Time to contact Senator?

Discussion in 'General Discussion' started by gidgetpb, Apr 29, 2010.

  1. gidgetpb

    gidgetpb Newbie

    I have tried to be patient, really I have, but this whole process is the ultimate in stalling and incompetence and I am now at the desperation point with my Dad's finances. We currently spend about $600 per month more than his income on his monthly expenses. He's got $1,000 left in his savings and I am about to move another $600 from savings to cover May's expenses. Next month we won't be able to make his rent.

    His application was submitted in October along with a 21-22a and complete documentation of every single item listed in the application process, and a cover letter requesting expedited processing due to his age of 83. I did not even get an acknowlegedement that they had the application until the end of December after I faxed them a request to let me know they had it. I have received a grand total of one "Be patient we are working on it" letter since then, in early February.

    Two weeks ago I tried to call and get an update on the status. They refused to speak to me even though they acknowledged the 21-22a was in his file. I was told that the 21-22a was discontinued in January and now a 21-0845 was required. So I made another 4 hour trip to my Dad's place to get his chicken scratch on the form. He had no understanding of what he was signing, but when I told him it would get him more money he thought that was a good idea and scribbled something resembling his name. I both faxed and mailed the completed form to Philadelphia.

    I then contacted the VA by way of their website and sent an email requesting status update (did this pretending to be him, it worked). First they claimed they did not have anything under his service record, so I once again supplied his SS# and claim number (they were included in the original email). Then they forwarded the email to Philadelphia, who finally replied with "other people applied before you did. We'll let you know when we get to your application."

    Meanwhile we have assisted living rent and medications to pay for. I am ready to contact the Senator in my Dad's state to see if he can intercede and get something moving. I've never done this before. I dont' even know how to address the senator - "your honor" s for judges, is it also used for senators? Is a brief outline of my problem and request for assistance what is required, or should I spell out the whole sad story in detail? I would think a long story might get tossed, I should keep it short and sweet (but maintain desperation).

    Do I write to both senators, or just one?
  2. Hello -

    I don't have an answer to your question, but there are very knowledgable people here and they will be very helpful to you.

    I just wanted to lend support/empathy for your situation and offer an observation. While my mom's application was pending, I sent a report to the VA from the rehab center where my mother was recovering when she had a stroke. I included a cover letter, signed by me, merely stating that she had had a stroke since her application, her current whereabouts, her release date, and that I was enclosing the report from the rehab facility. Last weekend, 2 1/2 months later, my mother received a very poorly written letter, with incomplete, choppy sentences, saying the VA could not "expect" (I guess meaning "accept") anything from "your daughter." So they refused and returned the update on her condition. I know they have their rules, but I have learned not to sign anything myself, not even a cover letter. I also did the same thing with the e-mail as you did, after sending one myself and getting a response that they couldn't communicate with me, even though I had sent in all the necessary forms. It defies all logic that they think people in their late 80s and 90s, who have had strokes and have dementia, are really filling out these applications themselves, but as long as they have that signature, that seems to satisfy them. Anyway, I'll post more about my recent letter later in another subject. My mother was approved for A&A, but I'm waiting for the amount to be increased. She too is almost out of funds, and I will have to somehow make up the difference.

    Best wishes, and I know that you will get a good answer on this site.
  3. vetadmin

    vetadmin Administrator Staff Member

    Two issues here and don't want to confuse, but let me start by saying that I hope you are both signed up for our newsletter. In the most recent one, I covered the 21-22a and the new form 21-0845 the VA is now using. If you are not subscribed you can read the latest issue on the site at www.veteranaid.org/newsletter.php You can send this form in anytime during the process to be added to the file. It simply allows the VA to discuss the claim with a third party.

    Gidget - If I am understand correctly here, you only submitted the application this past Oct 09. If that is correct, 6 months is not out of line with the time this process can take. If you were closer to a year (hate to say it) then contacting your senator would certainly be an option. By the way you simply address him or her as Senator XXXX.

    You can contact either senator and ask for them to assist you with getting an answer and let them know that at the end of May, he will be out of funds to pay for his care as a hardship case, but so many are in the same situation. Much will depend on your representavite. If you write a letter, I suggest calling and getting the fax number for the senator and try to keep it just a brief overview with the emphasis on the hardship and that he is out of money.

    Stressedout - Your points are well taken, and the entire process is insane given the age and mental challenges faced here. I hope you resbmitted the forms with your mom's signature. Keep us posted.
  4. gidgetpb

    gidgetpb Newbie

    A new wrinkle:

    Dad fell and broke his hand this past week. It is a very complicated fracture that will require surgery and PT. All of the doctors that have examined Dad feel that with his myriad health issues, declining coginitive abilities and high fall risk, it is ill-advised for him to return to Assisted Living after rehab. We are now persuing permanent placement in the VA Healthcare System's nursing home, possibly the dementia wing or possibly the regular nursing wing.

    I suspect that this will make him ineligible for A&A, since that would mean the VA would pay us to pay them for his care. I suspect they probably have some sort of scale they use to determine his NH fees based on his existing income.

    Am I right in assuming that he is still eligble for retroactive A&A benefits from date of application to date of admittance to the VA facility? If so, should I notifiy Phialdelphia of his change of lviing arrangements immediately, or wait until his benefits are finally approved? I am afraid if I tell them of the change the claims processor will automatically deem him ineligible and then I will have to battle to get the retroactive amount due.
  5. jpez

    jpez Full Member

    I have some experience but without all the info it is hard to tell you what to do.
    BUT, It is impossible to get into VA Nursing (custodial) Homes unless the vet has a service connected disability.
    Pension (non-service connected ) w an A&A rating is the main focus here.

    I f you are uot of money, you need to apply for MEdicaid (also). You dont have to be IN a nursing home to apply. each state is alittle different. Regardless of who's nursging home he ends up in, He will have to pay. It is not covered under the Pension A&A or Medicare.
    Medicare will cover "UPTO" 100 of Rehabilitation in a nursing home. THe average number of covered days is 23.

    When you apply for Medicaid as a senior, You keep your Medicare and Medicaid acts as a secondary insurance.
  6. vbcoder

    vbcoder Jr. Member


    This is from the above link

    Nursing Homes for Veterans

    Nursing home coverage for veterans is available from two sources within the Department of Veterans Affairs -- the veterans health care system and the state veterans homes system.

    Nursing Home Coverage through the VA Health Care System
    Nursing home coverage along with other long term care services such as home care and assisted living as well as geriatric care management are available through the Veterans Health Administration for qualifying veterans.

    In order to get into the veterans health care program, the veteran must have service-connected disabilities, or be below a qualifying income level or be receiving Veterans Pension income. Once in the system, veterans are not guaranteed long term care services, including nursing home care, unless they meet specific requirements. Here is a list of these requirements for nursing home coverage.

    Who is Eligible for Nursing Home Care

    •Any veteran who has a service-connected disability rating of 70 percent or more;
    •A veteran who is rated 60 percent service-connected and is unemployable or has an official rating of "permanent and total disabled;"
    •A veteran with combined disability ratings of 70 percent or more;
    •A veteran whose service-connected disability is clinically determined to require nursing home care;
    •Nonservice-connected veterans and those officially referred to as "zero percent, noncompensable, service-connected" veterans who require nursing home care for any nonservice-connected disability and who meet income and asset criteria; or
    •If space and resources are available, other veterans on a case-by-case basis with priority given to service-connected veterans and those who need care for post-acute rehabilitation, respite, hospice, geriatric evaluation and management, or spinal cord injury.
    VA's nursing home health system programs include VA-operated nursing home care units and contract community nursing homes. Many VA hospitals operate nursing home care units located in or near the hospital. Other hospitals, without adequate nursing home beds, contract with approximately 2,500 community private nursing homes nationwide to provide services.
  7. jpez

    jpez Full Member

    It is always nice to see the code sections.
    But the real value is in being able to share the actual day to day experience.
    Vcoder, maybe you could post how many non-service related vets you know who are recieving the Nursing home benefit in a VA facility?

    The 'benefit' that is quote is identical to the Medicaid beneift.
    Income and asset tested.
    It is not a 'better' benefit.

    Thomas Day (who owns the site you quote) is a Vet himself w/ service related disability.
    Perhaps you should continue the quote from his site:

    State Veterans Homes
    State veterans homes fill an important need for veterans with low income and veterans who desire to spend their last years with "comrades" from former active-duty. The predominant service offered is nursing home care. VA nursing homes must be licensed for their particular state and conform with skilled or intermediate nursing services offered in private sector nursing homes in that state. State homes may also offer assisted living or domiciliary care which is a form of supported independent living.

    Every state has at least one veterans home and some states like Oklahoma have a number of them. There is great demand for the services of these homes, but lack of federal and state funding has created a backlog of well over 130 homes that are waiting to be built.

    Unlike private sector nursing homes where the family can walk in the front door and possibly that same day make arrangements for a bed for their loved one, state veterans homes have an application process that could take a number of weeks or months. Many state homes have waiting lists especially for their Alzheimer's long term care units.

    No facilities are entirely free to any veteran with an income. The veteran must pay his or her share of the cost. In some states the veterans contribution rates are set at a certain level and if there's not enough income the family may have to make up the difference. Federal legislation, effective 2007, also allows the federal government to substantially subsidize the cost of veterans with service-connected disabilities in state veterans homes.
  8. vbcoder

    vbcoder Jr. Member

    jpez..I had a non service connected disabled family member to die in a VA nursing facility in Salisbury,NC.
    That makes your statement,It is impossible to get into VA Nursing (custodial) Homes unless the vet has a service connected disability inaccurate.

    You berated Max for not stating the whole truth.Why don't you do the same?

    I was simply posting the facts for gidgetpb, not trying to mislead her as your post did.
  9. gidgetpb

    gidgetpb Newbie

    The news that it is NEARLY impossible to get into a VA long term facility is discouraging but not surprising. We all know that what is written in the code is not necessarily what happens in real life. it may be foolish, but I have to hold out hope his doctors will help make it happen.

    I have already investigated the only veteran's home in his area - the wait list is currently 9 months or more. I will send the application this week, but we don't have 9 months to wait for placement. So I will also apply for Medicaid and look at civilian options. However, I know from prior experience that it is almost as difficult to find a Medicaid bed in a civilian NH bed without being an existing private pay patient as it is to be admitted to the VA facility with non-service related disability. Finding placement is going to be a herculean task no matter what.

    So back to my original question, rephrased: Should I notify Philadelphia of his change of living arrangements immediately upon placement or wait until he is approved first?
  10. jpez

    jpez Full Member

    you really are a piece of work. Can't read code. Can't post honestly. You were 'simply' omitting the rest of the facts. Oh if anything you do is so 'simply'. You FAILED to post the fact...in the next paragraph on Tom Day's longtermcare site..... that there is a shortage and that the chance of her dad getting in are slim to none.
    your post = "oh it's simply easy, ANYBODY can get in" (ignore the shortage, that's simply toooooo much for these simple fingers to type)
    my post = "it is impossible in your situatuion, here is a recomendation"
    Which one looks like the "whole truth"??????
    She needs a Nursing Home NOW!!!!! Can you help or not?????????
    Max was being paid to work for the VA and he had an obligation to know this stuff. He made stuff up and was basicly committing fraud by even being here.
    I have successfully helped over 1000 families pay for CARE over the last 10 years. From Medicare QMB, SLM, Q1, Part D Extra Help, VAPension, Medicaid, MassHealth, Medi-Cal.From how to correctly spend their money to all the possible tax deductions that CPA dont tell about. From Homecare, to Independent to Assisted to Nursing Home.
    Dont try to throw 'honesty' up in my face given just this most recent deceptive post on you part.
    But what really makes your second post pathetic....you don't help the op one bit. OK, he died there. You don't share your trick of how you got your loved one in there. You just what to 'try' to undermine the real truth. And that is that she cant rely on the VA system for this.
    Nice. ::)
  11. jpez

    jpez Full Member

    However, I know from prior experience that it is almost as difficult to find a Medicaid bed in a civilian NH bed without being an existing private pay patient as it is to be admitted to the VA facility with non-service related disability. Finding placement is going to be a herculean task no matter what.

    So back to my original question, rephrased: Should I notify Philadelphia of his change of living arrangements immediately upon placement or wait until he is approved first

    1. In my experience, I would not notify Philly until he his approved. Why? because the facts as of the date of the app are true and correct. The pension that is sent is based on a 'best case senario' that the facts will stay the same for 12 months. THEN, they will ask, "did you IN FACT spend what you said you MIGHT spend to justify the amount we sent. "
    SO, when he is approved and you get the first check, you can notify them of his change in status.
    2. If he is below $2,000 in assets any one day in the month then you HAVE to apply for communty Medicaid NOW. Having an approved Medicad card in hand is much easier than waiting to go to the NH and the applying for LTC Medicaid. Also, you can private pay to get in and then you will be reimbursed back when the Medicaid is approved. The trick is that someone other than dad has to pay the first month. AND note it. or medicaid will think it was dad's money and not refund it. (back to stupid things that Max said to do)
  12. gidgetpb

    gidgetpb Newbie


    Thank you for answering my question and providing some guidance.

    I have been contemplating (most of the night without sleep) how to go about paying a NH until the Medicaid and A&A finally get resolved. I was considering depositing some of my retirement money into Dad's account to cover payments, but according to you it is better for me to pay directly. I have also read on a demetntia board I participate on that some places will allow you to not pay and admit the patient as "Medicaid pending", so I will have to look into this further. I intend to contact the elder care lawyer who drew up our POA's and seek her advice before I finally decide what to do.

    Your response concerning notifying Philadelphia makes sense and agrees with my gut instinct.

    I contacted Dad's VA social worker yesterday and she flat out told me that without a 70% service-related disability there would be no chance of admittance there. I brought up the section of code that would apply in my Dad's case, but she repeated that without the service-related disabvility he would not be accepted regardless o fwhat is in the code. She also confirmed that the veteran's home wait list is 6 - 9 months, and that A&A is now taking about a year to get processed. She is helping me seek outside placement.

    While I recognize that your advice was correct, and that vbcoder's relative was a lucky exception, I also appreciate vbcoder's posting of the applicabvle section of code for me to read and refer to while speaking with the social worker. I want thank both of you for your useful input.

    To all who respond to this thread: I have participated in a number of message boards and I do understand that there will be differences of opinion in the reponses received. I also am intelligent enough to follow up with my own research on any ideas that are presented. I also l know that it is possible to present differing points of view without personal attack. A simple "so and so is incorrect" or "I disagree with so and so" will suffice. Please refrain from personal attacks on my thread. There is enough hurt in this world already.

    Thanks again to both of you.
  13. vbcoder

    vbcoder Jr. Member

    jpez..I made no comment about the info I posted.I left the link so that the entire page could be read.

    Your comment,your post = "oh it's simply easy, ANYBODY can get in" (ignore the shortage, that's simply toooooo much for these simple fingers to type), is your distorted view of my intentions and a "LIE".

    I have no intentions of arguing with you because you distort the written words.Just crawl back under the rock from which you came.

    Sorry Debbie...the devil made me do it...
  14. vetadmin

    vetadmin Administrator Staff Member

    Gidget, you may want to consider contacting A Place For Mom. They are the largest placement agency in the country and work with all the ALFs and nursing homes. They are very aware of the pension, and could possibly be of assistance. You may want to contact your senator now and get some support for getting your dad placed in a proper facility.

    We wish you the best in getting things resolved, and please overlook what can sometimes be too healthy of a banter here. Please let us know how things turn out for you.

    As a side note: I believe that Gidget made the point as far as personal attacks. Difference of opinion is one thing, but the manner in which you disbute or offer up additional information can be done in a way in which the poster does not feel caught in the crossfire.

    Jpez, please tone down the aggression in making your points so that our visitors don't overlook valuable information.
  15. jpez

    jpez Full Member

    I think someone on here posted that they had gotten a non-service related loved one into a Va nursing home.....they were trying to prove a point I think.......

    I guess they can't share that with the group....

    That was a key issue here.

    The truth was brought up as an issue. Then let's all here the truth so we too can simply and easily overcome the long wait and get into a VA nursing home. If there is a way to get around the list of the 100% SERVICE CONNECTED Vets................
    Since none of her posts have really addressed the issue, maybe she can help us all now.

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