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Aid and attendance benefit for 100% PTSD veteran


us_marine_8052008@yahoo.co

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I am 100percent service connected for PTSD. I depend on my wife to help me with so much on a daily basis. from reminding me of my meds. keeping me on track of my daily routine. and supporting me throughout my day with my triggers. 

I don't know if I would qualify based on the nature of my disability but I wanted to at least attempt to apply. 

who do I need to speak with? 

thank you in advance. 

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Maybe.  Check the criteria, below,  and see how much, if any,  of this applies to YOU.  You can apply online, send an application to VA (Janesville), or get a VSO to help you.  Its found in 38 CFR 3.352

 

 

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(a)Basic criteria for regular aid and attendance and permanently bedridden. The following will be accorded consideration in determining the need for regular aid and attendance (§ 3.351(c)(3): 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. “Bedridden” will be a proper basis for the determination. For the purpose of this paragraph “bedridden” will be that condition which, through its essential character, actually requires that the claimant remain in bed. The fact that claimant has voluntarily taken to bed or that a physician has prescribed rest in bed for the greater or lesser part of the day to promote convalescence or cure will not suffice. It is not required that all of the disabling conditions enumerated in this paragraph be found to exist before a favorable rating may be made. The particular personal functions which the veteran is unable to perform should be considered in connection with his or her condition as a whole. It is only necessary that the evidence establish that the veteran is so helpless as to need regular aid and attendance, not that there be a constant need. Determinations that the veteran is so helpless, as to be in need of regular aid and attendance will not be based solely upon an opinion that the claimant's condition is such as would require him or her to be in bed. They must be based on the actual requirement of personal assistance from others.

(b)Basic criteria for the higher level aid and attendance allowance.

(1) A veteran is entitled to the higher level aid and attendance allowance authorized by § 3.350(h) in lieu of the regular aid and attendance allowance when all of the following conditions are met:

(i) The veteran is entitled to the compensation authorized under 38 U.S.C. 1114(o), or the maximum rate of compensation authorized under 38 U.S.C. 1114(p).

(ii) The veteran meets the requirements for entitlement to the regular aid and attendance allowance in paragraph (a) of this section.

(iii) The veteran needs a “higher level of care” (as defined in paragraph (b)(3) of this section) than is required to establish entitlement to the regular aid and attendance allowance, and in the absence of the provision of such higher level of care the veteran would require hospitalization, nursing home care, or other residential institutional care.

(2) A veteran is entitled to the higher level aid and attendance allowance authorized by § 3.350(j) in lieu of the regular aid and attendance allowance when all of the following conditions are met:

(i) As a result of service-connected residuals of traumatic brain injury, the veteran meets the requirements for entitlement to the regular aid and attendance allowance in paragraph (a) of this section.

(ii) As a result of service-connected residuals of traumatic brain injury, the veteran needs a “higher level of care” (as defined in paragraph (b)(3) of this section) than is required to establish entitlement to the regular aid and attendance allowance, and in the absence of the provision of such higher level of care the veteran would require hospitalization, nursing home care, or other residential institutional care.

(3) Need for a higher level of care shall be considered to be need for personal health-care services provided on a daily basis in the veteran's home by a person who is licensed to provide such services or who provides such services under the regular supervision of a licensed health-care professional. Personal health-care services include (but are not limited to) such services as physical therapy, administration of injections, placement of indwelling catheters, and the changing of sterile dressings, or like functions which require professional health-care training or the regular supervision of a trained health-care professional to perform. A licensed health-care professional includes (but is not limited to) a doctor of medicine or osteopathy, a registered nurse, a licensed practical nurse, or a physical therapist licensed to practice by a State or political subdivision thereof.

(4) The term “under the regular supervision of a licensed health-care professional”, as used in paragraph (b)(3) of this section, means that an unlicensed person performing personal health-care services is following a regimen of personal health-care services prescribed by a health-care professional, and that the health-care professional consults with the unlicensed person providing the health-care services at least once each month to monitor the prescribed regimen. The consultation need not be in person; a telephone call will suffice.

(5) A person performing personal health-care services who is a relative or other member of the veteran's household is not exempted from the requirement that he or she be a licensed health-care professional or be providing such care under the regular supervision of a licensed health-care professional.

(6) The provisions of paragraph (b) of this section are to be strictly construed. The higher level aid-and-attendance allowance is to be granted only when the veteran's need is clearly established and the amount of services required by the veteran on a daily basis is substantial.

(c)Attendance by relative. The performance of the necessary aid and attendance service by a relative of the beneficiary or other member of his or her household will not prevent the granting of the additional allowance.

 

 

 

If you feel you dont meet the above critieria, then you can still apply for SMC S (housebound) if you are "substantially confined" to your premesis.  

Edited by broncovet (see edit history)
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I called the 1000 VA phone number and they sent me an application that needs to be  completed by my primary doctor. does this sound right?

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21 minutes ago, broncovet said:

Maybe.  Check the criteria, below,  and see how much, if any,  of this applies to YOU.  You can apply online, send an application to VA (Janesville), or get a VSO to help you.  Its found in 38 CFR 3.352

 

 

If you feel you dont meet the above critieria, then you can still apply for SMC S (housebound) if you are "substantially confined" to your premesis.  

thank you for  being quick about responding. The VA just now emailed me an application that needs to be completed by my primary VA doctor. does this sound  right?

 

it sounds like a qualify but i was just wondering if there were any veterans with PTSD that have been granted the aid and attendance. 

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Ok, it sounds like there is a form you can give your doctor, and thats good, but you still need to "apply" at the VA.  Dont send just the docs form only, also file.  

Ptsd Vets can get a and a, provided that they meet the criteria, above.  

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7 minutes ago, broncovet said:

Ok, it sounds like there is a form you can give your doctor, and thats good, but you still need to "apply" at the VA.  Dont send just the docs form only, also file.  

Ptsd Vets can get a and a, provided that they meet the criteria, above.  

https://www.va.gov/vaforms/form_detail.asp?FormNo=21-2680

 

VA form-21-2680

 

this is the application they sent to me.

 now can i still receive my 100% benefit compensation and receive aid and attendance if  i qualify?

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I recommend doing as this says, below,  also.  That is, fill out the 526 EZ also.   Remember, the Va wont hold accountable anyone on the phone, or in person, whether they are a VA employee, VSO, or whatever, accountable.  You have to pay for their mistakes, so do it as it says:

https://www.benefits.va.gov/BENEFITS/Applying.asp

Yes, you can still recieve 100 percent comp and Aid and Attendance.  However, if your A and A was caused by "something other" than SC conditions, you probably wont get any more.  

The good news is that SMC is inferred..when you meet the critieria...so you may get retro pay, BUT, you will likely have to fight VA for it tooth and nail, as always.  So dont be suprised if you were eligible for A and A in 2005, but they give you the date of the exam in 2019, instead of 2005, hornswaggling you out of tens of thousands of retro.  Its what they do best.  

Edited by broncovet (see edit history)
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1 hour ago, broncovet said:

I recommend doing as this says, below,  also.  That is, fill out the 526 EZ also.   Remember, the Va wont hold accountable anyone on the phone, or in person, whether they are a VA employee, VSO, or whatever, accountable.  You have to pay for their mistakes, so do it as it says:

https://www.benefits.va.gov/BENEFITS/Applying.asp

Yes, you can still recieve 100 percent comp and Aid and Attendance.  However, if your A and A was caused by "something other" than SC conditions, you probably wont get any more.  

The good news is that SMC is inferred..when you meet the critieria...so you may get retro pay, BUT, you will likely have to fight VA for it tooth and nail, as always.  So dont be suprised if you were eligible for A and A in 2005, but they give you the date of the exam in 2019, instead of 2005, hornswaggling you out of tens of thousands of retro.  Its what they do best.  

im rated 100%for ptsd. 50 percent for sleep apnea, 50percent for pes planus (painful flat feet). 10 percent for elbow  injurty and 10 percent for knee injury.

 

so no my condition for me wanting a&a  is for my service connected condition. 

 

Thank you again for your time.

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