his prosthetics and traveling outside the home.

“For the last 20 years, she has sacrificed so much so I can lead a high-quality life,” he said. “And largely, she has done so without outside support.

“It is virtually impossible for me to take Yvonne for granted, but I feel like the system does.”

Both Yvonne and Dave — the past commander of Disabled American Veterans — were present Wednesday for a rally inside the Capitol to extend Veterans Affairs caregiver benefits to individuals who served before September 2001, calling existing rules surrounding the program unfair and harmful to many military families.

Currently, family members who provide around-the-clock assistance to injured veterans are eligible to receive an array of support services from the department, including a monthly stipend to compensate for their lost time and careers.

But the program, approved in 2010, is only open to veterans of the Iraq and Afghanistan wars era. That leaves individuals like Yvonne — whose efforts veterans groups estimate have saved the federal government hundreds of thousands in health care costs — largely alone in their efforts to take care of their loved ones.

“Day after day, little by little, we have learned to get by without help,” she said. “I gave up working to provide his daily care, but through the years, it has only become more challenging.”

Veterans groups have pushed for an expansion of the program, arguing it excludes too many dedicated caregivers who face the same financial challenges as their younger peers. On Wednesday, they presented lawmakers with a petition signed by more than 180,000 individuals asking for a fix.

“Every day, hundreds of thousands of caregivers are providing unmatched care that allow the nation’s most seriously injured veterans to remain in their homes and out of nursing homes, giving them a chance at better health and a better quality of life,” said Garry Augustine, executive director for DAV.

“For caregivers who do so, they often work without assistance and without the benefit of comprehensive support.”

VA Secretary David Shulkin has voiced support for the expansion in recent months, but that move would have to be approved by lawmakers first.

Past opposition to the expansion has been based mostly on the cost. Extending the caregivers stipend to veterans of all eras is expected to total more than $3.4 billion over five years, a hefty price tag for a Congress already fighting over federal spending caps.

Last week, members of the Senate Veterans’ Affairs Committee included the measure in a broader, $54 billion health reform package. Lawmakers and veterans groups at Wednesday’s rally applauded that move but noted the legislation still faces a difficult path ahead in Congress.

Supporters noted that caregivers are often far less expensive than full-time medical care or nursing homes for the injured veterans and that the federal government should not take that for granted.

“It’s impossible to overstate the value of having a family member or loved one by your side while overcoming an illness or coping with an injury,” said Sen. Patty Murray, D-Wash., who sponsored expansion legislation in the Senate.

“But the sacrifices they make to provide vital day-to-day care for our veterans often goes unnoticed. Taking care of our veterans means taking care of those who make their recovery possible.”

House Veterans’ Affairs Committee ranking member Tim Walz, D-Minn., said he is hopeful similar legislation can move forward in his chamber soon, after broader budget issues are resolved. He said costs are a potential roadblock but should not mean an end to the conversation.

“We need to make the case for this, and we need to figure out how to pay for this,” he said. “I can’t look at Dave and Yvonne and tell them that shouldn’t happen for them. That’s simply not fair.”