AWARD ..... Whack up the side of the head :(

Discussion in 'General Discussion' started by caregiverx2, Apr 8, 2011.

  1. caregiverx2

    caregiverx2 Newbie

    Spoken to VA today & find myself wondering what went wrong.
    Dad's unreimbursed medical expenses & small caregiver amount placed his monthly income below ZERO.

    Yet VA only counted their monthly medicare, private medical & prescription drug insurance.
    After which they calculated their annual income at $15,500 when Dad is actually in the hole by $1752 annually.

    I've reviewed every which way & can't understand what happened or what I did wrong.

    Has anyone had this problem?

    I truly expected full award.

    any insight is greatly appreciated.
     
  2. caregiverx2

    caregiverx2 Newbie

    P.S. forgot to tell you that VA is NOT counting 'monthly prescriptions & caregiver monthly allowance of $800'

    I can't believe it
     
  3. KarenO

    KarenO Jr. Member

    Any indication at all why they did not count cost of prescriptions and cost of caregiving? Did you have a statement from the caregiver indicating the monthly cost? Does he have money in the bank?
     
  4. caregiverx2

    caregiverx2 Newbie

    No indication why VA didn't count prescription cost of $8199 or caregiver of $9600.
    Yes, I submitted Statement of Claim outlining caregiver dutes, time frame, & monthly$$

    Makes absolutely no sense, unless of course, the whole government budget thing has them holding back on awards.

    I've got the last 18 months of EVR completed & just checking to see whatelse I need to submit to get them to
    re-evaluate.

    Looking forward to Debbie's thoughts!

    caregiverX2
     
  5. caregiverx2

    caregiverx2 Newbie

    savings & checking less than $8000
     
  6. new57

    new57 Newbie

    Hi,

    In my dad's award letter they specifically stated that they were NOT going to count the prescriptions for the initial award as they were not an ongoing predicable expense (or the depends, for that matter). They further stated that since his income for VA purposes was below zero (due to the ALF costs), the prescription denial did not matter anyway.

    hope this helps explain their reasoning a little

    eric
     
  7. Caroliso

    Caroliso Jr. Member

    Eric, I have seen this reported by others as well and it still mystifies me. Maintenance medications are certainly predictable. As are Depends, unless patient is expected to suddenly become continent. I wish.
     
  8. vetadmin

    vetadmin Administrator Staff Member

    CaregiverX2

    Sorry to be long in responding. I have been out of state for the past week for my daughter's wedding.

    I would include another 21-4138 Statement in Support of Claim along with a letter clearly outlining the RX's cost of the medications and make the case that they are ongoing.

    I would also call and ask to speak with a supervisor, and request and explanation as to how they arrived at the award amount and why these were not counted as expenses.

    From all that I know, there is no logical reason for how they arrived at this. It is not uncommon for Depends to not be counted.

    Let us know what you find out, and good luck with getting someone to help.
     
  9. caregiverx2

    caregiverx2 Newbie

    Thank you Debbie -- Congratulations on your Daughter's wedding...it's nice to get away to see family & friends.

    I'll keep you posted.


    PS VA statement that prescriptions not counted as predictible or reoccuring baffles me.......we refill every 30 days.
    Only thing UNpredictible is what medicare & drug plan covers each month........and that's a whole other topic
     
  10. vetadmin

    vetadmin Administrator Staff Member

    Thank you for the congratulations. The only problem with going away is coming back and trying to get caugh up.

    Good idea on getting rx's refilled every month, and do let us know what happens.
     
  11. Max

    Max Hero Member

    Prescriptions are almost never considered reoccurring because cost changes can occur with insurance coverage, the donut hole, and dosage changes. The in home care is more concerning. Why did they say this wasn't counted?
     
  12. caregiverx2

    caregiverx2 Newbie

    VSR, they didn't count Caregiving Statement as Veteran signed instead of Caregiver
    I would have thought they wanted the Veteran to confirm statement as correct
    either way, I signed next to Dad.
    Thanks,
     
  13. Max

    Max Hero Member

    In that case, I would just go ahead and sign it the way VA asked you to. The prescriptions still wouldn't be considered to be reoccurring, but you could submit those expenses again later after you have already paid for them (i.e. don't report "$500 of RX monthly". Instead report "$25 of Lipitor purchased on April 23, 2011)

    Let me know if that doesn't make sense.
     
  14. caregiverx2

    caregiverx2 Newbie

    Perfect sense:)
     

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