Getting discouraged before we start!

Discussion in 'General Discussion' started by MaxieCat, Feb 19, 2008.

  1. MaxieCat

    MaxieCat Newbie

    My 90-year old mother is the widow of a WWII veteran and is currently living with my niece until she can get moved into an assisted living facility. She sold her home a year after my father died and she has exhausted the funds from the sale of that home paying for an apartment in an independent living facility. She now has a total income of $1060 per month (SS and a teeny pension) and has about $2000. in savings. My question relates to being able to qualify for A&A based on a medical and financial basis. I assume she will have no problem qualifying for the financial part because she doesn't even get enough money each month to pay for the new assisted living facility. My husband and I will help her out temporarily until she qualifies for some kind of additional financial aid. But, even though she is going into "assisted living" she still is able to take care of herself with respect to dressing, bathing and eating. She can walk without assistance most of the time, but occasionally uses a walker when she is feeling weak. She does have macular degeneration, a problem with her esophagus which limits what she can eat (and poses a risk of choking), occasional dizzy spells, and numbness in her feet. She has occasional memory lapses so she will need some assistance with med dosing, she can cook for herself (she has left the stove on...) if she uses a microwave, but she DOESN'T cook for herself if she is living alone. This is a long way around to asking if you think that the VA will deny her because she doesn't have enough health problems?

    Thank you so much for running this site and I look forward to your answer.
     
  2. veteranadvocate

    veteranadvocate Full Member

    Based on the information that you provided and based on the VA Regulation listed below, I feel your Mother would qualify. The doctor needs to focus on the concerns that you described in your inquiry. She needs some assistance for safety reasons.


    38 CFR Section 3.352 (a)

    (a) Basic criteria for regular aid and attendance and permanently bedridden. The following will be accorded consideration in determining the need for regular aid and attendance (ยง 3.351(c)(3): inability of claimant to dress or undress himself (herself), or to keep himself (herself) ordinarily clean and presentable; frequent need of adjustment of any special prosthetic or orthopedic appliances which by reason of the particular disability cannot be done without aid (this will not include the adjustment of appliances which normal persons would be unable to adjust without aid, such as supports, belts, lacing at the back, etc.); inability of claimant to feed himself (herself) through loss of coordination of upper extremities or through extreme weakness; inability to attend to the wants of nature; or incapacity, physical or mental, which requires care or assistance on a regular basis to protect the claimant from hazards or dangers incident to his or her daily environment. "Bedridden" will be a proper basis for the determination. For the purpose of this paragraph "bedridden" will be that condition which, through its essential character, actually requires that the claimant remain in bed. The fact that claimant has voluntarily taken to bed or that a physician has prescribed rest in bed for the greater or lesser part of the day to promote convalescence or cure will not suffice. It is not required that all of the disabling conditions enumerated in this paragraph be found to exist before a favorable rating may be made. The particular personal functions which the veteran is unable to perform should be considered in connection with his or her condition as a whole. It is only necessary that the evidence establish that the veteran is so helpless as to need regular aid and attendance, not that there be a constant need. Determinations that the veteran is so helpless, as to be in need of regular aid and attendance will not be based solely upon an opinion that the claimant's condition is such as would require him or her to be in bed. They must be based on the actual requirement of personal assistance from others.

    The Veteran Advocate
     
  3. MaxieCat

    MaxieCat Newbie

    Thank you for the information. The support you provide here is immeasurable. Thanks again.
     
  4. LQQKnMarion

    LQQKnMarion Newbie

    I echo what veteranadvocate has told you. Don't get discouraged!!

    Our mothers sound a lot a like. I have posted our experience under the "Personal Experience" section.
    She actually lives in what the facility calls "independent living". BUT, like your mom, she has vision problems(loss of sight in one eye), multiple health problems including rotator cuff tears that prevent her from being able to wash her hair. ( So he goes to the beauty shop there weekly.) She uses a walker all the time, and is at BIG risk for falls.

    Get your mom's doctors to write letters on their own letter head or fill out the nursing home form. I asked all of mom's doctor if they would write a letter for us. Just give them a brief description of the benefit. ( I used the VA's own press release about "aid and attendance". It contains those same criteria that veteranadvocate listed for you. I highlighted the part about protecting from dangers of environment.

    The doctors were then able to list or discuss her diagnosis and relate them to her need for assisted living, or protection from falls, etc.

    When you tell the doctors the benefit can amount to nearly $ 1, 000 a month they listen!! They know how expensive it is for their patients to live in assisted living, and the importance for them to be in assisted living. The doctors will be glad to help you out. Just give them a reasonable amount of time to get the letter done. I always told them "no hurry" -- "if you could get it done in the next week or 2 that will be fine".

    Then get some thing --any thing you can in writing from the facility that lists the services your mother IS getting that relate to her health conditions and needs. The admissions coordinator at mom's facility was
    a bit hesitant at 1st saying she couldn't say any thing fraudulent. Then she thought a minute, and said she'd work on something for us. She came back later and said she had some thing approved by her administrator. It was just a simple statement on their letter head of what services she recevied daily and weekly. ( or could receive). Things like house keeping, laundry, meals in their dining room, health care(doctors & nurses) on staff / 24 hrs if needed, and even listed the beauty shop as an amenity. I think she even noted the "in facility" US Postal Office". So, there was no fraud, but each service available related to some thing the doctors said she needed help with. It didn't make / doesn't make a difference what they call it. "Independent Living or Assisted Living" as long as she needs the services she is able to receive/ does receive that protect her from her environment. ( prevent falls, be able to have nurses available if needed, meals cooked for her, laundry done for her, etc.) It would be totally different if our Mom's were indeed "independent". If they were, they'd still be living at home, and driving to the grocery, the bank, post office, doing their own cooking, etc.

    Apparently those letters from the doctors and the facility are what helped my mom. We believe her application is almost "approved" and the 1st check to be sent soon.

    So... Don't get discouraged !!!
     

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