yuck - hit a roadbloack

Discussion in 'General Discussion' started by mamabears, Nov 14, 2012.

  1. mamabears

    mamabears Newbie

    I am helping my grandmother (age 96) , spouse of a WWII vet, apply for the A&A benefit.

    I submitted form 21-534 back in July. I just received a letter indicating that more information is needed. The situation is as follows:

    My Grandmother receives approx. $2300 of monthly income through SS and pension. Her monthly expenses (in an assisted living facility) are approx. $5000. At the time that I filled out the form, she also had $16,000 in savings - that has now been depleted.

    In order to explain the gap between income and expenses and not raise questions that we were hiding something, I wrote in the comment section that her daughter would be helping financially. Her daughter will be paying about $1700 a month (assuming my Grandmother receives the full benefit amount; if not, her daughter will need to pay however much it is to cover the cost)

    In the letter back that we received, it stated the following:
    "You reported on your application that your daughter will be helping you financially to partly cover the costs of your assisted living fees. Please tell us how much of the monthly rate of $5070 is paid by you and how much is paid by your daughter. Please note that VA cannot count medical expenses that are paid by someone else. ..."


    I am afraid that my Grandmother won't receive the full benefit amount (causing her daughter to have to pay even more) if they deduct $1700 (the amount my mother will potentially need to pay) from her $5000 of expenses.

    Any advice on how to respond? There were two other problems as well, but this was the biggie and I just don't know what to do.

    Thank you for any help you can offer.

    Kara

    (As a side note - her daughter, my mother, is drawing from her retirement and really can't afford this, but there is nothing else we could do. My mother is blind and just not able to completely care for her mother alone)
     
  2. vetadmin

    vetadmin Administrator Staff Member

    This was a mistake to include this information with the application, but at this point you now know this.

    I would suggest that you reply letting them know the $16,000 has been depleted, and that her daughter is only able to help modestly as the funds were from her own retirement.

    You need the application to stand on its own merit showing her need for the pension.
     
  3. mamabears

    mamabears Newbie

    Thank you so much for your quick reply.
    I will provide answers to their questions and hope for the best.
     
  4. vetadmin

    vetadmin Administrator Staff Member

    You're welcome, and good luck!
     
  5. gardener

    gardener Newbie

    I am sorry to hear of this snag you've run into with your grandmother's application. I am really surprised to hear that the money your mother has been paying for your grandmother's care each month will reduce the amount that can be counted as an expenditure for future months. This just doesn't seem fair! It doesn't seem right that your mother should use all of her money if your grandmother is actually entitled to A&A pension. I hope that sending in the statement in support of claim that the $16 K is gone and that the money being spent is someone else's retirement helps them decide differently, but it is worrisome to think that it might not.

    My husband and I are in the same boat with my mother. We pay 65% of her bills each month, or she wouldn't be able to stay in assisted living. (It isn't easy to come up with this much money, let alone think we will never be able to stop paying, especially when it sounds like she could have more easily gotten the pension if she were spending down her own money.) I also wrote in the comments section that "her expenses were more than her income, but she was getting by because family was helping pay her bills" and that "I mentioned this to clarify that there were no assests of hers not being reported or overlooked." I wonder if I will soon get a letter similar to yours. I applied in July also.

    Debbie, if you read this, do you have any comment on the likelihood that when relatives that have been covering the shortfall in cost of care, it might be more likely that the person will be denied because the money others have paid in the past will be treated as "income" that can be projected to the future? Have you heard of this happening?
     
  6. vetadmin

    vetadmin Administrator Staff Member

    What I recommend is that family memebers who are helping to pay expenses, do so out of their own accounts and directly to the facility or the caregiver.

    Do not deposit the money into the applicant's account.

    The VA needs to see that the applicant is at zero or negative at the end of the month. That is what they are looking for to determine a financial need for the pension. The VA does not count it as extra income, is just simple means that her individual finances may not reflect a true picture and demonstrated need for the pension.

    The added bonuse to paying the extra expenses separately is that "if" something should happen to the loved one before all the accrued back pay is released, you then have the option to file against those funds and have proof that you paid expenses associated with care and services, and can file for reimbursement.

    I would not be surprised if you do get the same type of letter.
     
  7. gardener

    gardener Newbie

    Thanks Debbie for the reply, but I am still confused. If the person is negative each month with their own money, isn't that enough proof that they are financially in need? My mom certainly is. But the wording of the letter that Kara received makes is seem like they will not allow as a deductions amounts someone else has been paying in the past, even if that person cannot afford to keep helping. This seems unfair, given that if the applicant were spending down their own money and were about to run out, the same expenses would qualify as deductions.
    As for our situation, my husband and I do pay directly to the facillity the portion of my mom's assisted living expenses that she can't cover. I write two checks each month, one from her account signing as POA, the other from ours. I started doing this because I thought our help would otherwise look like "income" if we put it in her account first. Even if we are paying directly, I am now unhopeful that they will allow it as a deduction. Here is exactly what I wrote on her application:
    "My bills each month are currently more than my income. For the moment I am able to stay in assisted living because my daughter and son-in-law are paying part of my bill directly to the assisted living facility. I state this to clarify the discrepancy between my income and expenditures. Without this explanation it could be assumed that there are mistakes in the numbers entered in this application, or omissions of other income or assests."
    I was trying to make things clear, but now I feel dumb for writing something that might only confuse the situation.

    Kara, if you are reading this, did you say that your mother was directly paying bills for your grandmother, or putting money into your grandmother's account? From the letter you received, do you think it would make a difference? I hope that you can get things straightened out for your family too.
     
  8. Marp

    Marp Jr. Member

    I'm wondering if your grandmother might still be eligible, even if the VA disallows the $1700 in expenses your mother pays. The total cost of the Assisted Living is $5,000 -. If the VA disallows the $1700 your mother pays, that leaves $3300 in expenses. That is $1000 more than your grandmother's income of $2300. You can also count any insurance premiums (Medicare, etc) your grandmother pays. I believe the maximum pension amount for a surviving spouse is around $1100. With the $1000 per month shortfall from the Assisted Living fee plus whatever your grandmother's insurance premiums are, you might just qualify for the maximum pension amount, assuming, of course your grandmother can demonstrate medical need as well.
     

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