Death Benefit for my Mother who is a spouse of WWII Vet

Discussion in 'Surviving Spouse Application' started by deloressimms, Dec 21, 2015.

  1. deloressimms

    deloressimms Newbie

    I am getting ready to submit my mother's package for the subject. I would like some advice on whether the forms I am submitting are correct:

    21-534EZ Application for Death Pension
    21-0779 Request for Assisted Living Facility Information in Connection with Claim for A&A
    21-2680 Examination for Housebound Status or Permanent Need for Regular A&A
    21-0845 Authorization to disclose Personal Information to a Third Party
    Assisted Living Facility Status Statement (no form number)
    Marriage Certificate
    Death Certificate
    Discharge Papers
    Social Security Benefit Letter for 2015
    Bank Statements
    Cover letter for an over 90 years old Recipient

    Can I, also, submit the 21-4138 Fiduciary with the original package or do I have to wait for the request to submit. The doctor's analysis states my mother is not able to handle financial affairs.

    I have listed on the 21-534 form my mother's assisted living monthly charge, Anthem Blue Cross Blue Shield supplemental insurance monthly charge, medicare monthly charge, and misc supplies (wipes, baby aspirin, desitin). Can I list her weekly shampoo/hair set as well? Not sure this would be considered as a needed expense.

    How many months of bank statements should I send?

    I will be sending the package with a "return receipt" as well.

    Please let me know if I am not submitting the correct forms or have not included another necessary form.

    Any help will be appreciated.

    Delores Simms
  2. Kaylin

    Kaylin Hero Member Staff Member


    It seems you have the correct documents ready to send off. Always mail return receipt and keep a copy of each document.

    The form 21-4138 is a Statement in Support of Claim form which is generally used to update information on an application or clarify an application's information. You do not tell the VA you are requesting to be her fiduciary until the VA rules her unable to handle her financial affairs and they mail you a letter informing you that you must appoint a fiduciary.

    I would send at least 2-3 months of bank statements. The main thing you are trying to show are the monthly recurring expenses your mother is having that is depleting her income as she pays for care and assisted living housing.

    I wish you best of luck in this application for your mother!

  3. Kaylin

    Kaylin Hero Member Staff Member


    After reviewing your documents again, are you making sure to include the physician's statement VA Form 21-2680? You need that as well.

  4. deloressimms

    deloressimms Newbie

    Thank you so much for your comments.
  5. Kaylin

    Kaylin Hero Member Staff Member

    You're welcome!

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