Dad awarded A&A benefit in 6 months

Discussion in 'Share Your Personal Experience' started by Kaiya, May 22, 2017.

  1. Kaiya

    Kaiya Newbie

    I filed the A&A application for my Dad, a 95 year old WWII veteran who has dementia, on November 28, 2016, and received the award letter via his Senator on May 19, 2017. Thanks to your excellent advice on many occasions, the latest being contacting the Senator's office, my brother received the award letter via email even before it's delivered by the Post Office. In the award letter, it states the monthly entitlement amount, the effective date, and the Reason for Change. The effective date for the monthly amount is May 1, 2017, and the Reason for Change is Benefits Released. The letter specifically said that "you will receive your first check on or around June 1." Earlier in the same paragraph, the letter states "We have withheld your benefits pending a formal determination of competency to handle your VA benefits." What should I believe?! Then I noticed that the Retroactive Benefits were effective December 1, 2016, but the amount was equal to only 1 month, not 5 months, December to April. The Reason for Change was "Original Award; Retroactive Benefits Withheld." Should I question this amount, which is short by 4 months to the VA? In addition to the Award letter, there is a letter marked Important - reply needed: this is the letter proposing rating our Dad "incompetent for VA purposes." It references a Rating Decision attachment which we didn't see because we only received the VA letters via email. I expect that my brother will receive the entire packet including attachments in the mail. The Rating Decision provides an explanation about the VA's proposal, the reason for it, and the evidence considered. The rating of incompetence is why the retroactive benefits were withheld, which was expected. My brother didn't know what the next step should be, but thanks to your forum, I knew what to do! I sent him the wording for waiving the 60-day period to contest an incompetency rating, which you provide on your website. I also suggested additional wording that waiting for the retroactive pay during the fiduciary process would cause financial hardship for our Dad and to please schedule a fiduciary appointment as soon as possible. However, although the letter said to mail the reply to the address "at the top of the letter," there was no address, just the header "Department of Veterans Affairs/Regional Office." Should we send the reply on Form 21-4138 Statement in Support of Claim (as you advised in your website) to the Claims Intake Center to which we sent the application? Also, should our Dad sign the Form 21-4138? We are also including a copy of the Form 21-0845 (Authorization to Disclose Personal Information to a Third Party) which was sent with the original application.

    I think the documents that may have helped were: a cover letter introducing my father as a WWII veteran, age 94, with dementia, and living in an assisted living facility; a numbered list of the forms and documents included in the application (VA forms first, then discharge papers, then supporting documentation); and requesting expedited processing. The VA acknowledged the application in about 1 month. About 1 month after that (2 months since filing), the VA requested more information. I was crushed because I did everything I could to file a fully developed claim, and now it didn't qualify for expedited processing. The VA requested a detailed income and expense statement for 2 years for our Dad's rental property, which was his residence before he entered the ALF. Even though in the original application, we wrote in the annual rental income in section VIII, and expected income, section IX, they wanted more detail. Fortunately my brother kept excellent records and he filled that part out quickly. They also requested an appraisal of the home. That would cost hundreds of dollars and would take several weeks. Instead I went online to a real estate website and printed out the home's estimated value which the VA seemed to accept. I didn't realize the VA would want that information because my understanding was that the VA would not count the first house, whether the applicant lived there or not. After waiting 2 more months for a decision, we contacted our Dad's Senator and within 2 weeks got a response (not a decision) from the VA. The VA's response was that they were in the "final stages" of working on our Dad's claim and would give an answer in "2-3 weeks." So after 3 weeks to the day, my brother called the Senator's office and requested an update. In 1 more week (last week) the Senator's office emailed my brother the award letter from the VA!

    I am including so much detail because I want to help others navigate dealing with the VA (and I'm not done yet; there's still actually getting the monies and getting my brother appointed fiduciary). Thank you, thank you, thank you for your help and encouragement!
    Kaylin likes this.
  2. Matt375

    Matt375 Jr. Member

    No the amount released will only be the month of entitlement when the benefits start. The retro benefits will not be released until the Fiduciary investigation will be completed. Your father will sign everything until formally declared incompetent by the VA. Yes you can always reply to the VA on a 21-4138, it's the VA's version of a blank sheet of paper.

    You are correct you do not need an appraisal of a property only Fair Market Value (if you sold the property the day you are reporting to the VA). You can base that off of any market report or the Fair Cash Value from the property tax statement. The VA will not count the property unless it is generating income then it is no longer their residence.
    Kaylin likes this.
  3. Kaiya

    Kaiya Newbie

    On June 1, my Dad had his first monthly pension benefit deposited into his bank account. I am so grateful. Without this pension, he would have depleted his funds in less than a year. As of June 3, he has not received his award letter by mail, just the email version through his Senator's office. My brother has prepared a reply to the VA's proposal to find our Dad incompetent, but there was no return address on the VA's letter he received via email from the Senator's office. Should we send the reply to the Claims Intake Center where we sent the original application?
    The award letter says that the retroactive benefits withheld is effective December 1, 2016, however, amount is equal to only 1 month of benefits, instead of 4 months, December through April. What do we need to do to make sure he gets the full 4 months of retroactive benefits?

    Thank you for all your past assistance. I greatly appreciate it.
    Kaylin likes this.
  4. Kaiya

    Kaiya Newbie

    Sorry I made an error on the number of months retroactive benefits that the VA withheld; it should be 5 months, not 4.
    Kaylin likes this.
  5. Kaylin

    Kaylin Hero Member Staff Member

    @Kaiya you would need to show evidence that your dad was paying for care that was depleting her total income/assets during all of those 5 months. Was this the case? Was his costs of care for each of those months more than his monthly income?
  6. Kaylin

    Kaylin Hero Member Staff Member

    Also @Kaiya I am so happy to hear your dad was awarded the A&A benefit! And thank you for the kind words about our assistance we were able to give you and your family during this process.
  7. Kaiya

    Kaiya Newbie

    Yes, during those 5 months since applying for the A&A benefit and the start of his entitlement (May), my Dad's expenses for care exceeded his income and the deficit came out of his savings. Now based on your question, I'm wondering if the VA is only granting my Dad one month of retroactive benefits based on some reason. I thought it was an error because my Dad's situation has not changed since the application date to the present. Perhaps I can ask my Dad's Senator's office to investigate this. My understanding (correct me if I'm wrong) is that once the fiduciary process is finished, the retroactive payments, presumably for 5 months, will be released to him into a separate fiduciary account which my brother as fiduciary will open. Is providing documentation that his care expenses exceeded his income during those 5 months part of the fiduciary process? If we have to supply this information independently of the fiduciary process, please advise me on how to go about this. Thank you.
    Kaylin likes this.
  8. Kaylin

    Kaylin Hero Member Staff Member

    Thank you for letting me know. Then in this situation I have no idea why the VA would only want to give you one month of retro pay for your father - he should be receiving all 5 months if his monthly care costs were exceeding his monthly income and depleting his assets. Unless he just recently got below the $80,000 total asset level excluding one home and one vehicle? That $80,000 is not a set in stone number but more of a guideline. That's the only reason I can think of they might withold the other months...

    Yes, I would make sure you have any and all evidence you can supply that his care expenses exceeded his income for those 5 months. You are right in that he will not receive all of his retro pay until the fiduciary process is complete.

    Personally, if it were me, since he has been awarded the benefit I would send in evidence of those 5 months of care costs to the correct office you have been sending your application papers to AND keep documentation to present when you go through the fiduciary meeting with the field agent. I would include a cover letter with the 5 months of care evidence that states why you are sending in additional documents for retro pay.
  9. Kaiya

    Kaiya Newbie

    I would like to post an update. On February 7, 2018, my brother met with the VA regarding his fiduciary status. On March 5, 2018, our father received his back pay for all 5 months. Apparently the 1 month of back pay stated on his award letter was a typo.
    He also received a form 1095-B for health coverage from the VA for the part of 2017 when he was receiving his pension. This was a surprise to us. How do we find out what kind of medical coverage he has?
    Again and again, thank you.

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