Mom medically approved last year but...

Discussion in 'General Discussion' started by Dru, Apr 5, 2008.

  1. Dru

    Dru Newbie

    My mom was medically approved for A&A in November, to be effective starting April 2007. I was told by a very nice VA counselor that she could not be financially approved until she actually moves into assisted living. Because one member of the family did not want her to be put into assisted living, we have delayed doing it. But now she is having more memory problems and she will require assisted living for sure. Can someone point me to the form that I need to reapply for financial approval, and does anyone have any experience with how long this might take. She has very little money to carry her til the approval comes through. It is my understanding that she will not need to be approved medically again. Also, if her house is sold to help pay for assisted living, would that income have to be counted against her financial approval situation? Thank you.
     
  2. Dru

    Dru Newbie

    I just want to add that I have located the forms that I think I will need for the reapplication. Forms 21-8416 and 21-0518-1.
     
  3. veteranadvocate

    veteranadvocate Full Member

    My mom was medically approved for A&A in November, to be effective starting April 2007. I was told by a very nice VA counselor that she could not be financially approved until she actually moves into assisted living. Because one member of the family did not want her to be put into assisted living, we have delayed doing it. But now she is having more memory problems and she will require assisted living for sure. Can someone point me to the form that I need to reapply for financial approval, and does anyone have any experience with how long this might take. She has very little money to carry her til the approval comes through. It is my understanding that she will not need to be approved medically again. Also, if her house is sold to help pay for assisted living, would that income have to be counted against her financial approval situation? Thank you.

    It is difficult to answer your questions without some clarifications.

    • Did the VA make an official decision on your Mom’s claim or did the VA counselor just advised you that your Mom would not meet the income/expense limits until she enters into an assisted care facility?

    • Was your Mom’s income considerably over the income limit?

    • Did she have any unreimbursed medical expenses to reduce her income between April 2007 and April 2008?

    • Did she have any in-home health care expenses or paid any friends or family members to assist her? If so, these expenses can be counted to reduce her income and could entitle her to some retroactive payment from the VA.

    The sale of her house will not be counted as income but the money will be considered with her assets.

    Those are the correct forms, if your Mom submitted an actual application and it was denied due to income.


    The Veteran Advocate
     
  4. Dru

    Dru Newbie

    Yes we did apply for her. The letter of decision states "Entitlement to aid and attendance allowance for (my Mom) is established effective April 30, 2007. Further down it states "The evidence shows your income effective April 30, 2007 exceeds the maximum annual limit set by law for death pension at the aid and attendance rate." It further states that "you may reapply for your death pension when your income drops or the medical expenses you pay increase."

    However, if she goes into the assisted living home, her expenses will go up dramatically and can be counted against her income. If we have figured correctly, she would be entitled to nearly the maximum A&A allowance after she enters the home. Her annual income is $19,268. She has no assets other than her house (worth about $70-75K) and about $9-10K in a savings account - that is what would be used to pay for the assisted living until her benefit comes through. (She gives $300 a month to a disabled daughter and her husband, but that does not count as an expense.) $1122 for supplemental medical insurance did count as legitimate expense.
     

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