Some help with forms please

Discussion in 'Surviving Spouse Application' started by boardt, Dec 9, 2015.

  1. boardt

    boardt Newbie

    I am applying for the Aid and Attendance for my mom.. well, I am filling in the paperwork for her.

    Here is what I have so far:
    My dad's discharge papers (DD-14)
    Copy of their Marriage Certificate
    Copy of my dad's Death Certificate
    Copy of my mom's SS award letter
    Net worth info - What do I need here? She doesn't own a car or home or anything really. Lives in small apartment.
    Proof of all income - (Pension letter) and SS Letter
    Proof of Insurance Premiums (this is included on the Pension letter - it shows what she pays for 3rd party Health care
    Physician Statement -Form 21-2680 and Nursing Home Status Statement
    VA Form 21-534EZ

    My questions are this:

    1) Do I need to fill out the following sections on form 21-534EZ?
    Section IV: Dependent Children (Complete Only If Claiming Benefits For A Child of the Veteran) - I am not claiming any benefit, but still wasn't sure if I needed to put anything here.
    Section VI: DIC (Complete Only If Claiming Dependency and Indemnity Compensation (DIC)) - I am not sure what this means... do I need to fill this out? If so, what box(s) need to be checked

    Section VII: Net Worth (Complete Only If Claiming Death Pension or Parents DIC) - Again, what if anything do I fill out here? She only has her bank account and nothing else. No 401k, no IRA, no stocks, etc. Doesn't own any property.

    Section VIII: Gross Monthly Income (Complete Only If Claiming Death Pension or Parents DIC) - I have listed Social Security and for OTHER I put in her pension amount. Is this correct?

    Section IX: Expected Income (Complete Only If Claiming Death Pension or Parents DIC) - There is no other expected income except what is from SS and Pension. No Wages or Salary, so I put in 0. Is this correct?

    Section X: Medical, Last Illness, Burial, or other Expense (Complete Only If Claiming Death Pension or Parents DIC) - Is this were we list prescription costs and cost paid to care providers?

    I really appreciate any assistance. My mom is in very bad health with COPD and many other conditions so I am trying my best to fill this out and get it processed as quickly as possible. We can't afford to pay someone to fill out the forms. I called around and places want $1000 or more. So I found this site and was hoping that I would get some help here.

    Thank you.
  2. Kaylin

    Kaylin Hero Member Staff Member


    1) You do not need to fill out the Dependent Children section if it does not apply. You are filing for Death Pension if you are filing for Aid and Attendance, NOT the DIC compensation.

    2) For net worth, I recommend using this form we have for countable income (

    3) Gross Monthly Income--please refer to Number 2 and the document I included. It seems correct what you are indicating on the form.

    4) Expected Income, your instinct also seems correct. If your mother is not expected to receive any other countable income.

    5) Yes, this is where you list the costs of care and prescriptions.

    Also, note that it is illegal for someone to charge you to help fill out the Aid and Attendance application. Please do not let anyone take advantage of you in this way. I hope these help answer your questions and feel free to use our entire website and forums for your inquiries.


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