Service Connected vs Non Service Connected disability for Aid and Attendance

Discussion in 'General Discussion' started by robzebr, Jul 3, 2013.

  1. robzebr

    robzebr Newbie

    Hi,

    If I'm wrong anywhere please correct me... thanks in advance..

    My dad is WWII vet that receives a non service connected disability pension. My Dad is 89.

    A Non Service Connected pension is for those vets whose disability DOES NOT stem from time in the military. It stems from a need that started occurring after their time in the service... hence the name "Non Service Connected Pension".

    A Service Connected Pension is for those vets whose disability occurred as a direct result of their military service. An example is someone who is injured in battle or an accident while on active duty in the military.

    I have been on no less than 10 different websites that list the requirements for Aid and Attendance benefits as follows... Must be over 65, must have served in the military during time of war, must meet the income level requirements and must need the help of another person for their personal attending to... (all the usual actions... dressing, bathing, errands basically the usual personal and household activities.)

    And that is it. Most of the sites do not mention "Service Connected" or "Non Service Connected". They just say a vet is qualified if the above criteria are met.

    I saw at least 1-2 websites (Veteran advocate sites and legal websites that offer Aid and attendance assistance. They both said that the Aid and Attendance is a NON SERVICE CONNECTED pension benefit which means the disability did not have to occur during the vets military service.

    I applied for Aid and Attendance for my Dad to the VA using Form 21-2680 Examination for Housebound Status or Permanent need for regular aid and attendance.

    His primary care physician filled out my Dad's current condition. On line 19 it asks "What disabilities restrict the listed activities/functions?"

    His doctor wrote, CHF, AFIB She is treating him for Congestive Heart Failure Atrial Fibrillation.

    His request to the VA was denied. The reason stated was:

    "Entitlement to an additional payment of compensation is established when Service Connected impairment imposes a special level of disability. Entitlement to special monthly compensation is not warranted in this case because the criteria regarding Aid and Attendance have not been met."

    REF. 38 CFR 3.350 (this is the Title 38 Code of Federal Regulations regarding pensions.. here it is on Amazon.. http://www.amazon.com/Federal-Regulations-Pensions-Bonuses-Veterans/dp/0160911818/ref=sr_1_1?ie=UTF8&qid=1372869020&sr=8-1&keywords=codes+of+federal+regulations+title+38

    "The benefit is payable for being so helpless (due to SERVICE CONNECTED DISABILITIES)
    as to be permanently bedridden or in need of regular aid and attendance.

    "You supplied VA form 21-2680 completed by your doctor. On this form the doctor indicated that you require Aid and Attendance due to the effects of congestive heart failure and atrial fibrillation: You are not SERVICE CONNECTED for either of these conditions.

    I researched into Title 38 Code of Federal Regulations and in section 3.350 it mentions that a vet with a disability occurring during their military service may apply for Aid and Attendance.

    I didn't see it mentioned in that section as to NON SERVICE CONNECTED pensions.

    Are all these websites and legal sites wrong when they say (specifically) that Aid and Attendance is a NON Service Connected Pension.. meaning any vet can get it not just those that received their disability as a result of their military service?
     
  2. robzebr

    robzebr Newbie

    This is an example of what I am talking about...

    https://www.youtube.com/watch?feature=player_detailpage&v=MTvHuBQm_TI

    He specifically says that the disability does not have to be service connected in order to qualify for A&A.

    At time :20 and then later at time 2:00
    They both say that this benefit is a NON Service Connected Pension. It is not (solely) for those vets that have a service connected disability....

    https://www.youtube.com/watch?feature=player_detailpage&v=es8RQGKDq6M

    I'm pretty confused... She says that this benefit has nothing to do with wartime disabilities... it has to do with things that happened after the war... the requirement is that you have to have served not that your current disability is wartime service related...

    So according to this... My Dad should qualify.... He was denied because his current disability which is just age and CHF/AFIB was not a Service Connected Disability....

    So which is it? Only Service connected disabilities like the VA said on my Dad's claim... .. or Non Service Connected disabilities that any vet acquires just by making it into their 90s....

    I'm meeting with my Dad's rep at the VA Regional office next week... so any comments would be helpful as I prepare for the meeting....
     
  3. Red Headed Mommy

    Red Headed Mommy Jr. Member

    It is correct that aid & attendance is non-service connected disability...

    Maybe the issue is that the physian's statement did not document to the VA's satisfaction that your Dad requires the regular attendance of another person to assist in eating, bathing, dressing and undressing or taking care of the needs of nature. It also for individuals who are blind or a patient in a nursing home because of mental or physical incapacity. Assisted care in an assisting living facility also qualifies.

    To qualify for A&A it needs to be established by your physician that you require daily assistance by others to dress, undress, bathing, cooking, eating, taking on or off of prosthetics, leave home etc. You DO NOT have to require assistance with all of these. There simply needs to be adequate medical evidence that you cannot function completely on your own.

    Maybe you could submit a statement of claim elaborating on this area-why you dad needs daily assistance.

    Good luck!

    Ps-you are working so hard on behalf of your Dad.... So commendable!!

    Initially, I too checked out other websites, but I have found this website to be MORE than sufficient. For me, I had to be careful not to "over think" the process and just focus on how to get my father in law the benefit I knew he qualified for :). I had to break it down to 1. Service qualification, 2. Asset qualification, 3. Financial need (his negative countable income qualified him for full benefit), and 4. Medical requirement.

    I then tried to make sure each of these areas was easily communicated in the paperwork....I figured the VA rep was SO SWAMPED, let me make it as easy as possible for them to approval the paperwork....:)

    Hang in there...
     
  4. robzebr

    robzebr Newbie

    "Maybe the issue is that the physian's statement did not document to the VA's satisfaction that your Dad requires the regular attendance of another person to assist in eating, bathing, dressing and undressing or taking care of the needs of nature."

    This was what was on Form 21-2680

    When I gave this to the doctor to fill out... I gave her two...

    The first one was a template completely filled in by me in the parts that talk about his daily needs... so she took that and on the blank one... she filled in the medical jargon and then just used what I had written on the template in the daily needs section...

    Line 23: Does the claimant need assistance in bathing, and tending to other hygiene needs?

    ans: Yes. assistance in and out of the shower, shaving, sometimes falls..

    Line 26: Does claimant require medication management?

    ans: Yes. Needs assistance keeping accurate med dosage, not able to keep track of meds.

    Line 27: Does the claimant have the ability to manage his/her own financial affairs.

    ans. No. needs someone to do his banking, shopping, housework, all household activities.

    Questions 28,29 30 all ask to describe how he physically is... upper and lower extremities, general condition...

    ans. unsteady gait, walker bound, exertional shortness of breath, decreased coordination, mild tremor, difficulty of fine movements, able to feed himself, needs assistance for daily living.

    ... poor balance, weak extremities, advanced age, loss of memory, poor balance..

    Question 34: Are aids such as canes, walkers, or the assistance of another person required for locomotion? If yes describe the effectiveness in terms of distance ... 1 block, 6 blocks 1 mile...

    The doctor checked yes and "other" and wrote "minimal distance measured in feet"

    The specific reason it was denied was line 19
    What disabilities restrict the listed activities and functions?

    The doctor wrote: CHF, AFIB

    The VA said ... CHF and AFIB is not a Service Connected Disability.

    My feeling is that the way the VA is structured.. somebody gets a applicants file assigned to them... They work the case ... do a little research in Title 38.. in this case they cited Section 3.350... do a cut and paste to get the verbiage and put that in the reason why it was denied...

    ... finish the letter and then the Veterans Service Center Manager either physically signs it... or they have one of those auto signing devices...

    I can't believe that the Center Manager personally signs every letter to every applicant... not possible.

    So what what you possibly have is a 1st year VA employee that has never even heard of Aid and Attendance ... Aid and Attendance according the youtube video is not a used term inside the VA... Most VA employees don't know what that is.... and as its estimated that only 11% of the vets who qualify take advantage of it ... that means that the VA employees rarely if ever even have to deal with it...

    So its not surprising that they get it wrong....when they actually see somebody apply for it...

    This is something that you want to have access to.. you can buy the hard cover or this is the electronic version... I don't know if the electronic version is complete. I am going to get on AMazon and buy the hardcover and take that with me to my meeting at the Regional Office..

    If it doesn't come in time then I have to print out at least that section that the VA used to reference why the claim was denied. Pretty powerful stuff.. to walk into the VA with their own reference book on how they made determinations...

    http://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=b1b9adcdd9beb3297369ccb6821cb4d5&ty=HTML&h=L&n=38y1.0.1.1.4&r=PART
     
  5. robzebr

    robzebr Newbie

    I didn't know that the caregiver expense needed to go on the 526 form when it was originally filled out 7/2012. So probably the claim would have gotten denied anyway because there was no caregiver expense to offset the income... it was ultimately denied as a service connected claim...

    The advice given was to not fill out a new 526 and just state that I want to apply for my Dad as Non Service Connected Pension with Aid and Attendance... and just use the Statement in Support of Claim....

    Regarding the Caregiver expense... should I just explain that on the Statement in Support of Claim...?

    I'm afraid they will just go back to the original 526 and do the numbers based on that....and not realize that the caregiver expense information is explained in the Support Claim....

    Or should I do a new 526 and add in the Caregiver expense

    Should I add the Caregiver expense on a new 526 or just explain it on a Statement in Support Claim...?

    Which would have more probability to go through without a another kickback..?.

    I would hate to have it denied again because the person doing the numbers didn't see it explained on the Statement in of Support Claim...

    Does anybody know if 1 person does each claim fully .. or does it get assigned to different people for different parts and then brought back together.. If different people do it... then the person doing the 526 wants to see that caregiver expense on it otherwise he/she will fail the claim because of the numbers.....
     
  6. Max

    Max Hero Member

    You can elect to receive pension instead of compensation at any time, but your father is receiving nearly $2,800/month for compensation and the maximum on pension is a little over $1,700/month.

    The law does not allow a veteran to receive both benefits.

    When you submitted the VA Form 21-2680, VA accepted it as a claim for special monthly compensation (the only possible way VA could pay him more money), but they were unable to grant because the conditions requiring aid and attendance were nonservice-connected. If your Dad submitted a statement saying "I elect pension instead of compensation," then they might grant him pension instead, but it will definitely be less money.
     
  7. robzebr

    robzebr Newbie

    This is off the Veterans Compensation Rate Tables.

    70% - 100% Without Children

    Dependent Status 70% 80% 90% 100%
    Veteran Alone $1,293 $1,503 $1,689 $2,816

    So with my Dad receiving 2,816 as 100% that would concur with what the VA rep was telling me that my Dad was getting the max....

    The only mention for AA in this 70%-100% section is with regards to spouse in this case n/a.

    70% 80% 90% 100%
    Additional for A/A spouse (see footnote b) $101 $115 $129 $144

    I'll keep digging but it looks like its a no go getting A&A for my Dad because that would put him over the max.... there is a provision for other cases but that involves injuries sustained as in loss of limbs etc...
     

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