Got Denied...Now What?

Discussion in 'General Discussion' started by redsunn21, Jun 5, 2011.

  1. redsunn21

    redsunn21 Newbie

    Hello all,great forums here.Recently my application for A&A for my disabled and terminally ill mother was denied because she made too much money.She makes around $1650 a month and has 2 money market accounts with only $2000 in each.Her bank account never goes above $2000 monthly.
    Are they saying that after she pays all her monthly bills,electric,water,cable,phone,bus fare,groceries and her semi-annual house insurance ($1,300) and property taxes ($1000) that she should have enough to hire an aide to care for her???I recently moved back down here to take care of her and am having a really hard time just keeping a part time job with all her needs.My bills (child support) are stacking up REAL quick and will have to relocate due to my job type.Do I just leave her here by herself???
    About her,she is 66 years old, partially blind(detached retina),diabetic,on dialysis for kidney failure(3 times a week),congestive heart failure,uncontrollable high blood pressure,Guillain–Barré syndrome,diabetic coma occurrences and recently broke her right foot.She walks with a cane and sometimes a buggy.She is 110% home bound and can NOT read nor does she drive.A letter from her doctor,a Major in the USAF at Eglin AFB was also sent in with her application describing everything.
    What should I do now?Please help!!! I don't want to leave her alone cause I know she will not make it but I don't want to land in jail because child support doesn't want to work with my situation nor cares.
  2. vetadmin

    vetadmin Administrator Staff Member

    Don't know if you realize this or not, but the majortiy of things you listed that she pays for each month are not allowable medical expenses. monthly bills,electric,water,cable,phone,bus fare,groceries and her semi-annual house insurance ($1,300) and property taxes ($1000) These are not considered by the VA. If she does not pay someone to assist her or have care services coming into the house, she does not have much in the way to claim.

    You have a difficult situation, and based on what you have shared, it may be wise to investigate having her move into an Assisted Living facility where her "rent" would be an allowable expense. It sounds as though she has needs beyond being able to stay by herself, and you can't afford to not work full time and stay current with your obligations.

    She can pay you as her caregiver as another option for you to consider.

    See below what she can claim and how to arrive at what her "countable" income is.

    The VA suggests that its adjudicators use a certain amount of personal judgment on this issue. But the bottom line is: does it realistically appear that the veteran or surviving spouse may outlive their assets? If so, they are likely eligible.

    Do NOT count their residence or vehicle when estimating net worth.

    Do NOT count a life insurance policy (because the policy holder must be
    deceased in order to benefit from it).

    DO count CDs, annuities, stocks, bonds, savings, checking, IRAs, Keogh, etc.

    DO count any assets owned by the spouse as well.

    As a rule of thumb, assets should not exceed $80,000. That amount drops
    depending on the age of claimant.

    List below the estimated ANNUAL income of the veteran or surviving spouse:

    Estimate total income (If married include spousal income): ______

    All income must be included. This includes social security, pension,
    interest income, dividends, income from rental property, etc.

    If the veteran is married, then any spousal income must also be included.

    List all unreimbursed, recurring health care expenses:

    This includes:

    Assisted Living costs (per month): _________________

    Nursing Home costs (per month):________________

    Home Care service (per month):_______________

    Health Insurance premium (per month):_______________

    Medicare premium (per month):_________________

    Regular (unreimbursed) prescriptions
    (per month & verifiable through a pharmacy print-out): _____________

    TOTAL Expenses per month: __________
    (multiply x 12 to get total annual expenses)

    Subtract your total annual health care expenses from your total annual
    income and write the amount here: _____________. This is your "countable"
  3. redsunn21

    redsunn21 Newbie

    Thanks for the reply indeed.
    My mom doesn't want to go into any kind of home.She wants to stay in her house until her final days.She was hoping A&A would pay me or my brother to stay with her but I guess that's not the case.
    She can NOT currently pay anyone as a caregiver,after all her bills she barely has anything left.I thought there were different levels of A&A and due to her being partially blind and home bound and terminally ill she would get instant approval? The income limit for this program almost seems its a welfare program NOT a program to help those who fought in combat for our government.....
  4. vetadmin

    vetadmin Administrator Staff Member

    It's a benefit that ensures that people have funds to pay for "care" whether that be in the home, or a facility. It is based off a medical need for assistance with day-to-day living. It is not intended to pay for the every day expenses such as those you listed. Being legally blind is an auto qualifer, but she has no medical expenses to claim, which is why I suggested looking at a facility since the total costs would be allowable. There she would have food and cable, electricty and someone to attend to her.

    I understand about her wanting to stay in her own home as most folks do, but when circumstances and conditions no longer are safe and that is not an option, you have to look for other alternatives.

    My father refused to even consider let alone have anyone come in to help. A house fire ended that conversation, and left them homeless in a matter of minutes.

    The bottom line is she needs to be safe and provided for.
  5. Max

    Max Hero Member

    Unfortunately Debbie is right on this one. To qualify for this benefit, she should move into assisted living, sell her house, and use her current income of $1,650.00 plus VA funds of $1,056.00 per month to pay for most of her AL bill while using the proceeds from the sale of her home to help her afford the assisted living facility. Based on what you've already described, it doesn't look like pension will be in the cards for her without moving into assisted living.
  6. Debra56

    Debra56 Newbie

    I'm surely no expert, but wouldn't the sale of her house put her above the asset level and need to be reported to the VA? The EVR that must be filled out annually, asks about any financial changes.
  7. ttoes

    ttoes Newbie

    iIam new at this as well and have just started the A& A process. I believe that your mother can pay you or someone else for care and bring down her income to negative.
  8. redsunn21

    redsunn21 Newbie

    You know ttoes,I was just thinking that last night when I was visiting her last night in the critical care unit,yup,she had a slight stroke last Thursday but thankfully it happened while she was at dialysis and not at home because I was work that day.I have NO choice but to work due to my child support.Her dialysis doctor is also getting involved in this VA program and is making calls to Philly Monday.
    So the only real medical expense that the denial letter said that she could claim was her $96.50 monthly ($1,158 annually) medicare premium.They figured her annual income at $16,818.With my math that leaves her around $3000 short of the limit.But she does have one CD account and one money market account both with around $2,000 in each does that count towards her annual income or monthly???
    Now,if she was to pay me $150 a week wouldn't that put her below the limit and be approved for aid and attendance???She pays me that much anyways but in cash so I did NOT report that.Should I appeal their decision and report the cash payments to me???
  9. vetadmin

    vetadmin Administrator Staff Member

    Cash payments are never a good idea. You can do up a receipt of total payments received by you showing that expense for her care. You would not "appeal" the ruling, you would submit a Statement in Support of Claim 21-4138 showing the additional expense.

    Going forward, your mom needs to pay you by check so there is a clean accounting of her expenes.
  10. redsunn21

    redsunn21 Newbie

    Thanks for the reply VetAdmin!

    So in retrospect,just submit a hand written receipt signed by me and my mom and that should get her approved? Starting Friday she will start writing me checks.
    Also,I've gathered only the interest from her money market and CD account can be counted as income,right?Which isnt really much per year.
  11. vetadmin

    vetadmin Administrator Staff Member

    Can't promise you that it will get you approved, but by submitting additional information that impacts her medical expenses, the VA will recalculate to see if that brings her "countable" income down enough for her to qualify.

    Regarding the CD, the interest is income, the principal is an asset.
  12. Max

    Max Hero Member

    Actually, at age 66, net worth would likely not be an issue for her because her actuarial life expectancy would be quite long. She would probably be fine with $120,000-150,000

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