Question on Letter(s) from Doctors

Discussion in 'General Discussion' started by Catie, Jul 13, 2010.

  1. Catie

    Catie Jr. Member

    I'll soon be tackling the VA application for A&A for my mother-in-law. Though we are working with an elder law attorney with some financial arrangements, he has reneged on the commitment he made early this year to provide hands-on assistance with the application.

    My question concerns a "tip" he gave me. He told me to solicit letters from all of my MIL's doctors. His advice was to have each of them write a letter explaining her need for care, since he believes the more people document her incapacity, the stronger her application will be.

    Do you think he's right? Or is this overkill, just too much information? Also, i appears there's one form for a doctor to complete. Does it matter which of her physicians fills it out? Her geriatrician is the one most informed about her mental condition.

    Thank you so much for this site and all the hard work invested in it. The information here is going to be super-helpful in the process!
  2. vetadmin

    vetadmin Administrator Staff Member

    Generally speaking you just want the primary physician to complete "1" form. Primary will have reports from all other treating doctors. We disagree with the suggestion to have letters from all doctors, and suggest you go with just the one.
  3. AngelaManz

    AngelaManz Jr. Member

    You really only need her primary care doctor to fill out the form. Sometimes the PCP doesn't have reports from other doctors if the client doesn't regularly see their PCP. I know this sounds strange, but many of my clients see their specialists more than their PCP for some reason. If that's the case, I submit the form to my client's PCP and any specialists that my client sees on a regular basis (like heart, cancer, psychiatrist, neurologist). But you really only need one good fully completed form.
  4. Catie

    Catie Jr. Member

    Thanks! I am only just beginning this task now b/c my MIL had a mild stroke and had to go into rehab awhile. She's doing fine now. I'm also now finished with the work with the elder law attorney.

    I'm going to have her geriatrician complete the form b/c she hasn't seen her PCP since early May. (She's seen a colleague of the PCP three times but...). Surely that will work. Is it correct to send him the one I found a link to on this site, "Medical Statement for Aid and Attendance" and have his office add medical records?
  5. Catie

    Catie Jr. Member

    Oops, or it looks like maybe I should be pursuing VA form 21-2680? I need to get into the groove. I printed off a bazillion pages and forms, etc. back in July. I'd sure appreciate the direction on this piece of it because it's going to take time for them to complete whatever I send and get it back.
  6. vetadmin

    vetadmin Administrator Staff Member


    You can use either form.
  7. Catie

    Catie Jr. Member

    Thanks so much!
  8. jpez

    jpez Full Member

    I have posted this previously but it is worth repeating.
    1. THe form needs to be LEGIBLE...very legible.
    2. no initials as diognosis.
    3. THe date that the diagnosis required A&A. THis is important and can trigger the 1 yr lookback award.
    4. If the answer is 'no' you MUST state: EXAMPLE Betty cant prepare her own meals because her Alzhiemer's causes her to forget that something is on the stove. She also is unable to shop because of her alzhiemers.
    5. I highly recommend to all clients that they fill the form uot themselfs....NEATLY and Completely. THen have the doctor sign. Most doctors rerally don't understand the importance of the 'because statement'.
    6. Form 2680 IS the trigger for the Homebound or A&A rating. THe clearer and easier it is to read, the faster the process goes.

    the above information has created approvals from date of app to approval letter of 47 days
  9. MJ

    MJ 85 year old mother is surviving spouse of veteran

    I totally agree with JPEZ on filling out the form yourself (because you KNOW the limitations better than the doctor). Then all the doc has to do is sign. That is what I did.. just took the filled in form along with Mom to doc appt and had him read over it and sign it. BAM! Easy Peasy!
    Good Luck to all who are in this process.
  10. Catie

    Catie Jr. Member

    "THis is important and can trigger the 1 yr lookback award."

    I tried to find info before on the one-year retroactive award and couldn't get an answer. Who is eligible for this and how? Is there a resource that gives details on this?
  11. jpez

    jpez Full Member

    1. qualify for Pension
    2. Be rated as "homebound' or 'Aid & Attendance'
    3. On form 21-2680 under Diagnosis: THe condition is reported as having existed for at upto a year before the date od application.
    4. The condition required a level of care that meets the "Homebound' or 'Aid & Attendance' level
    5. Have financial medical/care costs that reduce the grose income to a level that will trigger the award.
    you have to qualify moving forward first.
    THen, when the VA reads the 21-2680 (that was submitted with the application), the say to themselves "look, this person has had this condition for 2 yrs!"
    Example: Just being diagnosised w/ Parkinsons does not trigger an award. Meds can control early PK. But if the diognosis states that he has had it for say 5 yrs AND under the questions you state "has not been able to cook for the last 2 years because hand shake from Parkinsons". Now there is a clear picture that the condition has been bad enough to require help for the last 2 yrs.
    Notice that the 21-2680 form says:
    The purpose of this examination is to record manifestations and findings pertinent to the question of whether the claimant is housebound (confined to the home orimmediate premises) or in need of the regular aid and attendance of another person.The report should be in sufficient detail for the VA decision makers to determine the extent that disease or injury produces physical or mental impairment, that loss ofcoordination or enfeeblement affects the ability: to dress and undress; to feed him/herself; to attend to the wants of nature; or keep him/herself ordinarily clean andpresentable.
    the form determines not just the diagnosis BUT the need for care.
    this is how the retro claim is fiqured. you have to set it up in advance for it to ber clear that the need was there up to a year ago.
    hope this helps

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