Medically allowed but financially denied

Discussion in 'General Discussion' started by Dru, Nov 28, 2007.

  1. Dru

    Dru Newbie

    Recently we received a notification that my Mom had been medically approved for A&A; however she was financially denied based on an income slightly above the allowed level. I'm very thankful that her medical claim has been allowed. We have planned for her to live in a nearby assisted living facility when her application was approved. The cost of this facility will allow her to qualify under the financial guidelines. My question is - do we need to submit a completely new application based on the new financial situation if/when she enters the ALF? If all we need to do is submit proof that she has entered the ALF how long do we have subsequent to the initial denial to submit this revised financial information? Mom needs to be in ALF but our family cannot pay for it - this is the reason we were awaiting the medical decision prior to getting her into the facility. (She was in the ALF for a short period following her most recent hospitalization.) Thank you for any help you can provide.
     
  2. veteranadvocate

    veteranadvocate Full Member

    You can submit a EVR (Eligibility Verification Report) whenever she goes into an ‘assisted care facility’ or nursing ‘home’. There are several different EVR forms but from what I can gather from your e-mails, she should complete #8. That form can be downloaded from the following website.

    http://www.vba.va.gov/pubs/forms/21-0518-1.pdf

    You should send a letter from the facility stating the date she entered and what her monthly charges will be. You should also complete a VA form 21-4138 (Statement in Support of Claim) and ask that the VA consider her charges as reoccurring when they determine her net worth and anticipated medical expenses.

    The VA form 21-4138 can be downloaded at the following link.

    http://www.vba.va.gov/pubs/forms/vba-21-4138.pdf
     
  3. Dru

    Dru Newbie

    Thank you so much. I will follow your instructions. Is there a deadline after which these forms would no longer be appropriate, but instead an entirely new application would be required?
     
  4. Dru

    Dru Newbie

    Since posting my last question, I've received the letter and paperwork sent to my Mom which stated that she had been medically allowed but financially denied. We live in different cities, and I had to wait for my brother to send copies to me. I see that she has until 2009 to file a change of fianacial position. I wanted to post this in case others are in similar circumstances.
     

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