My Story - So Far Part 1

Discussion in 'Share Your Personal Experience' started by Deb K, May 13, 2017.

  1. Deb K

    Deb K Newbie

    First, thanks to everyone on this site. The information has been invaluable, and it's nice to know I'm not the only one on this journey! As much as everyone's story is the same, they're also very different in many ways. I hope mine can help someone else.
    My mom is now 89, a surviving spouse, and in 2012 broke her leg, necessitating a 3 month rehab and a return home with a 24/7 caregiver living in her home from that point forward. At that time, I took over as her POA, and brought all of her important papers home (I live 1,000 miles away). I become aware of the possibility of A & A benefits, but upon review, saw that she wouldn't need much help out-of-pocket, so I tabled it. However, at least I became aware that I had my dad's original military papers at my home, their marriage certificate and his death certificate, giving me important information I would need later to request new certified copies.
    In July 2016, mom experienced a medical situation, that combined with her existing physical decline from spinal stenosis, resulted in the need for a 2nd caregiver in her home 24/7/365 days simultaneously, as the 1st caregiver she had since 2012, to assist her. She's physically like a limp noodle and while not paralyzed, can't move herself around. Her long term care insurance is capped at a maximum amount payable per day and mercifully covers the cost of the regular pay of the 1st caregiver. It does not, however, cover the holiday difference in pay for caregiver #1, nor the regular and holiday pay cost of caregiver #2. That's when I began to accumulate all of the forms and documentation needed to support her claim. At times, I had to be creative to get what I needed on her behalf, but it got done more quickly than I thought.
    Mom had to sign some of the initial forms as you all know, which was challenging given the distance. What I discovered, is that Priority Mail is not guaranteed to arrive in a few days. Fast forward to 3 versions of the same form going back and forth, until 1 finally arrived that was also correctly signed. I think I lost about 2 -3 weeks with that fiasco.
    9/12/16, I mailed a packet to the VA, Priority Mail EXPRESS, return receipt requested with signature required. This enabled me to track online where it was, and print off documentation of it's arrival. Included were: 1) VA Form 21-534 EZ, 2) VA Form 21-22a, 3)VA Form 21-0845, 4)VA From 21-2680 and 5)VA Form 21P-8416, along with certified copies of: Affidavit for License to Marry, Marriage license, Marriage Certificate (these all arrived with my request to our records office so I included them), dad's death certificate, honorable discharge papers. Additional supporting documents included mom's federal annuity from dad's time with the USPS, Social Security, Charles Schab and bank information. Also included was a copy of her long-term care insurance premiums, dental insurance premium, a statement from her home health care agency documenting projected out-of-pocket expenses, bank information for automatic payments for some of these costs, checks written for medical expenses, credit card automatic payments for dental, medical statements of costs not covered etc. My cover letter listed all of the above. I then organized these into sections, put a labeled cover sheet on each section listing what was included. As you can imagine, this was probably 2 inches thick. Her date of claim was established as the very next day 9/13/16.
    A letter dated 9/19/16 was received by my mom indicating that a death certificate for my father with cause of death was needed (the one I sent didn't have that information). The letter also said that we told them she was in a nursing home, and that they needed VA Form 0779 and VA 21-8416 to document whether Medicaid covers all or part of these costs.
    10/1/16 I responded with a 2nd certified copy of dad's death certificate with cause of death, and indicated that I was not able to submit VA Form 0779 or VA Form 21-8416 because my mother was NOT in a nursing home, she was never in a nursing home and she was not receiving Medicaid. I reiterated that she was living at home with 2 caregivers. I further stated that I had reviewed the application and could find no place where I had indicated anything in reference to a nursing home.
    I'll end here and pick-up in Part 2.
    Kaylin likes this.

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