"we cannot increase DIC benefits due to an increase in medical expenses"

Discussion in 'General Discussion' started by Phantom47, Oct 2, 2014.

  1. Phantom47

    Phantom47 Newbie

    Firstly, thank you so much for this resource! It has been really helpful and informative along the process of obtaining A&A.

    My dad was an Air Force veteran that passed away in June of 2013. I'm doing this for my mom, the spouse. My dad was 100% service connected disabled. We filed for DIC and A&A a few months after his passing. She was approved for DIC and the VA wanted a VA form 21-2680 Examination for Housebound Status or Permanent need for Regular Aid and Attendance for the A&A to proceed. They eventually got the 21-2680 and approved my mother for the minimum amount. Under the direction of the AMVET we were told to leave the financial portion blank, among other things. But she did get approved for A&A so it seemed to work. With the DIC and A&A it came out to $1,538.75 monthly.

    With the current amount of total income she's receiving versus her care costs, she's going into the negative. She is fully disabled and bedridden nearly 24/7 relying on others for everything. So we sent in a VA Form 21-4138 Support of Claim to give the VA her income and medical costs. The VA's response back has me confused and hopefully you could shed some light on it for me. Here's their response:

    "After reviewing your file, along with the documents you sent us, we determined that no change is warranted to your VA benefits. You are receiving a benefit called Dependency and Indemnity Compensation (DIC), which is not income-based, and is therefore not affected by your income or medical expenses. As a result, we cannot increase your DIC benefits due to an increase in your medical expenses. You will continue to receive your current benefit, pending future adjustments."

    The bold part is where I'm having a hard time fully comprehending. She gets the DIC due to my fathers passing, and they awarded her the minimum A&A. The vet was 100% service connected so I thought the spouse could receive both DIC and A&A up to the maximum amount. Did I possibly word the 21-4138 wrong and they thought we were asking for an increase in DIC and not A&A? I assumed the purpose of the A&A program was to help with health care costs when the veteran/spouse reached end of life stages, but it appears the VA is saying otherwise? To get her proper care would be at least $4,000 a month. Way more than DIC can cover. Not to mention she's still living in her own home and paying to run that. Her medical costs alone are projected at $48,000 a year with an income of $39,600. I mean I can keep on working for free as I'm her son and would do that for her, someone else wouldn't, but at some point she may need to go into a living facility or if I get hurt and can't work, or even needed to move on with my life so I can make a living myself, she would have no way of paying for care giving.

    Is there a way to get the VA to see this or have I really misunderstood the A&A program? Thanks so much for your time and help!
  2. vetadmin

    vetadmin Administrator Staff Member

    First, can you please clarify if your Mom is paying you to act as her caregiver?

    Her expenses for running her home are not allowable medical expenses, so those costs do not count.
  3. Phantom47

    Phantom47 Newbie

    Sorry for not clarifying, yes my mom is paying me to act as her caregiver since May of this year. She's paying out of life insurance money, otherwise she wouldn't be able to afford running the home and paying for care giving at the same time. I didn't include any home expenses to the VA because I understood them to not be allowable medical expenses as you explained. Essentially for medical costs I presented to them $4,000 monthly for 24/7 in home care(this is the lowest amount paid in my area), her medicare premium, and her prescriptions which both of those together were about $116 a month. Medical expenses, income, and a note saying her medical costs have increased and asking for a review are what I presented to the VA. As I noted before, when AMVETS had us do the application they left her income and medical costs blank, so I thought all the VA needed was an update on her situation. I just don't understand the VA's response, and sadly the local AMVETS office isn't too familiar with A&A other than applying for it.

    We set up a household employer/employee relationship with the payments starting in May of this year. We have paid CA State taxes and some estimated taxes to the IRS. I only mentioned the costs to run the home to make clear if she were to pay $48,000 for 24/7 home care, she would not be able to afford to live in her home too.

    She is disabled, diagnosed in 1995 with Multiple Sclerosis, she can no longer do anything but feed herself with one hand. Her income is $668 a month after the medicare premium. The rest of her income, around $2730 monthly, comes from pensions and VA benefits awarded after my dad's passing. :'(

    If it comes down to it, I'll work for free to insure she stays happy and healthy. I just don't quite know where to go from here because I don't understand the VA response, and they say to contact your AMVETS with any questions. I hope this info will help give a clearer picture.

    A little off topic, she was due a Survivor Benefit Plan that my dad payed into under the impression that the insurance goes to the survivor... well since she's getting DIC they canceled the SBP and gave her a small offset instead. If they hadn't done that she would have made enough to be able to afford some cheaper care that could come throughout the day instead of the expensive 24/7 care. It irks me that they do this to veterans families and nobody finds out until the time of death, and they make you use a third party advocate to get these A&A benefits when I feel this should be something the government helps with. It feels a bit like I'm going in circles, but thank you kindly for taking the time to help and letting me vent a little. We appreciate it!
  4. vetadmin

    vetadmin Administrator Staff Member

    i would suggest you do VA form 21-4138 showing your Mom's monthly care expenses to clearly illustrate what she is paying for her 24/7 care. Leave all other misc. expenses out. Focus on the cost of care.

    With her receiving DIC, she is not going to get the full award of A&A.

    Yes, it is quite sad how this agency is allowed to run, and how veterans, and their widows have to fight for what should be easily available.
  5. Max

    Max Hero Member

    A&A is just an extra amount of money paid on top of either pension or DIC. Everyone in this forum is talking about pension because it is the easier benefit to receive, but DIC is a higher monthly amount.

    Medical expenses do not affect A&A because it is just an extra amount of money. They affect the rate of pension payable. But since your mother receives DIC, the expenses are irrelevant.

    So essentially, you get a flat rate extra amount of money every month based on her medical condition. If she was just receiving DIC, she would get $1,233.23. But since she is receiving DIC with A&A, she gets more than that.

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