There is a difference between Assets and Annual Income.

The Annual Income must be below the threshold, which can be reduced through various medical deductions.  I hope that you have been able to find the answers you need since your last post.

Just a side note about the Medical Exam form.  Be sure the doctor is very specific and states any and all disabilities and describes in detail how your loved one is in need of attendance.  I also suggest the claimant and/or attendant listing these as well in a Statement in Support of Claim.

Hi,
For those who count Life Alert as a Medical Expense, do we need to
1) send in a copy of the bill, or is a total okay?
2) accompany the expense with a doctor's note?

Life Alert is one of the ways my friend is able to safely live alone, due to her disability, so I assume it's countable.

We want to file it right the first time.  Thanks!

daughter #3,

I would also recommend that you fill out the Attendant Affidavit and submit it, or at least the same info contained on the form (search this Forum and you'll find a link for the form, as well as more info on this topic).

I would submit the expense using the Medical Expense form or a Statement in Support of Claim Form, since there will be no EVRs.  I'm not an expert on retroactive payments that pertain to non-recurring expenses, but I believe she should be reimbursed as long as she can prove it was a medical necessity  (e.g., my friend submitted one-time, non-recurring expenses, but the VA wanted a Physician's Statement to verify them as medical necessities).  When submitting the expenses, I would include her paperwork and bills that verified her injury and need for the facility.  

Just be aware that the expense won't factor into her monthly benefit.

Thanks, Foreignmoma!

I wish I'd had this form when we submitted our caregiver contracts.  I highly recommend that these affidavits be filled out by caregivers and claimants and filed along with the claim, saving any potential delays.

Thanks to another poster, here is the link for the Attendant Affidavit: http://www.stclaircounty.org/offices/veterans/forms/Attendant%20Affidavit.pdf

I highly recommend submitting it when filing the claim (or at least have identical info on your caregiver contract), as the VA may send it anyway and you don't want any months-long delays.

Hi VetAdmin!
Just wanted to clarify that in my friend's case, she applied within weeks of her husband's passing. His Final Expenses were enough to have her income beneath the threshold for the Initial & First Calendar Year(s).

Since she is legally blind, among other infirmities, there was no question that she was disabled.  (Initially she was rated Housebound, but after we sent more details & caregiver affidavits, she was upgraded to A&A).

I agree with you that caregivers should be paid asap.  Your website has been such a valuable resource; I only wish I'd known of it prior yo applying....the advice offered would have saved us numerous delays.

I see there wasn't a response to your question and am just curious if you ever got an answer from your local VA office or one of the pension centers?

It would seem to me that you could fill out an Attendant Affidavit for the family members and explain the lack of funds when it asks for payment amounts, declaring that once approved payments would begin.  But it seems you can already easily demonstrate that care is needed for her 24 hours a day, so from a disability standpoint, it seems you wouldn't have a problem (as many are granted the benefit who don't need round-the-clock care). 

If the income level is low enough, I believe from a financial aspect she'd still qualify, even if payment is not being given to caregivers yet (check/search the appropriate Threads for Income requirements).  My friend was awarded benefits even before she began paying caregivers; after she was granted benefits, she began paying caregivers.

I am sure others have been in your situation and am curious how they have proceeded.

I wish you the best.

Hi CaptainCarl,
This Thread might be helpful: http://www.veteranaid.org/forums/index.php/topic,1814.0.html

My friend is legally blind and lives alone, but we were able to demonstrate that she could not safely live alone without the regular aid & attendance of others.  Since your father is moving in with you, as VetAdmin stated, you need to describe the type of assistance he will be receiving from you.  Search for "Attendant Affidavit" for more info on how to report this.  (The claimant does not have to be bed-ridden to qualify, but the VA needs a very clear and detailed description of needed assistance).  Be sure his physician lists any and all infirmities and how they require assistance from others on the Medical Examination Form.

Be sure to see the Top Threads on each Forum Category on how to get started on this journey. 

Quick tip: be as detailed as possible in his application, (doctor on) Medical Exam form, Attendant Affidavits, any Statements of Claim, etc.  The more details, the better.  Be sure to keep logs of Medical Expenses.  If there are any Medical Expenses you have a question about (such as Adaptive Equipment, Home Improvements for Safety, Vitamins, Nutritional Needs, Filtered Water, etc., go ahead and have a Physician write a prescription or a statement declaring them to be a medical necessity, if applicable.  Otherwise, if the VA has a question about an Expense, you could be slowed down several months). 

I wish you the best!

I know it's been a while since this was discussed, but in case San Anton's situation has changed, I wanted to share a little of my experience.

As a friend of someone legally blind, I know the special challenges you face.  My friend was initially awarded Housebound, but after more detailed info was sent, she now has the A&A benefit.  When she was first widowed, we knew she needed financial help, but we did not know how to go about it.  Thankfully, sites like this helped us immensely.  I only wish I’d known about it prior to filing.

You say your MIL lives alone and cooks and cleans for herself.  I’m going to guess that she could not live alone without the regular aid and attendance of others to assist her with the tasks of daily living.  If that is so, I believe you stand a chance of approval.  As someone who has been close to the legally blind for years, I know most cannot use knives or stoves/ovens and can only re-heat what others have first prepared.  While they may be able to do some cleaning, from personal experience I know they cannot fully maintain their home without assistance.  If this is the case with your MIL, I would seriously consider her beginning to pay family as caregivers for tasks such as cleaning, cooking, transportation, medication administration, etc. so that the expense can help her meet the monthly expense threshold for eligibility.  (search for Attendant Affidavit on this forum for more info.  Be sure to be very specific with the VA).

Her doctor can be of great help.  Be aware that the VA’s definition of legal blindness is stricter than the standard medical definition.  However, the doctor can be very clear in his description of her disability in the VA Medical Exam form.  I would also list any other infirmities and how they might restrict her.  (Search for “legal blindness” on this forum for the appropriate definitions and provide them to her physician, asking that if her visual acuity is 5 degrees or less and/OR if the vision is 5/200 or less to state this).  The physician would need to be very clear in his wording and list how she needs an attendant to perform the tasks of daily living.  It’s very important for the claimant, doctor and caregivers all in their respective forms to list any type of help she needs (not only major tasks like bathing, walking, protection from the hazards of her environment, but also any grooming tasks (keeping hair clean/nails trimmed), cooking, cleaning, transportation, etc.).  It is very important for the doctor to state that she could not safely live alone without the regualr aid and attendance of others.  EVEN IF she is not “legally blind” by the VA’s standards, that doesn’t mean she wouldn’t qualify for A&A or Housebound benefits if it is demonstrated by the physician and caregivers that she is in need of assistance.  (For the first year, the VA did not consider my friend legally blind but still granted her Housebound.  After the doctor provided more information on her visual acuity and we provided more info on all the types of assistance she was receiving, she was awarded A&A).

Just wanted to give an update on this for new applicants!

When you are in the process of submitting expenses, if there is any question-mark on any expense (basically anything that falls outside of Prescriptions, Medicare, insurance, doctor bills, eyecare, dental and any other verifyable medical need), be sure to have your doctor write you a statement verifying it's a medical need.  I highly recommend this especially for adaptive equipment or home improvements related to the disability, as the VA will almost certainly question some of these expenses.  If you have special vitamin, food or drink needs (including filtered/bottled water), according to the VA Manual you almost certainly need a statement/prescription since it's not technically medicine.  They are likely to approve the expense if you have a physician's statement.  They aren't if you don't.

Include your statement/prescription from your doctor with your claim.  That way, if there's any questions you won't be slowed down on reimbursement (it usually slows things down 3-4 months when they have a question).  If they don't need it, you haven't lost anything....if they do need it, you won't be slowed down!

I know it has been a while since your post, but in order to help those in a similar situation, I wanted to advise that the VA may ask for an Attendant Affidavit.  I can't seem to find one online, so I don't know if they have them as files for printing.  It seems they send them out to the claimant.  

I'm guessing that if Care Givers send the exact same information that's on the form, then that would lessen the possibility of being sent one (and thus slowing the process down by several months).  If I knew before applying what I know now, I would have sent exactly what was on the form.

Here's what's on the form:
Top right of page:
ATTENDANT AFFIDAVIT
Veteran's Name (last, first, middle):
VA Claim or SSN:
Claimant's Name:
Claimant's Address (street):
City, State and Zip Code:

Main Body of form:

My name is______________________, and I provide health care for the above claimant.

The services I provide are:
(then there are "YES" and "NO" check boxes for each)
Assistance with bathing
Standing and sitting
Getting in and out of bed
Eating
Walking
Dressing and undressing
Taking medication
Other (please describe): {there are 3 lines for this}

For these services, I am paid by the claimant _______ per day/week/month/year (please circle only one).

I began employment on ____________________________________.

Signature of Provider
Street Address
City State and Zip Code
Phone number (including area code)


In a separate box at the bottom of the paper is the following:
I CERTIFY, under the penalty of law, that the above information is true and correct, that I do pay the above referenced sitter the amount listed for the services listed.  (If claimant signs with his/her mark, the mark must be witnessed by two witnesses).

Signature:________________________   Date:____________________
Witness:__________________________   Date:____________________
Witness:__________________________   Date:____________________
------------------------------------------------------------------------------------
END OF FORM

Be sure to include tasks like transportation, pharmacy pick-up, cooking and cleaning in addition to the above under “other” if they apply (while the VA doesn’t use those tasks to factor into someone’s needs for A&A, they do realize those are tasks a caregiver provides and therefore deserves compensation).  Something they DO factor into a claimant’s need for A&A, in addition to those items on the list in the affidavit, is if they require grooming assistance, not only with bathing as listed above, but trimming nails and keeping their hair clean.  If you assist with those matters, it is of utmost importance to include it on the caregiver form and also have the physician state this, as well.

I cannot stress enough the importance of being clear and detailed!  Not only for care givers, but the doctor.  It is very important to list all of the tasks and how the claimant requires help.  From personal experience, once we were able to get the physician to be very clear in his descriptions, my friend was awarded A&A.  He thought they would take his word for it that she needed assistance.  The VA, though they trust doctors, need the claimant’s needs to be spelled out with specific details.  It took nearly two years of back-and-forth with the VA before my friend was granted A&A (she was first rated as Housebound, after a FULL YEAR of being in-process, but after we provided more detailed specifics, they changed the rating to A&A.  Unfortunately, my friend missed out on A&A retroactively for the first year, with its extra $3,000 of benefits, because the doctor was not specific enough with the dated material for the first year).
Hope this helps!

My condolences to you.
I know it's been some time since your post, but for others in your situation, I believe the widow is entitled to burial in a Veterans cemetery with a plot provided at no charge (but no help with funeral expenses).  Social Security has a small burial benefit.  To my knowledge, the VA will pay some burial expenses if the veteran died in a VA facility, but I am unsure about widows.  Life insurance is separate from the pension to my knowlege.

I have a question about the EVR.  I have conflicting information.  I've read in some places that annual EVRs have been discontinued.  In others, that the VA will send them out as needed.  In other places, that they're not required every year for everyone.  Anyone have an update?  Just trying to make sure my friend reports some increased expenses.....we were waiting for the EVR, but if it's not going to come, I'm guessing we should go ahead and send the updates.  Also, if we are expecting it and it doesn't come, I know we'd need to notify VA.  Is there an official VA link with updated EVR info?

UPDATE: I found this article, http://www.startribune.com/local/184767991.html?refer=y
It says that the VA is cutting "red tape" by not sending out the EVRs and that it will help them with their backlog in processing current claims.  
CONFIRMED info at: http://www.va.gov/opa/pressrel/pressrelease.cfm?id=2414