does not work when I try to use a basic voice command set up for the game.
Make sure you're using the "Windows Game (DirectX)" method to send keys. DCS doesn't recognize "Standard".
since I created the first profile for DCS the option to create a new profile is now not available for some reason.
If you've made this observation with the same windows open as in the screenshot(which is a PDF for some reason), it's because you have the "Edit a Profile"(and "Edit a Command") window open.
As in any windows application, if there is a child window open, the main window cannot be interacted with. That's not VoiceAttack specific.
As an aside, consider using the beta instead; It has a lot of new features and bugfixes, and the UI has changed slightly(you create new profiles using a button now, not the dropdown).