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Author Topic: Has VA overestimated medical expenses?  (Read 228 times)
Marp
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« on: January 05, 2012, 10:36:16 PM »

We recently received the award letter for my dad's A & A.  My mother read it to me over the phone.  It sounded a little weird, so I asked her to send it to me, which she did.

In reading the breakdown of how they calculated his eligibility, it seems that they have allowed about $5000 more per year for medical expenses than we reported.

Has anyone else had this happen?

We reported expenses for the 12 months prior to the application (as our VSO suggested), and the VA disallowed some, as we expected they would, but they still came up with more expenses than we reported.

It looks like the analyst may have taken the 12 month total we reported for Private Medical Insurance
and regular prescriptions (for high blood pressure and such) and used those numbers as one month amounts.  For example, my parents pay $303 a year for private health insurance.  I wonder if the VA analyst calculated that as $303 per month, bringing the total private health insurance cost to over $3600 per year.  It seems they may have done that with other recurring medical expenses.

I don't know why they would do that.  They didn't do that with the Medicare Part B premiums or with the Assisted Living charges.  We listed the 12 month total for those, and the analyst seemed to understand that that amount was an annual amount, not a monthly amount.  I don't know why they would be confused about the private medical insurance or the recurring prescriptions; we reported them all the same way we did the assisted living & the Medicare premiums.

Has anyone else had this happen?  Or is it routine for the VA to allow more in medical expenses than the applicant reports?
 
This has resulted in a monthly award of $400-$500 more than what I think it should be.  If I'm right, the VA will eventually make my parents pay it back, and we'd like to get it right sooner, rather than later (without provoking an audit).

I did try to call the 800 number in the letter, but couldn't get through.

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Fit2009
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« Reply #1 on: January 06, 2012, 05:29:11 AM »

Wait until the first deposit is made so you don't end up down a rabbit hole with no monthly payment, then write a letter to the VA explaining you think they may have over paid you - but double check your math first.
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Marp
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« Reply #2 on: January 06, 2012, 08:06:49 AM »

Thanks Fit2009 for responding to my question at such an early hour!

I definitely would like to avoid losing the monthly payment before it's begun.  All of this has stressed my mother out enough & getting a delay in the first payment could put her over the edge.   Then, again, having to pay back $3000 or $4000 later, when the overpayment is discovered would scare her too.

Do you work for the VA? Have you handled a veteran's claim where this happened?  How did it work out?
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ssals05
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« Reply #3 on: January 06, 2012, 07:58:10 PM »

I got dads evr today and they had already typed in his 2011 medical expenses. It was alot more than i had reported also. Now after receiving 6 mos of benefits i am afraid when they see the corrected
amount( which is what he was approved on) that there will be a problem. He qualifies with the lower amt which is what i had reported back in june.  So i dont know what to think
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