Benefit Amount

Discussion in 'General Discussion' started by Maven, Jul 1, 2016.

  1. Maven

    Maven Jr. Member

    My 89 yo MIL received notice today that she was awarded the A&A pension because her Dr. said she had congestive heart failure, vertigo and dementia and is unable to care for herself any longer although he did not state on the form that she needed nursing home care..The amount of her benefit is $219 a month.Since her physicians assessment a month ago she got the flu, had a fall and declined significantly.Today July 1 she moved into a residential care facility which costs $2,500 a month.She has only her SS benefit of $930 so our family pays balance for her.My question is how can we request that her benefit be increased?

    Thanks Maven
     
  2. toxdoc49

    toxdoc49 Jr. Member

    From what I learned on this forum, once a person is in a facility and the facility issues a certificate of occupancy, then you can show on the application what the cost is for monthly care and then the VA sees that the cost exceeds her income and awards the A&A level of benefit. If that was not on the VA application originally, i think you submit the form 'statement in support of claim (i forget the form #) where you detail the changes and why the benefit needs to be increased. I hope others can confirm this for me but that is my understanding. I don't know why the award would be only $219 per month unless she had other assets that they saw on the application.
     
    Kaylin likes this.
  3. Kaylin

    Kaylin Hero Member Staff Member

    Maven,

    toxdoc gave you the right information. Thank you toxdoc49! You would submit a Statement in Support of Claim form 21-4138 to ask for an increase in your mother's award amount due to her increase in expenses recently. Make sure you include bank statements that show her costs of care and the certificate of occupancy from the facility, as toxdoc said. Use this Nursing Home Status Statement. And fill out this (the nursing home will have to fill out the bottom half): http://www.vba.va.gov/pubs/forms/VBA-21-0779-ARE.pdf

    You can cross out all instances of "nursing home" and write "assisted living facility" or "ALF" on the forms.
     
  4. Maven

    Maven Jr. Member


    Thanks for information.You say include bank statements that show her cost of care, if the payment was made in cash can we just include copy of receipt? Is Nursing Home Status Status Statement same as certificate of occupancy you refer to? Sorry for all the questions but we live in Belize and things are differnt here than US.Thanks very much for help.
     
    Kaylin likes this.
  5. Kaylin

    Kaylin Hero Member Staff Member

    Yes, you can include copies of the receipt. But in the future, I would recommend using checks to pay for care so that you can show bank statements. The Statement of Occupancy is generally something the facility would know about and be able to complete for you. Since it is in Belize, they may not have the same form or even know what that form would look like. If you include the Nursing Home Status Statement form that I linked above and have them fill out the bottom half, that would best to include if you cannot get the facility to give you a Statement of Occupancy.
     
  6. Maven

    Maven Jr. Member


    The Statement in Support of Claim form #21-4138 is filled out by who? The claimant, my 89 yo mil w/ dementia? The Dr who recommended the skilled nursing care?
    Thanks
     
  7. Kaylin

    Kaylin Hero Member Staff Member

  8. Maven

    Maven Jr. Member

    Kaylin likes this.
  9. Kaylin

    Kaylin Hero Member Staff Member

    It would probably be best to send in the Medical Expense Report as well if you want to indicate any increased or additional medical expenses that have come up.
     
  10. toxdoc49

    toxdoc49 Jr. Member

    About Section X of the 21-534EZ form: I put 'home care' under the 'purpose' section. Under the 'paid to' section, I put the name of the caregiver (or service). Under the 'relationship of person for whom expenses paid' I put 'self.'

    I assume that the VA then makes the 'countable income' calculation. If the countable income is below the amount that the veteran aid site states for eligibility based on the tier of benefit being applied for (A&A, housebound, etc), the VA should award the amount stated for each tier (1,149 if A&A, ~800 if housebound).
    I'm just trying to ask how accurate this is in people's experience. I also understand that, following submission, there is the incompetency process and the fiduciary process. One should not challenge the incompetency process as I recall.
     
    Last edited: Jul 22, 2016

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