Review Call from VA

[smokingun]

Last year, my dad was approved for A&A, based on living in assisted living for Parkinson's and his expenses exceeding his income.  My mom was a community spouse.  The A&A award said, "We are providing this benefit for your wife," though I have read here that the benefit is for the veteran.

This past summer, my mom had a stroke and recently entered assisted living herself, due to memory/safety/balance concerns and has been told she cannot live at home or drive until she improves (which may be never), though she is generally functional dressing, eating, etc.

Today VA left a voicemail for my dad (claimant) wanting a call back because his file was "under review." It has been 14 months since he began receiving A&A, so I believe this is routine.

First, should I respond in writing or by phone?  If I talk to them and tell them dad cannot talk to them because he has speech/cognition problems from Parkinson's, OR if I let DAD talk to them and he proves it, I am concerned they will appoint a fiduciary.  If I handle it in writing, he can still sign his name.

However I respond, should I tell them, NO CHANGES because my mom "may" recover and return home, in order to keep the benefit continuing without a complicated review?  Or, should I state my mother now lives permanently in assisted living and their combined expenses are much, much higher (they ARE), in order to seek a higher benefit?

The A&A benefit is currently $950.  Their combined income is $66000/year.  His health-related expenses are  $79,000 per year, and now my mom's are $68,000 per year.  My mom is not a veteran.

Thanks for all your help!

[AngelaManz]

Appointing a fiduciary is not a horrible thing. Many of the folks I work with go through it.

However, if you want to avoid it, use the 3rd party authorization form.  Have Dad sign this and send it to the VA. Then you can talk with the VA on his behalf.  They do take some time to process the form, but call and follow up regularly. 

http://www.vba.va.gov/pubs/forms/VBA-21-0845-ARE.pdf

[smokingun]

Could I bump this up, as I am now completing the EVR?

My dad (vet) AND MOM (civilian spouse) are now both in assisted living.  My dad gets a monthly A&A.

Since VA requires me to list my mom's income (short term disability for only a year, and SSI) as well as my dad's, should I also list all of my mom's deductible medical/care expenses as well as my dad's?  Their combined income is $60K/yr and their combined expenses, $127,000/yr.

Seems unfair to consider my mom's income but not her ALF expenses.

They live in separate apartments in an ALF.

Thanks!

[vetadmin]

First question is, when you originally filed, dId you do it just for your dad and not file as a vet with a spouse who also needed assistance? If yes, then you need to do a Statement in Support of Claim indicating he is now a veteran with spouse.  You will need to get the physcian's statement and all her medcial expenses. You also need to do the EVR, and if possible send everything in one packet.  You do have a limited time on getting the EVR back, so you may need to jump through some hoops here.

Yes, her income needs to be counted if you file as a vet with spouse, but you also get to claim her allowable expenses, which will bring that income down real fast. It does not matter that they live in different facilities.

[smokingun]

First, it's after midnight, so you are DEFINITELY earning your moniker! :-)

Yes, you're correct, mom didn't need care until her stroke last summer, so I noted dad was married but didn't specify mom needed care (though the Award Letter stated, "we are providing the benefit for your mother," which I took to mean to assist with her expenses as dad was spending all of his monthlies in the ALF.  Now, she's in the same facility as dad, in a different apartment and their income/outgo disparity is truly terrifying, especially myself and sisters are paying the difference.

1.  Is it worth the risk, review time, etc. to refile a whole statement in support to add my mom's expenses?  Or, since dad is getting 2/3 of the max each month, am I better off just not mentioning her expenses and leaving the status quo?  Dad is not expected to live out the year.

2.  Does it matter that my dad didn't actually spend his funds on her care?  His funds are exhausted each month on his own ALF bills, so it is me and my sisters paying for mom's care and ALF expenses, as dad has nothing left.  I noted this on dad's original AA application.  I don't understand how VA can see expenses greater than income and restrict a benefit because the kids helped when the vet couldn't pay his own way.

3. Finally, because this isn't complicated enough, mom and dad moved from Ohio ALF to Nebraska ALF last month.  Should I send the EVR to a different VA office? I assume I don't have to complete a whole new application...

Thanks again.  In fact, before you go to bed tonight, you might take a minute to stare at the ceiling and really let in just how many, many people you have helped in this life.  I don't have a way to explain it.

dAve.

[swainlaw]

If the VA called your father and requested a phone call you should reply.  Have you filed to be his representative?  If not file form 21-22a and 21-0845, so you can talk to the VA.  Always respond to the VA as quick as possible in the way they requested (also in writing for your own records).

You should definitely include all of your mothers medical expenses for the previous year and project her expenses for 2011 based on her current expenses.  The VA will owe for the pension they did not receive last year.  If your mother's health improves and her medicaid expenses decrease you should notify the VA.

With the figures you have given there is no reason your father is not receiving the full $1,949 per month.

[smokingun]

Thank you, so much!

My issues currently are:  my dad first reported his NET retirement income (instead of GROSS), as the initial application asked for income he "received"; shouldn't be much of a problem, as even his gross income is less than his expenses (I am correcting this in the EVR); my mom went back to work to make ends meet after he became disabled, leading to her own stroke and subsequent disability, so their income last year was unexpectedly higher than I forecast, from wages and disability payments.  These won't continue, as she can no longer work and her disability will run out, so I need to somehow apprise VA of this.

Also, the bulk of her medical bills and ALF rent in late 2010 were paid by the kids from their own money because, after her stroke, they couldn't get at hers while she was in recovery.

Does it matter who actually pays the medical bills?  I.e., do they have to come from an account in my dad's or my mom's name?  Or, if they didn't, is it too late for her to reimburse the kids for paid medical bills, then claim the deduction?  I can certainly show the bills attributable to her, it's the payment for them that is fuzzy.  Seems if VA uses her income to reduce my dad's benefits, they should use her medical expenses (even if he didn't actually write the check for them, someone did) to increase his benefits.

I DID reply to the VA's call; now just filling out the annual EVR, which is compli

[swainlaw]

It does matter who pays the medical bills, but if the kids paid the bills as a loan to the parents (get a written agreement between the parties stating the reason for the loan and the obligation to pay the loan back) then they can count the medical expenses.  This is also important for Medicaid purposes so the repayment of the debt is not treated as a gift.

I agree the EVR can be complicated.  The VA makes plenty of mistakes with them.  In the first year they do not always ask for all of the periods of time that they should.  You should file for whatever periods the VA asks for plus the 12 month period from the date of the award and the first Calendar year after the award and the next calendar year (if not already reported).

This is the only chance you have to file for reimbursement for medical expenses not considered in the application.  You said your parents income was $66,000 but they had $79,000 of medical expenses.  That would mean they were qualified for the full pension of $1,949 but they were only paid $950 per month.  Therefore they would be owed $999 for each month.  Also you would project next year's expenses based on last year's expenses so the VA should adjust the payments for 2011 to $1,949 per month.

Example:

Award date of June 1, 2010
EVR is due March 1, 2011
Report the 12 month period starting June 1, 2010 - May 31, 2011 and
January 1, 2011 - December 31, 2011


Award date November 1, 2009
EVR is due March 1, 2011
Report:
1. the 12 month period from November 1, 2009 - Oct 31, 2010
2. January 1, 2010 to December 31, 2010
3. January 1, 2011 to December 31, 2011


I have seen strange requests from the VA.  (less than 12 months, more than 12 months, dates starting prior to the award date -generally the date the application was received)  Whatever they want you give them but also include the dates they should have asked for as shown above.
 

[vetadmin]

Jim,

Thanks for jumping in here with your expertise and clarifying things.

Dave, I am deeply touched by your words, and I thank you from the bottom of my heart for your kindness and appreciation for the work I do.