Dad not going to get A&A. Here's why.

Discussion in 'General Discussion' started by robzebr, Jul 9, 2013.

  1. robzebr

    robzebr Newbie

    Went to the VA office today loaded for bear as to why my Dad qualifies for the NON Service Connected pension... aid and attendance...

    I spent 2 nights making sure I had all the necessary documents, went and got the binders, added my Dad's Army portrait for a little humanization etc.

    I wasn't sitting down for 3 minutes when I realized he wasn't going to get it.

    My Dad has been rated as 100% disabled for Service connected injuries sustained during WWII... Loss of Hearing, PTSD and Nerve damage from frostbite.

    Because he is rated at 100% he is already getting (just started getting it) the max allowable by the VA... So compensation, pension, service connected, non service connected... none of that matters... If he is getting the max... the max is the max...

    If my Dad was rated as 50% disabled he would be getting 50% less than what he is getting... and then could apply for Aid and Attendance ... to fill in the gap potentially getting back up near the max allowable...

    So it looks like if somebody is 100% service connected disabled ... A&A is off the table because the Vet is already receiving the max amount that the VA is going to authorize ... under any circumstances...
     
  2. vetadmin

    vetadmin Administrator Staff Member

    NOT TRUE!

    If a veteran is rated 100% service-connected, and now needs the assistance of others for their daily living, then all you do is VA 21-4138 Statement in Support of Claim stating that "I now require the assistance of others for my daily living." You also need VA form 21-2680 Phy's evaluation stating the same.

    You do not have to complete the 21-526 or provide financial information. This situation is unique and only applies for those who are 100% service connected that allows the veteran to have both pension and compensation.
     
  3. Max

    Max Hero Member

    This is close, but not quite correct. A veteran can never receive pension and compensation at the same time, they can only receive whichever benefit is greater. Because this particular veteran is already receiving compensation at the 100% rate (which is about $2,800 per month) there is no way that pension could ever be a greater benefit.

    Aid and attendance or housebound for pension purposes is called Special Monthly Pension. Disabilities under pension for aid and attendance don't need to be service-connected. Regardless of how severe the disability is, qualifying for either housebound or aid and attendance will result in a specific increased rate in pension.

    Aid and attendance or housebound for compensation purposes is a bit different as there are multiple types of special monthly compensation available. The rates vary, but the compensation award can increase the award by anywhere from $67 per month to over $5,000 per month. That being said there are requirements for service-connection for the disability causing the need for the additional assistance may.

    In addition to this, if a veteran is in receipt of compensation, the compensation award can be increased based on the veteran's spouse's need for aid and attendance. This is different from pension because with pension, only the primary beneficiary's need for aid and attendance is relevant.
     
  4. robzebr

    robzebr Newbie

    My Dad is receiving 2816 a month. The VA rep said that that was the max. Its for service connected disabilities.

    This is the way it was explained to me...

    Because its compensation and not pension the VA rep explained that any VA aid and attendance would have to be considered under his existing benefit which is service connected.... so then the need for aid and attendance would also have to be service connected....

    My Dad needs assistance due to CHF, atrial fibrillation and a bunch of other ailments ... one of which is weakness in his extremeties and trouble with fine movements.. dexterity...

    My Dad's service disabilities are hearing loss, PTSD and nerve damage from frostbite.

    So in order to qualify for aid and attendance now... it would have to be in connection with one of those service connected issues...

    The only one that is feasible is the nerve damage that could possibly be attributed to the reason as to why he needs help at home...

    That would mean his current doctor would have to parse out the fact that he needs help at home because of the nerve damage to his arms.

    She wouldn't be able to say that it is definitely from the service...

    The VA Rep said that his current dollar benefit... is the max already and any aid and attendance would have to be related to the service disabilities.

    So the 2 issues I am left with are that at 2816 he is already getting the max and one can't get aid an attendance as a pension if the existing benefit has been classified as a compensation due to service connected disabilities...

    He said that if you went the pension route... and not the compensation route then the service connected disabilities listed above wouldn't factor in and therefore his benefit would be less...

    If that were the case... My Dad could then apply for the pension benefit aid and attendance 3.352(a) and if approved the VA would give him an amount that could conceivably get back to the max which is 2816... which he is already getting...

    So the question I am left with is....

    Can a vet that is rated 100% service disabled be receiving 2816 as disability compensation then apply for the aid and attendance under Pension and be granted additional benefits.

    The answer I was given is no.

    The reasons being is that in his case he is already receiving the max... and that any new additional A&A would have to be considered under service compensation... and his disabilities that he is currently being compensated for ... are NOT what is causing his need for aid and attendance at present...
     
  5. robzebr

    robzebr Newbie

    This is what I believe is the bottom line on my Dad's case...

    A vet can't collect both compensation and pension....

    My Dad went in as compensation.... 100% disability.

    So the only way for him to get A&A is as a compensation.

    In order to get that.. the A&A has to stem from the need based on what went into his 100% disability rating... his need has to come from what he is currently receiving benefits for... hearing, PTSD and nerve damage..

    One of those 3 issues would have to be the cause of why he needs Aid and Attendance today....

    ... and unfortunately that is just not the case... he needs aid and attendance because he is 89 and has an 89 year old body... it doesn't have anything to do with PTSD, hearing loss or nerve damage....
     
  6. vetadmin

    vetadmin Administrator Staff Member

    I believe that you should "try" doing as I suggested with the 21-4138. All they say is "no".
     
  7. robzebr

    robzebr Newbie

    I'm getting ready for one last shot at the buzzer...

    I'm going to repackage everything with a new 4138 ... but this time send it to the Phila. office.... the thought being that another set of eyes from a different office will be looking at it... and might have a different opinion...

    I was in the regional state office... the person I met with appeared to be a liaison between the applicant and the "real" VA .... by that I mean one floor down ... 50 desks in the center of a room, white shirts, Clark Kent black glasses... all processing claims....

    He even made a comment somewhat acknowledging as to the problems with "those" people downstairs.... So his head could be anywhere... maybe he doesn't want to do battle with "those" people downstairs... and its easier to tell me that my Dad is getting the max and that is that....

    I'm going to send it in as the original claim ... not a new claim to the Philadelphia office... and just explain that I believe my Dad is qualified.... having the knowledge of what the State office guy said but not mentioning that I was there....

    ... so in effect I'm just doing a rebuttal to the denial letter from the state office and using a different avenue to get it through the system...

    I don't think its going to work as the state office denial letter is in there and they just might agree with the state office ... but Yes it is worth a try....

    Thanks...
     
  8. Max

    Max Hero Member

    Please don't send your claim to Philadelphia. They will not process it. Because it is a compensation claim, it will be returned to the regional office.
     
  9. robzebr

    robzebr Newbie

    So then the only claims that get processed through Philadelphia are claims for pension?
     
  10. Max

    Max Hero Member

    No. Philadelphia will also process compensation claims for eastern Pennsylvania. Your claim should remain in NJ.
     

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