Form 21-4142

Discussion in 'Surviving Spouse Application' started by Scott C, Jun 15, 2016.

  1. Scott C

    Scott C Newbie

    We are applying for aid and attendance for my mother-in-law. She is the widowed spouse of a deceased veteran. My question is whether or not we need to fill in form 21-4142. The form itself says:

    YOU SHOULD NOT COMPLETE THIS FORM UNLESS YOU WANT THE VA TO OBTAIN PRIVATE TREATMENT RECORDS ON YOUR BEHALF. IF YOU HAVE ALREADY PROVIDED THESE RECORDS OR INTEND TO OBTAIN THEM YOURSELF, THERE IS NO NEED TO FILL OUT THIS FORM. DOING SO WILL
    LENGTHEN YOUR CLAIM PROCESSING TIME

    So, is it acceptable to simply get the medical records from the doctors yourself and send them to the VA? If so, what part of the records do you need to get - all? Do the doctor's records have to be certified in some way to be acceptable to the VA?

    Thanks,
    Scott
     
  2. Kaylin

    Kaylin Hero Member Staff Member

    Scott,

    Most VSOs and VA employees have recommended not sending in the 21-4142 as it will delay time of processing the application. Yes, it is recommended to get the medical records from the doctors. Any medical expenses that your mother-in-law has had that are not reimbursed by Medicare or insurance.

    Here is a list of examples of medical expenses you should be looking for records of: http://www.veteranaid.org/docs/medical.pdf

    Also, sending bank statements will help to show proof of these expenses.
     
  3. Scott C

    Scott C Newbie

    Thanks. So, is form 21-4142 only to note medical expenses? If we get the doctor's notes do we need all records or only a record of expenses and payments from medicare and from the patient?
     
  4. Kaylin

    Kaylin Hero Member Staff Member

    As I understand the nature of the form, it is meant to be sent to physicians for them to release any medical information related to the applicant's Aid and Attendance medical expenses. You would need records of expenses and payments from Medicare and from the patient that were not reimbursed. Any expenses (as per the examples listed in the medical expenses list I gave to you) that provided a shortfall in the applicant's income and show a need for help in A&A money to help pay for care.
     
  5. toxdoc49

    toxdoc49 Jr. Member

    So I am a little confused. I know you need the physician's statement in the application but this form was not mentioned as part of that application. Or is this just more relevant to establishing the homebound level of benefit? I ask because it's pretty easy to show that assisted living expense exceeds income and that the A&A benefit is needed. It does require specific documentation I believe to demonstrate this for home bound level of benefit, although I am not sure how closely the VA looks at expenses if the care remains in the home.
     
  6. Kaylin

    Kaylin Hero Member Staff Member

    This 21-4142 form was not mentioned and we do not suggest sending it because it is not required and, as I mentioned, most often causes a delay in the processing of the application. The physician's statement is required and should always be included in the full application. As long as you are showing proof of care expenses even if the veteran/spouse is in the home, then the VA will understand that their costs of care are depleting their income and/or assets.
     

Share This Page