Our initial appt with the VA rep was 4/5/2011. The next week, I gathered all the doctor's reports myself and delivered them back to the VA rep who sent them on to an American Legion rep in St. Paul, the St. Paul Pension Management Center received it on 4/15/2011. I got a Rating Decision on 7/22/2011. This is the reply I've come up with...too much, too little? We have reviewed the Rating Decision, page 1, dated July 13, 2001 and have determined: 1. The veteran accepts Entitlement to special monthly pension based on the need for aid and attendance established effective April 12, 2001. 2.The veteran accepts the rating of incompetent for VA purposes. Regarding the front side of VA Form 21-4138, date signed 7/22/2011: 3. The veteran names XXXXXXXXXX, his legal fiduciary since 2008, also his fiduciary for VA purposes. 4. We propose benefits be paid directly to beneficiary pending certification of fiduciary for VA purposes, as the management of the veterans affairs will be handled by same person, in either case. 5. We have determined, as noted on the previous page, that delaying payment would create an unecessary financial and mental hardship on the veteran. Pursuant to VA Manual M21-1, Section 17.15: Procedure Upon Receipt of Evidence of Incompetency, your manual states "Do not routinely suspend direct payments to a beneficiary pending development of an issue of incompetency or certification of a fiduciary." It also states,“The determination should consider if delaying the payment of the benefits would cause undue hardship for the beneficiary.” Thanks for your input! P. S. My dad has two new monthly prescriptions adding another $221 to those reported with the initial claim. How and when do I handle this?