I process claims for pension benefits at the VA. Ask me anything.

Discussion in 'General Discussion' started by Max, Aug 12, 2013.

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  1. Kaylin

    Kaylin Hero Member Staff Member

    toxdoc49,

    The main reason Section IX is there is to see if your mother-in-law is expecting to see any additional income coming in within the next 12 months. Typically, these could be things like the money from the sell of a house, rent money from renting out her house, etc.

    The section about Gross Monthly Income is the main area where the VA is looking at her current monthly income. So this would be the income from her SS and government pension.

    The medical expenses section is similar to the Medical Expense Report (http://www.veteranaid.org/docs/21p-8416.pdf). What you feel like she is paying for, or you and your family are paying for in her regard, for medical expenses you would indicate on these sections.

    Keep in mind, the VA is mostly looking at her income vs. how much she is paying in care each month. The shortfall there between the two is why the Aid and Attendance benefit would be necessary. I hope that helps.
     
  2. toxdoc49

    toxdoc49 Jr. Member

    Thank you, that helps me understand. It also clarifies (If I am right) that it is easier to show that in an assisted living facility, the expenses are greater than her income would be compared to home care. I am not sure how the VA looks at expenses being greater than income in her current home care situation; I don't want her to be denied the benefit.
    Basically, I am submitting the application with her getting in home care from my wife. We do intend for her to be in an assisted living facility, but not sure how to convey that to the VA and if the award amount is different. I am hoping for the maximum amount so that the cost can be made up for assisted living. Do I have to wait until she has an agreement to live in a facility to submit?
    I appreciate your time and responses!
     
  3. Kaylin

    Kaylin Hero Member Staff Member

    toxdoc9,

    Exactly! If her care expenses are depleting her income (and assets) currently with the home care situation than she could certainly qualify for the benefit. If you think it would be best to wait until she is moved into an assisted living facility before applying for the benefit, you can always use the Intent to File form to get the process started while you wait for her to move. You have one year from the date you put in the Intent to File. It gets the date established from where the retroactive funds would be owed to your mother-in-law.

    If you are looking at assisted living facilities, I highly recommend calling (866) 900-4969. They can connect you with a local care advisor in your mother's area who can assist you with finding the right assisted living facility for her. Their services are completely free and the best in the business.
     
  4. toxdoc49

    toxdoc49 Jr. Member

    You are very helpful and I apologize for asking so many questions. I think the form is 21-0966 for Intent to File; I found it on the web. Thank you again
     
  5. toxdoc49

    toxdoc49 Jr. Member

    So section IX, other income (expected) does not have to be the same numbers as section VIII sources of income. That's where i get confused.
     
  6. Kaylin

    Kaylin Hero Member Staff Member

    toxdoc49,

    Correct. The sources of income are her current monthly income. The expected income would be anything that might change within the next 12 months to give her an additional source of income.
     
  7. toxdoc49

    toxdoc49 Jr. Member

    Thank you for the clarification, I appreciate it.
     
  8. toxdoc49

    toxdoc49 Jr. Member

    For Section X, how do you list recurring monthly expenses? Do you just use the latest date before you submit the application? or can you list a date range there? For example, if she is getting around 1700 per month now and all that goes to her care (not all for medical, but all for her care, plus what we contribute), how do you list that? as a monthly expense (so it matches up with section VIII)? or for the year? It looks like you can list any un-reimbursed expense ("other unreimbursed expenses").

    I assume also that once there is a contract in place with an assisted living facility, that cost amount goes into one of the boxes in this section too and is listed as assisted living cost as a monthly expense. Then you submit the application. Sorry for the long question. This section just confused me.
     
  9. vetadmin

    vetadmin Administrator Staff Member

    You do not want to include what you and your wife are paying to offset care expenses, and what you are paying needs to be paid out of a bank account that is not attached to your MIL, so that your payments are completely separate.

    The VA does not factor in during application what families members are having to pay. The claimant (your MIL) needs to show her financial need for the pension in order to pay for care.
     
  10. toxdoc49

    toxdoc49 Jr. Member

    I've been seeing the term 'countable' income in posts on this site as well as some other sites. I think this is the same term as 'net' income. A site (agingcare.com) states that for a surviving spouse of a veteran with no dependents, the net income has to be below 13, 794. I don't know where they came up with this figure. So my understanding of this would be, the annual gross income of the surviving spouse minus expenses (all expenses?) to arrive at that figure. Is this what the VA does to determine the A&A benefit amount? If my MIL ends up in an assisted living facility, we would need the maximum A&A benefit to help make ends meet there.
     
  11. Kaylin

    Kaylin Hero Member Staff Member

    toxdoc49,

    This sheet here should help you understand and determine countable income: http://www.veteranaid.org/docs/income.pdf

    The VA mostly looks at the applicant's current monthly income and current monthly care expenses. If the care expenses are clearly depleting the income and any remaining assets the applicant may have, then they are clearly showing a need for the Aid and Attendance benefit.
     
  12. toxdoc49

    toxdoc49 Jr. Member

    Thank you, the form does clarify that for me. It does not look like the figure for countable income goes on the Aid and Attendance application, it is just for seeing whether care expenses are greater than income?
     
  13. Kaylin

    Kaylin Hero Member Staff Member

    You can use the countable income form to help you determine WHAT is considered countable income by the VA. Yes, it is also meant to be used to see if expenses are greater than income.
     
  14. toxdoc49

    toxdoc49 Jr. Member

    I think I saw this thread somewhere else, but I could not remember. I hope it is ok to ask here.

    Filing the 'intent to file a claim' form: will it speed up the approval process at all? Or should I talk to a veterans service organization who can advocate for me to speed up the approval process? Thank you.
     
  15. Kaylin

    Kaylin Hero Member Staff Member

    toxdoc49,

    The main benefit of the Intent to File is to secure an earlier date the retroactive funds would be owed back to the applicant after the approval of the full A&A application. As for if it speeds up the process, it might help! It certainly couldn't hurt. If you follow the suggestions and advice on these forums and use the How to Apply page on VeteranAid.org than you should be doing the best you can on your own to secure a faster decision by the VA. Nothing is guaranteed for the rate of which the VA decides, but getting the application right the first time can help.
     
  16. sschramm

    sschramm Newbie

    I spoke with a rep at VA in Philly today -- told me determination letter will be sent out today, but she could not disclose contents of the letter to me (even though I have third party authorization). Is this typical?

    Thinking out loud, in the event mom is denied, what are next steps? Can we appeal? Do I write congressman? Sister and I are extremely concerned as mom is running out of money quite rapidly.
     
  17. Kaylin

    Kaylin Hero Member Staff Member

  18. sschramm

    sschramm Newbie

    Thanks, I appreciate your help. Hoping for the best!!
     
  19. sschramm

    sschramm Newbie

    We just received our determination letter. Also with a proposal of incompetency. I am meeting with mom's attorney next week to discuss how exactly to handle this. Assuming we will just file to make me fiduciary.

    Also, when mom passes, are we required to pay any of this money back to the VA? I've never seen this question posed before, but know someone who was receiving assistance from the county (not VA) for many, many years. After this person passed, the survivors were told they owed $225,000 in reimbursement . . . and a lien was put on this deceased's property.
     
  20. Kaylin

    Kaylin Hero Member Staff Member

    sschramm,

    I'm happy to hear you got the determination letter with a quick turnaround. Yes, I recommend getting on the fiduciary process ASAP, as it can take a while as well.

    As for the money you may owe back when your mother passes, you will only owe back what she was awarded that current month if she did not make it until the end of the month. For example, if your mother received a payment for the Aid and Attendance benefit for the month of May 2016 of $1000 and she did not live until June 2016, you will owe back to the VA that $1000 for that month.

    I hope that clears up your question.
     

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