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

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

  1. biekshaj

    biekshaj Newbie


    You (and many in the Forum) helped me tremendously while working through the A&A benefits application process. My mother was so grateful and able to utilize these benefits for a few months until she passed away several weeks ago - February 8. She had yet to receive her retroactive benefits. Shortly before her passing, we were interviewed by the Field Examiner for my Fiduciary appointment. I just returned home to find in the mail my approval as her legal custodian, with approval to reimburse a family member for personal funds used. The retroactive benefit check has not been received and I am pretty sure I could not process it anyway (I think).

    I quickly scrolled through the forum postings to try and find someone with a similar situation. There are probably a few there, but I just have not found them.

    My question is, "what must I do next?" I did not have any of my VA paperwork with me in Florida while helping to close my mothers affairs. I know I need to call the VA to officially notify them of my mother's passing, but am not sure if I call the Fiduciary Hub, Pension Center, or both. What do I do if I receive the check? And there is still a tremendous need to obtain any portion of the retroactive benefits we can to cover past personal expenses. At the time of the fiduciary interview I only had a portion of these expenses documented to provide to the Field Examiner. I now have considerably more. I know the process to have these expenses reimbursed after her death is long AND I am already finding them confusing.

    Long story short, I am looking for guidance. After I have finished filing the paperwork, I will definitely publish my experiences - obtaining the A&A benefits, Fiduciary process, and the final reimbursement process.

    Thank you in advance.

  2. TheAdmiral

    TheAdmiral Newbie

    My mother has been receiving the A & A benefit for a little over a year. For the past several years, my husband and I have been helping her try to regain assets stolen from her by her son.

    She was recently successful in obtaining a judgment in her favor, but the judge is considering appointing a guardian ad litem due to the fact she is a vulnerable adult and not able to make financial decisions for herself.

    Can you tell us how the appointment of a guardian ad litem will impact her A & A benefit? What type of review will the VA do? How long will it take? Will it suspend her benefit or jeopardize it? Any other issues we should be aware of?

    Many thanks for your assistance.
  3. Froggy

    Froggy Newbie

    I helped my father-in-law (WWII & Korean War vet) apply for Aid & Attendance pension when his wife became bedridden over 5 months ago; I'm listed as his fiduciary on the application. I know it's way to soon to expect a determination, but circumstances have changed and it's unclear to me what additional information (if any) I should submit and in what form it should be. At the time of application they were in their home and both I (uncompensated) and a home health aid & hosice were providing their care with ADL. The situation in their home became no longer practical and we had to relocate them (900 miles) to be closer to our us. His wife was admitted into a nursing home where she died almost 1 month later and my father-in-law lived with us until an assisted living opening was available almost 1 month following her death. He's received 2 form letters (forwarded from his home address) saying that his application is in process and to notify them of any address changes. As I'm taking care of all his financial and other matters I'd like to notify them to send any future correspondence to my address and include any other relevant information at the same time:

    - I assume that they should be notified that his wife has died - include death certificate?
    - Should they be notified that he is now no longer in his home but in assisted living and include that expense?
    - With regards to their homestead, will he be required by the VA to sell the property and now count the proceeds as part of his assets?

    Should information be included on some official VA form or just submitted as a "notification of status change" letter for addendum to the application?

    Thanks so much for you valuable help. The VA needs more people like you who actually seem to care about veterans and their families!
  4. DutifulSon

    DutifulSon Newbie

    I helped my mother apply for surviving spouse A&A benefits in May 2013. My father served in WWII but died in 1963. Mom is now 90 and in assisted living. We followed the instructions and submitted the form 21-534 with complete information (so we thought). Mom received a denial last week (March 2014) that states they denied the claim "because there is no evidence to show that the veteran's death was related to military service." This cannot possibly be correct, can it? In everything I've read about A&A, including Debbie Burak's articles and this wonderfully helpful website says that there's no connection to service-related injuries or death. The form language in the denial letter appears to treat the application as one for DIC, not A&A. The letter went on to say also that Mom's income exceeds the maximum death pension limit. Not all of the numbers they claim to have relied on are correct. Finally, they stated we did not submit medical evidence to support the A&A claim so they could not count the medical expense portion of her assisted living expenses (which we listed separately and expected it would have lowered her countable income). But in fact we included a letter from her doctor explaining her physical and health limitations. The letter talks about "reapplying" with Form 21-0779, which covers nursing homes (she is in assisted living, not a nursing home). Do we have a basis to appeal? Is appeal the best way to rectify or get clarification of why she was denied, or is there another way to communicate with the VA about the denial? Many thanks for any insight you can share!
  5. vetadmin

    vetadmin Administrator Staff Member

    You DO NOT appeal this decision. Use VA form 21-4138 Statement in Support of Claim, and nicely tell the VA that the application was not for Death Indemnity Compensation, but rather it was for the level of Aid and Attendance of Improved Pension. Include copies again of her ALF fees and any other medical costs.

    This is not uncommon for the VA to process for the wrong benefit, so it's not anything you did.
  6. Hi!

    Is there a special form I need to bring to the Doctor to start the application process?
  7. DutifulSon

    DutifulSon Newbie

    Thank you VetAdministrator! Quick follow-up question before I dig in to your advice-- must I get my mother to send the clarification (she applied under her own signature after I prepared the application for her) or can I?
  8. vetadmin

    vetadmin Administrator Staff Member

    Your Mom has to sign everything. She is the applicant, and you cannot sign for her. If she is unable to sign, then do either a thumbprint and have it witnessed by two others, or have her mark with an "X" and also witnessed by two others.
  9. Froggy

    Froggy Newbie

    Udpate: We just received notice that the A&A pension was approved under the Fully Developed Claims process. They did however find Incompetance so I'll have to do the Fiduciary process to get the back withheld payments for him; apparently what he signed when originally applying was not "Fiduciary". With regards to my other concerns:

    - They apparently already know about his wife's death back in Oct. through the cross checking with Social Security system (based upon their indicated findings to determine his pension rate) so I guess we don't need to further notify them.
    - Still not sure about notifying them regarding his move into assisted living (and relocation to different state) now or wait until Fiduciary process complete.
    - Still unclear how his homestead should should be handled and what impact that may have on his pension going forward. Would rather not have to sell at this time in a badly hit but recovering real estate area (FL).

    He's still unbelieving about actually receiving pension payments, "Nobody ever gave me anything in my entire life!" I've tried explaining to him that it's something that he earned by virtue of surviving his service time in the Pacific during WWII & Korea but he'll remain skeptical untill he sees money going into his bank account and maybe even beyond.

  10. mcsteffenson

    mcsteffenson Newbie


    My dad is a vet age 92 and had a stroke. I have just started the A+A process form him. His (and Moms)total income is $24,000 minus $3,500 for health insurance. I believe the current income limit is $19,000. Do we have any chance in obtaining funds to help with an independent living place?
  11. Max

    Max Hero Member

    Which numbers were incorrect? did you report her care expenses?
  12. vetadmin

    vetadmin Administrator Staff Member


    You do not mention if they are in a facility or paying outside services to come in and provide care. Those expenses are allowable and would bring their "countable" income down.

    Independent Living properties are not the same as Assisted Living, and the rent at the Independent is not going to be an allowable expense. If they are paying for outside services to come in, they can claim that, but it may not be enough to bring them down to the threshold.
  13. Vetkid

    Vetkid Newbie

    I have a semi-complicated situation. My mother was married to my father (WWII Vet) for 40 years and then he died. After 15 years, she remarried. Her current spouse is still living, although they have recently separated. The marriage to the current spouse occurred after November 1990. I've seen that date mentioned in several posts, but I am not sure why it is significant. To my knowledge, she receives death benefits from my father. Based on this, is she eligible for A&A under my father?
  14. vetadmin

    vetadmin Administrator Staff Member

    The reference to the November 1, 1990 date is for a divorce where a spouse may be able to still qualify for A&A. This would not apply to your Mom's situation.

    In addition just for clarification for others, she could not draw both the DIC Compensation from your Dad, and A&A. She would have to choose one or the other.
  15. Vetkid

    Vetkid Newbie

    Vetadmin, Thank you for your response. If she was not receiving DIC Compensation, would she qualify for A&A?
  16. vetadmin

    vetadmin Administrator Staff Member

    She could only be "eligible" if the 2nd husband was a veteran and his service qualified. She would not be eligible for the A&A pension from your Dad due to the remarriage.
  17. Melody361

    Melody361 Newbie

    First of all, thanks for your help! I am working on the A&A application for my mother as surviving spouse and have a couple of questions:

    1. Question about first marriages: My father was married before his marriage to my mother. I have the marriage date & name of first wife, but not their divorce date or decree. My mother was also married before - I have the dates, name and divorce decree but not the marriage license from the first marriage. Is this okay?
    2. My mother is in an assisted living facility and I am confident there will be an incompetency ruling. She will not understand this paperwork. Also, she broke her right arm 2 weeks ago and would have a difficult time physically signing the application. Should I try to get her to make an "X" or can I sign my name and indicate I am signing on her behalf?
    3. Her doctor is completing the evaluation form. Does she also need the list of doctors & hospital visits for the last 12 months or is that just for the veteran?

    Thank you!! :)
  18. VA Legal Team

    VA Legal Team Full Member

    "My dad is a vet age 92 and had a stroke. I have just started the A+A process form him. His (and Moms)total income is $24,000 minus $3,500 for health insurance. I believe the current income limit is $19,000. Do we have any chance in obtaining funds to help with an independent living place?"

    The key question to ask is whether your parents are paying someone for activities of daily living (bathing, dressing, transferring, toileting, eating).

    If they are, they may be eligible for A&A. If they aren't, I'm afraid they won't be eligible.

    The VA will count ILF's as an unreimbursed medical expense in some situations. But unless your parents are paying for ADL's, it's a moot point.
  19. vetadmin

    vetadmin Administrator Staff Member

    99% of the time, the VA is NOT going to allow the rent at an Independent facility as an allowable expense. If paying for outside services to come, those expenses are allowable.
  20. VA Legal Team

    VA Legal Team Full Member

    I respectfully disagree. Fast Letter: 12-23 explains when the VA will count IL as an UME.


    I've seen IL counted as an UME on many occasions.

    With that said, no one should could on an A&A award when the applicant lives in an ILF unless that person is paying for ADL's and follows 12-23 to the T. I'd say most denials are based on excessive income, which is the result of the applicant residing in an ILF and not paying for ADL's.

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