Sample Of Completed Hb/aa Exam 21-2680

[silke]

This was completed by my husbands psychiatrist, we have an awesome doc who suggested we apply for A&A and voluntereed to do this without us even asking for it......I thought I would post key points so you all can have an idea of what should be on one of these......

From form 21-2680 Diagnosis: Schizophrenia, paranoid w/depression, GAD

21 is the claimant able to feed himself? No

If veterans wife does not feed him he will not remember to eat or drink. Sometimes requires assistance in feeding himself due to tremors.

23 Does the claimant need assistance in bathing and tending to other hygiene needs?yes

needs prompting and encouragement in taking care of hygiene. Is unable to initiate activity and focus well enough to complete tasks of daily living.

25 Does the claimant require nursing home care? No

But does need to live in a protected environment or assisted living.

26 Does claimant require medication management? Yes

The veteran cannot be relied on to take his required medications on his own, and he requires the constant monitoring of another to ensure that he does, which assistance is being provided by his wife.

27 Does the claimant have the ability to manage his financial affairs. No

Veterans wife takes care of financial matters. VA has proposed incompetency.

33 Describe how often per day or week and under what circumstances the claimant is able to leave the home or immediate premises.

The veteran is unable to leave the premises on his own due to the inablity to care for himself, delusional thinking, and hallucinations. Veteran would be at high risk for injury or psychotic break if not accompanied at all times when leaving his home.

....hopefully this will speed things up and maybe we wont need a C&P, if so I will bring this with to the C&P. Thanks for reading.

[silke]

Based on the exam, what do you think his odds are of getting A&A?

[Pete53]

I would say odds are good.