Need Help Applying For Aid & Attendance

[JAB]

My mother is living alone in her 80s, and her health is failing to the point that she needs assistance to remain at home. She appears to be elgible for spousal A&A, because of my dad's service in WWII. I've been reading over the 21-534 application and I have questions.

She's become unable to drive and needs assistance to leave home, needs someone to prepare meals, buy groceries, and monitor her diet. If left alone, she only eats junk food since it doesn't require preperation. She can still bathe herself, but wants and needs someone to help her into the bathroom and stand by the door, in case she gets dizzy or were to fall. She has too many medical issues to list here but mainly it's PMR (been on steroids for years), recurring infections that have occasionally required hospitalization, osteoperosis, digestive disorders, and malnutrition (IMO).

First question: I don't know which of her doctors she should ask to fill out the doctor's form. I'm thinking her GP at her local clinic would do this, but he doesn't have access to the various records that the other doctors have. We also don't know what the doctor's report should state specifically, and what the VA case workers are looking for to qualify her..............we're wondering if it might be better to ask the VA to have their own doctor examine mother, since they would know what to look for.

Secondly, her yearly income which consists of SS check, a small pension, and a small IRA withdrawal, amounts to a little over $10,000 a year. She can deduct her medical expenses, etc, and reduce that to $4-$5K or less. She recently began hiring "in home care" from the Visiting Angels, but she's only able to afford them for 3 hours, once weekly, which costs $50. She really needs them to come in 5 days a week 3 hours a day, which would be exactly $1,000 a month. Finally, my 2nd question: Can she state on the application that she needs to spend $1,000 a month for in-home care, and deduct that from her remaining income, or would the service need to be started first, before it could be deducted from her income?

Thanks in advance & sorry for being long-winded,

Glad2Bhere

[Berta]

Does she receive DIC?

If yo use the search featur up top= there is info on A & A for spouses of veterans as well as a link to the form she will need to have doctor fill out.

[JAB]

Berta, no I've assumed that mother wasn't elgible for DIC since she has an IRA asset in the $40,000 range. Also, dad didn't die of service related issues, although he was 30% SC. If you're suggesting that she might be eligible for DIC because I'm 100%, my disablility was a 1151 claim.

I still hope to get feedback about my original post. I will try the search tool, but I haven't been successful so far. Thanks

[Berta]

Her income or assets are not a factor in a DIC award. They would be a factor if she applied for a VA death pension.

I am not at all aware of how she could receive A & A from VA unless she receives either DIC or the death pension.

DIC involves SC contributing to or causing death and the pension depends on wartime service of the veteran, and limited income and assets of the surviving spouse.

Aid and Attendance for a surviving spouse is predicated first upon receipt of either DIC or a VA wartime pension.

The regulations are found within 38 CFR 3.351.

NVLSP (VBM) has considerable info on this type of benefit making the point that the spouse might be eligible for a Housebound SMC award if not fitting into the Criteria of the A & A award.

But it appears that your mother does not receive either DIC or a VA pension.

http://law.justia.com/us/cfr/title38/38-1.0.1.1.4.2.65.143.html

Others will chime in here I hope-as I am confused by this situation.

Is she going to apply for DIC? What basis of service connected death will she raise?

"Can she state on the application that she needs to spend $1,000 a month for in-home care, and deduct that from her remaining income, or would the service need to be started first, before it could be deducted from her income?"

She could state this is what she expects to pay yet make sure they know this isnt what she is paying now-but if she is awarded DIC I dont think this would be an issue as the VA would add an additional benefit to her DIC check.

The VA will make a determination as to whether she is eligible for the VA death pension if she is not eligible for DIC.

[JAB]

Aid and Attendance for a surviving spouse is predicated first upon receipt of either DIC or a VA wartime pension.

Berta, I wasn't aware of this and I don't know how she could get DIC since dad's death wasn't service connected. I figured that mother was eligible for A&A, as implied below. Copied from http://www.veteranaid.org/eligibility.php

I'd still like an opinion about having her examined by the VAs doctor, as opposed to her GP.

thank you, JAB

ELIGIBILITY FOR THE AID & ATTENDANCE PENSION

Any War-Time Veteran with 90 days of active duty, 1 day beginning or ending during a period of War, is eligible to apply for the Aid & Attendance Improved Pension. A surviving spouse (marriage must have ended due to death of veteran) of a War-Time Veteran may also apply. The individual applying must qualify both medically and financially. To see the periods of war that have been qualified by Congress, Click Here.

To qualify medically, a War-Time Veteran or surviving spouse must need the assistance of another person to perform daily tasks, such as eating, dressing, undressing, taking care of the needs of nature, etc. Being blind or in a nursing home for mental or physical incapacity, or residing in an assisted living facility also qualifies.

Eligibility must be proven by filing the proper Veterans Application for Pension or Compensation. This application will require a copy of DD-214 (see below for more information) or separation papers, Medical Evaluation from a physician, current medical issues, net worth limitations, and net income, along with out-of-pocket Medical Expenses.

To qualify financially, an applicant must have on average less than $80,000 in assets, EXCLUDING their home and vehicles.

[Berta]

I personally feel an outside doctor, who has the proper criteria for the specific type of A & A claim ,which they can compare to her medical records, might be a better source for help here - than any VA doctor.

It does appear from that you found in the regs that she would not necessarily have to be in receipt of either DIC or a VA Wartime widow's pension.???

But I am not sure of that at all since the A & A is added to any existing comp or pensions check a survivor receives from what I understand.

You mentioned you get 100% under Section 1151, 38 USC.

For years I too was a Sec 1151 DIC recipient but proven direct SC death last year.

Since we are 1151ers you probably can understand well my point that trusting a VA doctor to properly assess her disabilities and eligibility for A & A might be an exercise in futility and I feel she would need medical evidence and an opinion from her treating private doctor anyhow. VA under the VCAA will ask for those records.

"Berta, no I've assumed that mother wasn't eligible for DIC since she has an IRA asset in the $40,000 range. Also, dad didn't die of service related issues, although he was 30% SC."

The IRA would not affect any determination as to her potential DIC.I had assets and property when me husband died. I think they asked for my complete financial statement as part of the 534 application to see if I was eligible for war time pension if not eligible for DIC award.I was awarded DIC but am not familiar with the way the VA determines pension criteria as it depends on each individual's situation.

My husband died with 30% SC and I now receive direct service connected death DIC.The 30 % SC he got was not a factor in the DIC award.(multiple malpractice -long story)

What was his 30% for and it there any possible way the 30% could have contributed to his death?

Can you tell us what he died from as stated on his death certificate?

I sure hope others help here because I am well versed in DIC but not the A & A benefit.

I know I am eligible for it if my medical conditon warrants it- but it would be added to my DIC check every month.

Or added to a VA pension check for some widows.

She might be fully eligible for the pension and I feel you should try to get a good vet rep to help with the 21-534 to make sure her medical bills and her income are properly considered by the VA.

But DIC is the better benefit.It has no restrictions on income.

VA will make a determination on both- and hopefully could award pension /or DIC in addition to the A & A.

I just do not know if they would award just the A & A without a determination on pension or DIC.

There is info here -I will try to find it for you.

If she lives with you as your dependent it seems to me VA should have considered that when they awarded you 100% under 1151.

In that case there would have possibly been an additional dependents award included in your check.

I am not sure about that either -however-I did receive dependents award for my daughter before she joined the Mil under my 1151 DIC.

DIC- there is always a potential that one can overlook the fact that a 30% VA disability could cause or contribute to death.

As I said my husband was 30% for PTSD at time of his death with claim for higher rating pending as well as his own 1151 claim pending.I re opened both claims when he died and proved them both.

Nothing is impossible with the VA so it pays to consider the cause of death and the SC rating he had to see if there could be any potential DIC award.

Real case: vet died with hearing loss SC rating. He died of heart disease. The spouse proved his HL was so bad that he could not do any exercise and the NSC heart disease had caused him to become unable to work.He apparently had many dizzy spells from the HL and sat for hours watching TV as the imbalance from his ear problems made him fearful of falling if he did anything involving walking and standing.His inactivily was a strong factor in his heart disease and his weight gain.

The BVA granted DIC as they determned his SC HL contributed to his death.

A SC only has to 'contribute' to death by medical evidence,it doesn't necessarily have to 'cause' death, to have the death service connected.

[Berta]

In this discussion here Sharon posted the A & A criteria for all who might be eligible:

The VA will have to receive the 21-534 and make a determination for your mother first as to whether she quslifies for a wartime pension or for DIC.

I suggest-if the 534 has not been filled out yet- that you obtain a vet rep to help her with it.and to request not only the pension but DIC as well if the rep sees any potential for DIC at all.

As you know there are a million or more claims in the system so this might take some time for the claim to be resolved. When she receives a VCAA letter -within a few months after they get the 534 application=it will tell her exactly what the needs to have as evidence.The vet rep should be aware that she is also requesting the A & A benefit along with either the wartime pension or DIC.