Similar Claim different Outcome so far

Discussion in 'Share Your Personal Experience' started by maralina1, Jul 2, 2011.

  1. maralina1

    maralina1 Full Member

    I am comparing my dad's claim with " Hallelejah award received " post on 7/1

    4/18--sent form 21-4138 (statement in support of claim)

    5/5-- recieved letter from Va saying form was incomplete

    5/8--sent completed application and included:

    Form 21-526 ( application for compensation and/or pension

    Military discharge statements

    Income statement (SSA income )

    Form 21-4141- Consent to release info to the VA

    Form 21-2680= MD evaluation

    Form 21-0845- Authorization to disclose info to third party (my mother)

    List of MDs seen regularly

    A letter from myself(daughter) stating I am the caregiver, what my duties include, how many hours I work, what I am paid- dated and signed by myself anf both parents.

    Note from my mother saying she would like to be appointed fiduciary

    Did not include- form 21-22a or any receipts (was advised they were not necessary)

    5/17- Recieved letter from VA saying they would like to decide promptly but because of large number of claims yours could be delayed

    This was sent to Philadelphia
     
  2. vetadmin

    vetadmin Administrator Staff Member

    What may be the hold up here, is the note from your mom asking to be appointed as Fiduciary.

    It is best to not address this in the initial stages as it will flag the file. You want to wait until the VA makes the ruling of incompetency based upon the Dr's evaluation.

    It is best to let the application go through the entire process to get the award, and then address the Fiduciary appointment. Without realizing this, you may have encountered a "speed bump".

    Let's hope you hear something soon.
     
  3. maralina1

    maralina1 Full Member

    Okay, thanks for the advice. We included the note hoping it would speed up the processs not knowing it might delay it.

    Also, sorry for all the mistakes I've made with this forum format. I'm new to all of this.
     
  4. Max

    Max Hero Member

    Keep in mind that the letter that says "we are working on your case, but it might take awhile" or whatever is an automatically generated letter that is sent to everyone with a pending claim. Since your claim needed development (i.e. a letter requesting documents since the original claim was incomplete), they sent out a letter which requires VA to wait at least 30 days before making a decision. I would bet good money that your case is probably with Philly's rating board for a rating decision. Call the call center or go on iris.va.gov and ask to find out if a rating decision has been made. If one has been made, ask them if there has been an incompetency proposal. If there is, then you know that you'll have to go down the fiduciary route.

    Please let me know if you have any questions as I know that this is a lot of information all at once.
     
  5. maralina1

    maralina1 Full Member

    Actually, I just spoke to my mother about all this. She called on 6/20 inquiring on process and was told it was in very beginning stage. Then yesterday (7/1) she recieved a letter again saying they would like to decide promptly but because of large number of claims yours may be delayed.
     
  6. maralina1

    maralina1 Full Member

    If we have to go down the fiduciary route, will the process take a lot longer?
     
  7. Max

    Max Hero Member

    Yes, the fiduciary process unfortunately takes awhile. You should call again and tell them that it has been longer than 30 days and that the claim should be reviewed. 6-20 was also two weeks ago and the situation could very well have changed by now.
     
  8. maralina1

    maralina1 Full Member

    My mother called the VA today in reguard to progress of claim. She was told the claim was almost complete with the initial phase. She did not ask if my father recieved a rating as I suggested. Does anyone know what this means? The representitive filed a report requesting the claim be expedited because of my Dad's worsening condition.
     
  9. Max

    Max Hero Member

    The claim is probably pending a rating decision. This is good news. If I were a betting man, I'd say you have another 5 weeks to go.
     
  10. maralina1

    maralina1 Full Member

    My mother called on Friday and was told my father has been rated and the claim was in the final stage of processing. They need to go over it and proofread before decision. They should recieve a letter in 7 to 10 days. Hopefully good news.
     
  11. Max

    Max Hero Member

    Did I call it or what? ;)
     
  12. vetadmin

    vetadmin Administrator Staff Member

    :D Great news and great call!
     
  13. maralina1

    maralina1 Full Member

    I guess you're both saying the claim will be approved?
     
  14. Max

    Max Hero Member

    More than likely.
     
  15. maralina1

    maralina1 Full Member

    My mother called VA again today to see if claim had been approved. She was told previously that claim was in final stage and needed to be proofread. She was told this time that a medical expense report was mailed out and she should recieve it within a day or two. I am confused. Shouldn't this have been addressed earlier? What type of info do they need? The only proof of payment to me is cancelled checks. Is this sufficient? I already sent a caregiver statement. We can also send pharmacy printout. All MD visits and pharmacy payments were payed in cash. Any idea how much longer this will take after they recieve this info?
     
  16. maralina1

    maralina1 Full Member

    I forgot to add the following: The expense report is for May to the present. Why wouldn' they send the incompetency form along with this?. I thought this needed to signed before any previous payments could be sent. Also, does anyone know why they didn't call asking for this information earlier like they did for the "Halleiujah" claim? The medical expense report and waiver was faxed and the claim was approved in a month.
     
  17. maralina1

    maralina1 Full Member

    Actually received the letter from VA today. It states "what we still need from you": They are to fill out Form 21-8416 (Medical Expense Report) from May 10 to present.For medical expenses paid after the date of claim.

    Documentatiion from me as the caregiver. It also must include proof of payment to me. We only have cancelled checks dating back to April. I have been caring for my dad for over 1 year. However, I was payed in cash most of the time. Should I state this?

    Also, received statement in support of claim form. What is this for?
     
  18. Max

    Max Hero Member

    Where is the claim being processed?
     
  19. maralina1

    maralina1 Full Member

    Philadelphia. Should we just submit expenses from May to present along with pharm. printout and cancelled checks to me? That would complete that part of info that is needed.

    The other part is proof that my parents have paid home attendant expenses. I am supposed to submit a signed letter explaining what I receive as payment for care and date of hire. They said that they have received a statement from me with original claim, however there was no proof of payment. We are to include information below:

    Documentation includes: a receipt bill, statement on the provider's letterhead,computer summary, ledger or bank state ment.
    The evidence submitted must include: the amount paid. the date payment was made. the purpose of the payment( service provided), the name of the person the service was provided, identification of the provider to whom payment was made.( cancelled checks are acceptable proof of payment) I was paid cash until this April.

    What do you suggest? Also, what do we do with statement in support of claim form? thanks.
     
  20. Max

    Max Hero Member

    Did you actually receive the letter yet?
     

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