Success Story -- We Hope !!

Discussion in 'Share Your Personal Experience' started by LQQKnMarion, Jan 1, 2008.

  1. LQQKnMarion

    LQQKnMarion Newbie

    I've been sitting and reading through this forum for about an hour deciding if I should post and where.
    This question is an excellent place to start.

    I can't thank NBC Nightly News and VeteranAid enough for the information I and my sister learned this past Feb. ('07). It was after one of the NBC News programs on adult children helping aging parents that the A & A benefit was mentioned. I followed the link on their web page to VeteranAid, and am so glad that I did so.

    My father was a WW II veteran, and he and my mother have lived in assisted living since the spring of 2004. He passed away in Oct. '04, and my mother continued to live in assisted living. Not being a wealthy family by any means, the proceeds from the sale of their home, their savings, IRA's, and small investments have been greatly consumed by the $ 2,500 to $ 3,000 a month facility charges.

    We were in the process of moving our mother from one facility to another when I read about the A & A benefit. I had talked to some one from the VA in Ft. Wayne, IN the year before about this benefit but he did not know that the monthly fee for assisted living was a countable expense itself. After reading all of the information on this site, I contacted my county's Service Officer. He knew about this pension benefit, and that it did pay for assisted living fees. Since my mother was moving out of county, he directed me to that county's Service Officer.

    After talking to that Officer, he was not sure if the facility she lives in would be considered "assisted living" by the VA as she lives in a portion of the facility termed "independent living". This is part of a large facility housing skilled care, Alzheimer's care, assisted living, and independent living. BUT, she gets and uses the services that would be considered "assisted care" by most any one. She does not require direct hands on care, but can not cook for herself, could not live alone, can not live with any of her children as she really requires some one being near by in case of a fall, etc.
    In this facility she receives all of her meals, has housekeeping provided, they do all of her laundry, has 24/7 nursing care available if needed, access to family physicians, etc.

    So, "we" (my sister and I ) decided it was worth a shot to apply. (Even though the Service Officer thought it would be a long shot). He and his secretary helped us get the correct forms. (I downloaded them from here after I knew which # form we needed to use.) She worked on the forms this summer. I helped her get copies of the needed documents, and worked on getting letters from all of her doctors to document "need" to be in assisted living.
    (She is 85yrs old, is legally blind in one eye, has no real grip strength in her hands, a torn rotator cuff on her dominate side, loss of balance that puts her at a risk for serious falls, on & on.) I took a copy of the VA's own press release about the A & A benefit with the most important parts highlighted to each of her several doctors. (Primary care, neurologist, ophthalmologist, orthopedic surgeon)

    In that VA press release I highlighted this portion of the "basic criteria": " as well as those who have a physical or mental injury or illness that requires regular assistance to protect them from hazards or dangers in their daily environments."
    All of the physician's statements pointed out her diagnoses, and limitation very clearly. Each one of the doctors stated that she either required or would benefit from living in assisted living.
    The application itself asks if the applicants vision is limited.

    I also got a statement from the facility she lives in stating the services she receives on a routine basis, and the other services like nursing care, doctors, etc. that she can use if needed.

    I took the application to the Service Officer and his secretary in September. They corrected a couple of couple of items, and helped in fill in expense section. He also had my mother sign a form making him a power of attorney of sorts in order to follow up on any questions, or problems after the application was submitted. He mailed the application to a state of Indiana American Legion office in Indianapolis. I guess that AL office is recognized by the VA as a "Service Office" and is able to submit applications to the VA for a veteran or his/her spouse.
    Within a few days of that, my mother received notification that the AL had submitted the application. It noted the form #, and each of the attachments (documents, and letters).

    The local Service Officer told us it could be 6 to 12 months before we might hear any thing about the approval / denial.

    The Good News -- About a week before Christmas she received a letter from the AL in Indianapolis stating that the VA " will soon approve your pending application." !!! It instructed her to contact that office or the local Service Officer if she has not gotten a letter from the VA within 4 weeks.

    So, it's only taken the VA a little more than 3 months to review and approve her application.

    She is still "skeptical" , and will only "believe it when she sees it". But, I read the Legion's letter again, as has my sister. The Service Officer has also been sent a copy of it. It's short and to the point. "will soon approve".

    I'll let you know when we get the actual award letter.

    I'm just sure that having all of the documents together, and having worked with the local Service Officer were both important factors in the VA being able to approve it this quickly.
    This Service Officer and his secretary were very thorough in reviewing the application. I think having the American Legion in Indianapolis review and submit the application was helpful. I'm sure if any one there had found some thing missing, we would have been asked for the document or information before they submitted it to the VA.

    <--- Fingers crossed, and waiting to hear my mom's voice when she calls to read the VA's approval notice.
     
  2. veteranadvocate

    veteranadvocate Full Member

    That does sound like good news. We will be waiting to hear the confirmation. I think the key was the work that you and your sister completed in getting all of the documents together. This saved the VA from having to request the information and cut down on the processing time.

    Glad to see that you did not take no for an answer from your first contact.

    Keep in mind that there will be a yearly EVR form that will have to be completed or the benefit will be terminated until the VA receives it. The VA will mail it to your mother when it is due.

    Thank you for sharing the good news with us.
     
  3. LQQKnMarion

    LQQKnMarion Newbie

    UP DATE 3/04/2008

    The American Legion got a little ahead of itself. Mom's application was probably "approved", but the VA still had to confirm her income, expense, and asset information.
    Mom received a call from a lady at the VA in INDY yesterday, and passed along my number to her.
    I talked to her this morning. She needed updated asset and medical expense information.

    Mom's application should be finished up, and passed on her Supervisor today. If all of the calculations are correct, a letter and check should go out to Mom in 2 to 3 weeks !!

    This woman was very. very nice. Told me "you have my number if you have any questions."

    Patience is a must in this process. AND--- Keeping in contact with your County Service Officer.
    The local Service Officer and his secretary were great in tracking down why we didn't her any thing from the VA by the end of January.

    I'll give you a "final" notice when "the check arrives"! ( None to soon, as my sister is depleting Mom's assets rather quickly to pay her monthly assisted living charges. That 1st check should be enough to pay about 4 months charges. )

    TC

    (Thanks Debbie for catching my "date" error. I can't believe March is here! I'm ready for spring...we're having an ice storm and snow today! )
     
  4. LQQKnMarion

    LQQKnMarion Newbie

    I spoke WAAAY too soon.

    Not having received any letter from the VA as of today, I called the lady at the VA in Indianapolis that I spoke to on March 4th. Left a message for her.

    She just returned my phone call, and said that my mom would be receiving a letter soon saying she has been denied the A & A benefit.

    This is based on her assets being too high.

    What I understood from her was basically my mom would have to spend down her assets to almost zero, which at that time would leave her with just her SS as income each month. Then, she could reapply to have the A & A bring her income up. Like: (Expense for assisted living per month) minus (assisted living +other medical expenses) = x dollars. The VA would then pay up to the monthly limit toward the "x" dollar amount.

    Is this correct ?? If so, we've misunderstood some where along the line, or read clearly.
    We didn't realize that the assets had to drop to zero before the benefit would apply.

    Either way, it will help in the long run since her SS + the maximum benefit would be about 2/3rds or so of her monthly assisted living care.
    This way, she's just going to have to move to a "one room" vs. a "two room" situation a little sooner.


    Does this all seem correct??????
     
  5. veteranadvocate

    veteranadvocate Full Member

    I recommend waiting until you receive the official letter from the VA and then we can work with facts and not 'what ifs'. I don't feel you are being provided the whole story and all of the facts. I would hate to compound the confusion by guessing at what the VA is doing or not doing.

    I will be happy to respond with my recommendations after you receive the VA letter. I'll be looking to hear back from you.

    The Veteran Advocate
     
  6. LQQKnMarion

    LQQKnMarion Newbie

    I hope you got my "long" explanation / update I sent from the message you had sent to me here on the forum. When hit "send" ( or submit) it was gone... but I don't see any out going messages listed in my "out" box. lol I didn't want to type it all over again if you did get the message.
     
  7. veteranadvocate

    veteranadvocate Full Member

    I did not receive any messages from you. Maybe Debbie can see if it got posted to another section of the forum. That stuff is all greek to me. I will get back to you as soon as I receive the info in question.[/color]

    The Veteran Advocate
     
  8. vetadmin

    vetadmin Administrator Staff Member

    For clarification, VetAdmin got the message and has forwarded to Advocate.
     
  9. LQQKnMarion

    LQQKnMarion Newbie

    Update:

    I spent a couple of hours with the Service Officer today. He had not received a copy of the info. that was mailed to mom. The woman at the VA in INDY didn't fax him any thing last week either. ( She didn't call either my self our my mom to let of know she didn't do that. )

    He read every thing over. He too was "stumped" because the VA did not show the dollar amounts they used in consideration of assets, or income. No way to verify the information they used was correct. He said
    "they" (the VA) keeps him / his secretary.. other service officers in the dark on asset guidelines used.
    And, he wasn't completely familiar with the calculation of the benefit.
    (
    He wanted to know whom I had talked to last week/ the first of March. I had forgotten to bring her telephone number with me.

    He got on the phone with someone... at the VA in INDY I think... he didn't put her on a speaker phone , but she had access to mom's claim and was going over it with him . ( He was looking at what his secretary had scanned in of her original application.)

    He learned "some thing new" today. lol The woman told him to be considered financially the general guideline is that one's combined assets and income should be less than $ 80, 000. Mom should meet that test. ( He said the VA has told him in the past 50 to 80 thousand.)

    Then, she went over how they calculate the benefit. He had to run over that a couple of times with me after he hung up with her.

    It all sounded correct from the conversations I had with this lady in INDY at the first of March.
    She kept talking about mom's income along with her assets, and expenses.

    He prepared a brief, "to the point" "Statement in Support of Claim" for my mom to sign. To start an appeal. Gave the VA notice that this was a formal appeal, for them to reconsider her financial status, the she is spending her assets down quickly, and to approve her pension.

    He printed out a couple of extra forms to submit. ( One that was supposed to have been included in the packet mom received this week, but that some one left out.)

    We / my sister and I are going to submit and EVR. Include all of her medical costs for 2007. And income up date to include all of her current assets , and how much and why her income has increased.

    It appears to us that mom will be sort of limited in her payouts to begin with. Here's why. ( He and I think the VA should approve her on appeal based on the fact that her assets (liquidation of IRA, and bonds) are being depleted very quickly.

    The kicker is in the way the VA calculates the benefit and what is considered "income".

    My sister is taking out nearly the entire Room and Board cost of mom's assisted living each month from her IRAs. IRA distributions are "income". (I'm saying nearly all of the month's bill of $ 3,000.)
    Add to that her SS before Part B deduction. Add to that a little bit of interest from a couple of bonds.
    Then subtract off her medical expenses.--- Her assisted living, Part B, AARP, a few small Rx costs.

    What's left is her "income" for the year. Subtract that from the almost $ 12,000 a year maximum beneft, and that will be her aid and attendance / pension benefit.

    Right now... since she has a "large" income from IRA's + SS, by the time you take out the allowed medical costs... even the assisted living... the payout will be VERY low at this time. She might be lucky to get $ 200 a month to start with.

    I can't see that she will ever get much more than that unless she has to be put on a Medicare Drug Plan next year. ( has increased medical costs)

    The "thing" that is "penalizing" her is having the IRAs. ( I think?) If that money were in savings or checking , and being taken out....it wouldn't be "income". Since it's from the IRA, her income will always be very high until all of that money is gone. I'm not so sure that any money from her bonds cashed in , isn't income.

    The benefit will be when her money is gone..... The place where she lives may (probably will) pay for her care out of 'benevolent" funds. ( A church foundation.) The VA pension along with her SS, would mean the facility would only have to make up about 1/3 or less of her charges each month. More incentive to take her on as a "benevolent" cause.

    Am I getting all of this correct now?? Savings wouldn't be "income"?? We can't mess around with the money now, as we will probably have to apply for Medicaid in a year and half or so.

    As my sister says, $ 200 is $ 200. Every little bit helps.

    I tell my mom... take what you can get.. every penny. Dad was in the Navy in WW II. Didn't see "action", but wasn't always out of harms way either. AND.. I tell her.. that she and all the other women "back home" were working, and living with rationing, etc. THEY sacrificed just like the guy's at sea did.
    (She told me she think she got $ 50 for her self and another $ 50 for my sister ( 1 yr old) from the Navy to live on. She also worked some. And, lived with her parents for a while. )
     

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