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Assistance with Form 21-4192, Helping my father with his claim



I am trying to help my father, a Vietnam Veteran, get through his claim. However, there are issues getting the 21-4192 form completed - he is the business owner, and I am the running the business entirely for him and an officer of the company. 

Some years ago (6 years maybe), it was determined that his involvement in the business was detrimental to the company. There were too many instances of altercations between him and the people working there, as well as customers. He would also just become unavailable and unreachable. There were many times our utilities or phone service became disconnected. He was either on edge or withdrawn and unavailable. He is still this way to this day, and more importantly than this claim, I hope he improves but he is now in to his 70's and I'm afraid that may not be the reality for him. Anyway, it was readily apparent that these altercations or absences were correlated to his mental health. There’s more but I’m trying to keep it short and the purpose of this post is about the form. 

So, 5 years ago it was decided that I would handle the affairs of the business. And herein lies the problem: He was also unable to manage his personal affairs and finances, so I then made all necessary payments for him from the business, and continue to do so to this day. And in order to keep everything legal, our CPA would tally up these payments and create a W-2 for him, and add the FICA taxes and everything to that month's payroll taxes. 

But the fact is, he never received a paycheck. No check that he could cash or deposit in to an account and spend. I was simply trying to make sure he was not living in the dark, and made these payments directly.

But this circumstance does not work with Form 21-4192. He was never “fired.” He was just unable to perform in the company and created a sense of unease and liability for the company and he has had not one duty, job or role within the company for many years. But, technically he has received a W-2, which as far as I know are considered wages from employment.

So how do I fill out and answer questions such as: 
-    8. Ending date of employment
-    10. Amount earned during 12 month preceding last date of employment
-    12. Hours worked (he has not “worked” any)
-    13. Concessions 
-    14B. Date last worked
-    15A. Date of last payment
-    Etc.

It would be more relevant if I could put the amounts he received from the company for his personal expenses under “benefits,” but he has received a W-2, since that was the strategy our CPA came up with.

The business last year has filed a loss rather than a profit and the 2,000 totaled payments on his behalf monthly is becoming unsustainable. He genuinely suffers from intrusive thoughts and I have a great deal of concern for his mental state and well-being. But this is something that does need to be handled. The PTS(D) as a result of his experiences are worsening in my opinion. And he is entitled to what he deserves. 

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On the form it has:


I feel the CPA could give a good explanation that would help you.

"The business last year has filed a loss rather than a profit and the 2,000 totaled payments on his behalf monthly is becoming unsustainable."

Yet that money does not go to him?

Do you hold his Power of Attorney?

In any event- this is an odd situation,yet maybe not that unusual at all,  but-regarding the PTSD claim- 

I assume you know he needs a valid stressor- has he shared any stressors with you?

Does he have the CAR ,PH, or CIB on his DD 214?

Was he incountry Vietnam, during the War? If so, he was exposed to Agent Orange.

Does he have any of the presumptive conditions  due to AO exposure?



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