I process claims for pension benefits at the VA. Ask me anything.

Discussion in 'General Discussion' started by Max, Aug 12, 2013.

  1. splishsplash

    splishsplash Newbie

    That part I understand, I'm not trying to recoup money for what has already taken place, but you are telling me that if she doesn't demonstrate that she is paying for these services, she can't qualify for help ever ?? I am trying to establish the need is there and the services are being used aren't I? The only reason she hasn't been billed or paid for these services is because she can't afford it, not that she isn't using them. That to me is where the absurdity comes in as the reason that she is applying for the A&A is that she is using and in need of services the VA states they will provide some compensation for if she can't afford them, but her only way of showing that she can't afford them is by showing that she is paying for them ????

    I have a headache lol, and I'm sure I have given you one also!
  2. vetadmin

    vetadmin Administrator Staff Member


    This is a means-tested benefit, which means that you need to demonstrate a financial need to pay for your care. If you are not paying for care because you cannot afford it, that is not going to get you this pension. You have to be currently at the time of application paying for care, and be able to demonstrate a short fall in being able to afford or cover that care expense.
  3. Hello All,

    I am a 100% va rated for PTSD alone. Can they reduce my benefits if I work? Ive been out of work for 7 months now but the bills are stacking up. So i decided to apply for jobs and got an interview. I have read through a lot of forums and documents and I can't find a definite answer. I'm not perm and total or TDIU, so I believe i can work but I also think if I work they will reduce me. Anyone able to answer my question?

  4. Kaylin

    Kaylin Hero Member Staff Member


    I recommend speaking with a benefits rep at the VA or at a Veterans Service Organization in your community to understand your disability rating and how having a job would affect your rating (if at all). It may depend on the type of rating you have. Best of luck, and thank you for your service!
  5. JeanT

    JeanT Newbie

    My mother originally applied for A & A in March of 2015. We received a letter stating she was eligible for the benefit but was denied the because her income was too high. The VA was not counting the $40,000+ a year it costs for her to live in an assisted living facility. At the time she was not rec. assistance with bathing & dressing. In July I arranged for her to have help with those 2 things. On Sept. 1st I sent in an update using the forms the VA sent me in the event her situation changed. Because she is now rec. help with dressing and bathing she should meet the criteria for approval. I did receive a letter on Sept. 30th saying they were in receipt of the updated application and would try to process as quickly as possible. Should I be calling to check on the status or is this a usual wait time?
  6. vetadmin

    vetadmin Administrator Staff Member


    I would call them, and ask for an update. It's been enough time for them to review the claim.
  7. kwalsh999

    kwalsh999 Newbie

    Medicaid and A&A

    Thank you for the reply. So I think you're saying if my mother becomes a Medicaid patient and my father doesn't we should inform VA office and they will 1) mothers amount to $90 a month and 2) reduce the pension to be lower/not account for 'spouse'- or ? My mother is not a veteran but we filed as Veteran and Spouse.
    Currently they -as a couple- are receiving $2,120/month from the VA.

    would it be $90 for mother plus some other amount for father? like max is $1,076 for a single vet or something like that I've seen out there?
    would we have to 're-file' ?

    thanks for any advice
  8. vetadmin

    vetadmin Administrator Staff Member


    They should just reduce Mom down to the $90, and drop Dad down to single veteran since her expenses for care will no longer factor in, but again, we are not the Medicaid experts.
  9. annie49

    annie49 Newbie

    My Dad is 93, living with my family for three yrs. and I have been his 24/7 caregiver. On a short list for an ALF, and am trying to figure out this maze of A&A paperwork.
    He does receive a VA disablity (non service related), does he have to fill out all the paperwork or would he be applying for an increase in pension benefits.
    Reviewing his rating, it says 100% Parkinsons
    Rheumatoid Arthritis 10%
    He has been getting this since 1993
  10. vetadmin

    vetadmin Administrator Staff Member


    The issue here is that disability "compensation" is quite different from Aid and Attendance, which is considered "pension".

    Since he is rated "non-service" connected, he would have to give up the amount he now receives in order to receive A&A pension award.

    You would want to look at the amounts and make certain that A&A would pay him more.
  11. VA Legal Team

    VA Legal Team Full Member

    The VA is very likely to reduce your rating. Compensation benefits are meant to replace income that you've lost because of your disability. So if part of your rating was based on inability to find or maintain employment, and now you are employed, a reduced rating is a very real possibility. I would assume, if you told the VA that you are now working, that they would want you to come in for another C&P exam. At that point I think it likely you'd see a reduced rating.
  12. Rboyer

    Rboyer Newbie

    My mother receives a benefit of $918 per month in aid and attendance. Back in October she was moved to an assisted living facility. We paid an application fee in Sept. And sent all documentation to the VA in Philadelphia, requesting her allowance be increased to the max of $1149 because of all the additional costs. It is now almost Febuary and to date all we have recieved is one letter from them back in October stating they were very busy and we would not here from them for some time and don't call. Why so long. Almost five months has gone by. Can anyone truely be that busy? I have even written to my congressman and he to said it could take him a month or more to get a reply. In the mean time I must make up this money from my pocket and am retired myself with limited income. This seems more like incompetent people not doing the job they are being paid for and not so much being over worked. In a private company this type of service would bankrupt you. But then private business doesn't get unlimited money from the taxpayer do it?
  13. k2

    k2 Newbie

    My 92 year old veteran Dad was awarded A&A in 2012, but has been receiving nominal monthly payments since he had already exhausted his financial resources and did not file annual MERs.

    I feared it was too late to file MERs when I heard that new deadlines were being considered. Encouraged by posts here that said A&A recipients are able to file at any time, I filed MERs for 2012-2014 in September 2015. Last week he received a response. I haven't received my copy yet, but am hearing that it only talks about reimbursing him for 2014. If true, the consequences will be devastating.

    Is there any hope? Or are new deadlines in effect for all vets, including A&A recipients?

  14. debgerhart

    debgerhart Newbie

    Please help! I'm attempting to process the paperwork for Veterans AId and Attendance for my mom, who is going to be 96 years old this month, has had a recent Below the knee amputation, and has just been diagnosed with pancreatic cancer. I have an important question - it says in the instructions to list all hospital visits and doctor's visits within the past year. Does this just mean listing facilities and dates, or do we actually need to have discharge papers or proof of doctor's visits. The same question applies to out of pocket expenses for medications .. do we have to list every medication time and date, or is it sufficient to say we spent X amount of money in 2015 for co-pays on medication? Any help would be most appreciated!! thanks!!
  15. Kaylin

    Kaylin Hero Member Staff Member


    What the VA is mostly looking for is monthly medical expenses that are depleting a veteran and/or spouses' income. The monthly expenses (such as those on medication or regular doctor visits) are the most important. However, if you provide a bank statement that shows how your mother's assets has been greatly depleted due to large sums of money put into surgeries, doctor's visits, etc. then that should also help.

    I hope that makes sense. Definitely use our website, in particular the "How to Apply" page which is listed below in my signature, to navigate you through the necessary paperwork. You can request the application be expedited as well, due to your mother being over the age of 90 years old.

    Make sure to keep a copy of everything before you send in the complete application and always mail return receipt.

    Good luck with the process. I wish for the best for you mother.
  16. vetadmin

    vetadmin Administrator Staff Member


    You can file at any time informing the VA of any changes to include increases in care expenses.

    I'm a little confused as to what his situation is and why he was receiving a nominal amount. Can you please provide more details on his situation?
  17. k2

    k2 Newbie

    Thanks for the reply!

    Yes, I understand that when a veteran reports they are paying more for home care, they may receive a larger award for the amount under the cap.

    This member of the Greatest Generation exhausted all resources (including the proceeds of a reverse mortgage) before filing for A&A because he figured: (a) others need it more than him, (b) he surely wouldn't survive this long, and (c) didn't realize that he needed to reserve enough capital to fund home care for 9 months or more to prove his need. Like so many others new to the process, he logically thought his physician's certification of his physical limitations (e.g. parapelgia with pancreatitis, IBS, etc., etc. ad nauseam) would be sufficient.

    Consequently, his 91 year old severely disabled wife has been handling the lion's share of home care with predictable results.

    We filed MERs for 2012-2014 to obtain retroactive medical expenses to enable them to establish a contract for more outsourced home care, pay medical debts, and cope with deferred home maintenance. Since medical expenses exceeded income one year, it looked like the pay back would handle all of this and put them back on an even keel. I am still awaiting my copy of the decision, but it sounds like the only change is for 2014 (when his medical expenses were lowest, having exhausted his resources).

    As the saying goes... "It gets curiouser and curiouser."
  18. k2

    k2 Newbie

    An aging disabled veteran was unable to arrange a payment plan with his medical provider. Instead, the veteran obtained a multi-year guaranteed bank loan.

    He did not report the transaction on that year's MER because he had already exceeded his medical cap. He wishes to report continuing loan payments made in subsequent years, since the regs emphasize date of payment (rather than origin of debt).

    #1. Which medical cap applies? The medical cap for the year of origin or when the loan payments were made?

    #2. If it's permissible, how does he identify the medical provider for a bank loan? "Dr. Doom via Chase loan?" If so, what evidence would he provide? The original bill and proof of monthly payments?

    #3. Can a previously submitted MER be amended with new information?
  19. SheilaB

    SheilaB Newbie

    I'm looking for some basic guidance regarding whether my mom may or may not be eligible for A&A. She's 91 years old, living independently in a retirement home, and does not yet require assistance with basic daily functions (but if the application process takes 8-10 months, as I've heard, she probably will need some assistance by that time). She definitely would meet the financial requirements, as she only receives social security and $625/month from my dad's pension, and has no assets such as investments, CDs, etc. I guess my first question would be: does she need to be eligible both medically AND financially. I've always thought that was the requirement, but she was talking to a friend yesterday who is also living independently in a retirement home and receiving $1100/month from A&A, and her friend encouraged her to have us check into this for her. Appreciate any assistance you might be able to provide.
  20. Kaylin

    Kaylin Hero Member Staff Member


    You can always put in an Intent to File form to start the process for the Aid and Attendance application if your mother will be paying for care. But she really does need to show some need for help with care in some way or another. She would have to show the expenses towards care costs, and the VA does not count a retirement facility as a care cost for the Aid and Attendance benefit.

    The Intent to File form is here: http://www.vba.va.gov/pubs/forms/VBA-21-0966-ARE.pdf

    Your mother may also be eligible for the Basic Pension since she is not technically medically qualified yet. Go to this FAQ page:
    and go to the section about "Are there other Veterans Improved Pensions that are available besides Aid & Attendance?" for more information on the Basic Pension.

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