Now what do I do?

Discussion in 'General Discussion' started by 90degreesok, May 16, 2011.

  1. 90degreesok

    90degreesok Newbie

    Great forum, has helped alot, thanks. My Mom is now receiving $274 per month since I applied for her in November based on my Dad's service. Two questions. It looks like VA has determined, correctly, that she cannot accept the funds so what form do I submit so my brother can be the official acceptor of the funds (he's already on her joint bank account). Second, Mom is living in a independent/assisted living facility. She gets twice daily med reminders and insulin shots. From what I can determine, the VA did not include these med services or her monthly rent in her expenses, nor did they include out of pocket prescription costs. They said Medicare Pt D will be considered next year. Do I complete another form to have them include these other expenses? Are they legitimate expenses?Any advice is truly appreciated!
  2. vetadmin

    vetadmin Administrator Staff Member

    Is your mom in a Holiday Independent property?
  3. 90degreesok

    90degreesok Newbie

    No, it's a facility that has about 1/2 of the residents in Independent living and the other 1/2 as Assisted living. She was accepted into the Independent living section in October but with an exception that the facility will dispense her meds and insulin for additional costs due to her short term memory issues. Meals are provided in a dining room.
  4. vetadmin

    vetadmin Administrator Staff Member

    When your mom got the award letter, was noted the determination that she was "incompetent" to handle her own affairs? If so there should have been something included with that letter allowing your brother to file a request to be appointed her Fiduciary.

    Is the facility actually giving the injections to her?

    The following are allowable medical deductions:

    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,

    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" income
  5. 90degreesok

    90degreesok Newbie

    The letter from the VA states "A finding of incompetency is proposed". We agree with that assessment. There was no form to complete to assign a fudiciary. The instructions contained information that the VA will base their decision (of they don't hear from us in 60 days) about incompetency on the evidence they already have and we can send additional information to present our side of the case. We didn't because we agree with them. Now that 60 days has passed, we assume they will make a final decision and send us a form to complete for the fudiciary, does that sound correct?

    Yes, the facility is giving her the injections.

    Additionally, the letter stated that her Prescrip and Insulin Help costs were "not a projectable medical expense". What is that and what should/can we do about that?
  6. vetadmin

    vetadmin Administrator Staff Member

    You need to get a Statement of Occupancy from the facility if you did not already turn one it with the original application showing all the services being provided. If she has to have insulin every day, then yes it is predictiable as she requires it every day.

    Their finding of her to be incompentent warrants the full award and they need to allow for the rent in the ALF, which will bring down her countable income.

    You can do all this with the VA form 21-4138 Statement in Support of Claim. You also need to see this FAQ on the site on how to apply for the appointment of Fiduciary.

    Hope all this helps.
  7. 90degreesok

    90degreesok Newbie

    I will submit form 21-4138 to support the expenses.

    I did read the FAQ regarding the fiduciary assignment. Do I use form 21-4138 or 21-22A, as I am not sure which is correct.

    Thanks for all you do, this helps tremendously!!!
  8. vetadmin

    vetadmin Administrator Staff Member

    You are most welcome.

    You can use the 21-22a, but you also want to do the 21-4138 clearly stating who is requesting to be appointed which should be the same person noted on the 21-22a.

    The 21-22a is an older form that was used before the introduction of the 21-0845 Approved 3rd party. It used to be used so that the VA would talk with the person who had been delegated as the Claimant's Representative.

    You will also use the 21-4138 to show the additional proof of expenses that need to be counted.
  9. 90degreesok

    90degreesok Newbie

    Thanks again, I really appreciate your help.
  10. vetadmin

    vetadmin Administrator Staff Member

    You're welcome. Having been that daughter for 9 years, I'm glad to do so.
  11. caregiverx2

    caregiverx2 Newbie

    Medical expenses - regular prescriptions

    Debbie, I'm challenged to understand why VA has you report all unreimbursed medical expenses you paid for dependents you are under an obligation to support....then not count accept.

    VA letter stated, "We were not able to accept your estimated December prescription costs as submitted. We also could not determine from the pharmacy print out, what your actual amount paid was for November & December."

    Print out attached to application was by month with totals for veteran & spouse, separately.

    Both Veteran & spouse were in 'catastrophic coverage' on Medicare D prescription drug plan, which didn't accurately represent the months they were in the 'donut hole' with no insurance co-pay. Parents annual NET income has been in the RED for the last 5 years & we were hopefully they would receive full award. I've been caring for both parents the last 4 years & forced to quit my full-time job 2 years ago. They do not own a home or car.

    Do you think sending a Statement in Support of Claim VA 21-4138 with further explanation would help our cause?


  12. Fit2009

    Fit2009 Sr. Member

    to get the medical expenses counted in the monthly award calculation the medical expense must be the same amount every month - otherwise it is "not predicatable" - but, not all hope is lost, you can submit the expenses that were not covered at the end of the year and they will issue you a lump sum check for unusual unreimbursed medical expenses. You have two years after each yearend to do this.
    BTW, If they pay you the same amount each each month, you can claim that.

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