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A&a


jpride407
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Question

I am rated at 160% 100%for COPD 20 for hearing and 40 for knees. Does this mean that I qualify for A&A? If so will i automatically receive it or will I need to file another claim for it?

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  • HadIt.com Elder

It doesn't necessarily mean that you qualify. You will need a few things first, and then you will need to file a claim for it. You need:

1. (from 38 CFR 3.352)...inability of claimant to dress or undress himself (herself), or to keep himself (herself) ordinarily clean and presentable, frequent need of adjustment of any special prosthetic or orthopedic appliances which by reason of the particular disability cannot be done without aid (this will not include the adjustment of appliances which normal persons would be unable to adjust without aid, such as supports, belts, lacing at the back etc.); inability of claimant to feed himself (herself) through loss of coordination of upper extremities or through extreme weakness; inability to attend to the wants of nature; or incapacity, physical or mental, which requires care or assistance on a regular basis to protect the claimant from hazards or dangers incident to his or her daily environment.

2. Then you will need a physician's statement saying that you need some of the items listed in number 1. The reg states that you do not need to meet all of the criteria, nor that there needs to be a constant need for A&A. Some on here will tell you that you MUST have a 100% schedular rating, and that you must be housebound. This is not the case, per the regulation. The only place these requirements are mentioned is in the C&P Service Clinician's Guide. This is a manual, not a law or reg, and therefore has not merit in determining the award of A&A.

3. After you file for A&A, and send in the evidence listed in 2, you will most likely have a C&P for the award. It is much easier to get this award if your disability is blindness, deafness, loss/loss of use of one or more limbs, paralysis, or a severe mental condition. That is not to say that your condition would not qualify you. It will depend upon your circumstances.

Hope this helps a little.

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  • HadIt.com Elder

The VA still does its own math. If you were 100% plus 60% for one rating its a slam dunk.

You should still apply for it. I went to my primary care Doc and she wrote it up and I submitted the claim had a C&P and was awarded A&A.

I am still not sure that I got it for my rating for panic disorder with agoraphobia or they think that I qualify cause of other medical problems.

I guess I will find out one of these days I have appealed my denial for an earlier effective date.

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Rentalguy1

I have a few questions I have an in-law 85 yr old 100% SC WWII and recently had hospitalization with gout and numerous clots in lungs...spent 11 days in hospital, and discharged to nursing home...not ambulatory now, unable to do any ADL's or care for self at all...his VSO told him he wasn't eligible for A&A or if could get it maybe $93.00 per month.

I told him to apply. Already was depressed, now totally. Was basically independent prior, did have homehealth come in 2 hrs 2x per week, and was on sliding scale to pay. Wants to stay in own home but costs of homecare is outrageous, especially for 16 to 24 hours a day.

Have any ideas on:

1) Any way to speed up application process for A&A?

2) Vets home 85 miles away and is going on waiting list, but has home and wants to go home.

3) Has been in civilian hospital and what are the form #'s need to be filed for A&A?

4) Should he be taken to a VA 130 miles away to have "VA" physician file paperwork or civilian Dr ok?

5) Any idea how long this process will take with someone this elderly?

Any info you can give will be appreciated. Thank you. :rolleyes:

It doesn't necessarily mean that you qualify. You will need a few things first, and then you will need to file a claim for it. You need:

1. (from 38 CFR 3.352)...inability of claimant to dress or undress himself (herself), or to keep himself (herself) ordinarily clean and presentable, frequent need of adjustment of any special prosthetic or orthopedic appliances which by reason of the particular disability cannot be done without aid (this will not include the adjustment of appliances which normal persons would be unable to adjust without aid, such as supports, belts, lacing at the back etc.); inability of claimant to feed himself (herself) through loss of coordination of upper extremities or through extreme weakness; inability to attend to the wants of nature; or incapacity, physical or mental, which requires care or assistance on a regular basis to protect the claimant from hazards or dangers incident to his or her daily environment.

2. Then you will need a physician's statement saying that you need some of the items listed in number 1. The reg states that you do not need to meet all of the criteria, nor that there needs to be a constant need for A&A. Some on here will tell you that you MUST have a 100% schedular rating, and that you must be housebound. This is not the case, per the regulation. The only place these requirements are mentioned is in the C&P Service Clinician's Guide. This is a manual, not a law or reg, and therefore has not merit in determining the award of A&A.

3. After you file for A&A, and send in the evidence listed in 2, you will most likely have a C&P for the award. It is much easier to get this award if your disability is blindness, deafness, loss/loss of use of one or more limbs, paralysis, or a severe mental condition. That is not to say that your condition would not qualify you. It will depend upon your circumstances.

Hope this helps a little.

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  • HadIt.com Elder

First I want to be upfront and say that I am not a A&A expert, but I have read the regs, and the information that the RO needed to award in my own denial.

Have any ideas on:

1) Any way to speed up application process for A&A?

Only way to speed up any claim is due to a terminal illness, such as cancer. You can try asking to have it sped up due to advanced age and deteriorating health, but I don't think it would help.

2) Vets home 85 miles away and is going on waiting list, but has home and wants to go home.

I assume it's a waiting list for home-health. I've always said that if a sick or elderly person wants to live out their remaining days in their home, and there is a way to make it happen, then you should let them do so. My 92 year old grandmother lived at home up till her last month here on earth. The whole family pitched in to take care of her, and her medicare paid a lot of the bill. I don't know the first thing about medicare, though, so I can't really help there.

3) Has been in civilian hospital and what are the form #'s need to be filed for A&A?

Doesn't matter what kind of a hospital. The only form would be a request for A&A on a VA Form 21-4138.

4) Should he be taken to a VA 130 miles away to have "VA" physician file paperwork or civilian Dr ok?

A civillian doc is as good, or better than a VA doc. He just needs to use the proper language. Refer to my prior post in this thread for that language from 38 CFR 3.352.

5) Any idea how long this process will take with someone this elderly?

It will take as long as any other claim, unless there is a terminal illness. I would look for a minimum of six months, depending on the RO you are dealing with. If all of the evidence is not submitted up front, when you file the claim, it will add more time to the process.

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Thanks rental...2) Veterans State Home is 85 miles away, his home is 1/2 mile away. Medicare does not pay for the home care aid, only for hosp stay and for the therapists. Will pay for partial in nursing home and up to 100 days only if meets regulations. Will proceed with form.

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First I want to be upfront and say that I am not a A&A expert, but I have read the regs, and the information that the RO needed to award in my own denial.

Have any ideas on:

1) Any way to speed up application process for A&A?

Only way to speed up any claim is due to a terminal illness, such as cancer. You can try asking to have it sped up due to advanced age and deteriorating health, but I don't think it would help.

2) Vets home 85 miles away and is going on waiting list, but has home and wants to go home.

I assume it's a waiting list for home-health. I've always said that if a sick or elderly person wants to live out their remaining days in their home, and there is a way to make it happen, then you should let them do so. My 92 year old grandmother lived at home up till her last month here on earth. The whole family pitched in to take care of her, and her medicare paid a lot of the bill. I don't know the first thing about medicare, though, so I can't really help there.

3) Has been in civilian hospital and what are the form #'s need to be filed for A&A?

Doesn't matter what kind of a hospital. The only form would be a request for A&A on a VA Form 21-4138.

4) Should he be taken to a VA 130 miles away to have "VA" physician file paperwork or civilian Dr ok?

A civillian doc is as good, or better than a VA doc. He just needs to use the proper language. Refer to my prior post in this thread for that language from 38 CFR 3.352.

5) Any idea how long this process will take with someone this elderly?

It will take as long as any other claim, unless there is a terminal illness. I would look for a minimum of six months, depending on the RO you are dealing with. If all of the evidence is not submitted up front, when you file the claim, it will add more time to the process.

I hate to scof since I have follicular cancer, just had a heart operation to remove a thrombus (tumor) VA, back to the RO, and finally back to the BVA. Clot formed because I had to have a high speed injection port placed in my chest because chemo made it extremeluy difficult to draw blood. Hurry ? Expedite ? You say ? Have had expedited process for serious nature to my condition since January 2005. Let me see ..........that is like 2 years and 8 months of expedition......!!!!!!!!!!!!!!!!!!!!!!!!!!!! Give me some of that good oh expedition.....

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