Aid And Attendance

[windy city]

I was accepted in the VA ILP but when I went to see the counselor she told my wife that she needed to apply for A&A because she is sick. I recieave A&A, but the question that haves me wondering is she suppose to apply for monetary compensation or is it that they will send somebody to the house to help here. I just need some clarification on this issue, because my counselor is note going to be in her office for a while.

[sixthscents]

Thats a good question and one we dont see much.

Aid and Attendance for a disabled spouse is a GOOD thing. Yes there is a small monetary benefit... something like $172 a month, just check the rating schedule and look at the bottom. You can find it at www.va.gov under compensation. Its in small print and says how much is added for a spouse being disabled.

Yet, thats just the small part. It will cause the VA to consider you for several other programs,, and even a higher level of SMC, if constant care is needed. Since the spouse cannot provide the additional care, the VA will pay someone to. Now, a clear definition of what you can and cannot do is necessary, and a doctors statement in support of that. However it can cause the VA to consider you for a highher A&A rating if necessary, it certainly will be a factor in consideration.

So, personally I think the ILS, or Voc Rehab person is dead on. It cannot hurt anything, only help.

[windy city]

Thats a good question and one we dont see much.

Aid and Attendance for a disabled spouse is a GOOD thing. Yes there is a small monetary benefit... something like $172 a month, just check the rating schedule and look at the bottom. You can find it at www.va.gov under compensation. Its in small print and says how much is added for a spouse being disabled.

Yet, thats just the small part. It will cause the VA to consider you for several other programs,, and even a higher level of SMC, if constant care is needed. Since the spouse cannot provide the additional care, the VA will pay someone to. Now, a clear definition of what you can and cannot do is necessary, and a doctors statement in support of that. However it can cause the VA to consider you for a highher A&A rating if necessary, it certainly will be a factor in consideration.

So, personally I think the ILS, or Voc Rehab person is dead on. It cannot hurt anything, only help.

Thanks for answering back, know what should I do and what do I need from my doctor, any information will be usefull to me since I do not have to much knowledge with thw va and its regulations.

[sixthscents]

Sure but let me get specific and show my guidance. The rates for A&A spouse are shown here: http://www.vba.va.gov/bln/21/Rates/comp02.htm

It looks like $126 is the base rate, but theres a footnote, so please read it...

Now I was a bit unsure how to answer the doctor question for HER... since you will have to prove she is disabled. Normally though in my experience simply showing that she is receiving Social Security Disability is enough.

OK, now your statement from your doctor will need to address things like can you dress yourself, bath youself... the specific under cfr 38 states:

(3) Need for aid and attendance. The criteria for determining that a veteran is so helpless as to be in need of regular aid and attendance are contained in §3.352(a).

And that says:

§3.352 Criteria for determining need for aid and attendance and

“permanently bedridden.”

(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©(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.

Now there's more to it than this but I didnt see the need to post the whole thing, just search at www.va.gov under CFR 38 3.352... ok?

I hope this answers everything. Anything else just ask... more than happy to help.

[windy city]

Sure but let me get specific and show my guidance. The rates for A&A spouse are shown here: http://www.vba.va.gov/bln/21/Rates/comp02.htm

It looks like $126 is the base rate, but theres a footnote, so please read it...

Now I was a bit unsure how to answer the doctor question for HER... since you will have to prove she is disabled. Normally though in my experience simply showing that she is receiving Social Security Disability is enough.

OK, now your statement from your doctor will need to address things like can you dress yourself, bath youself... the specific under cfr 38 states:

(3) Need for aid and attendance. The criteria for determining that a veteran is so helpless as to be in need of regular aid and attendance are contained in §3.352(a).

And that says:

§3.352 Criteria for determining need for aid and attendance and

“permanently bedridden.”

(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©(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.

Now there's more to it than this but I didnt see the need to post the whole thing, just search at www.va.gov under CFR 38 3.352... ok?

I hope this answers everything. Anything else just ask... more than happy to help.

She does recieave Social Security and her doctor filled out the VA form for spousal A&A. I do not know if I mentioned it I recieave the regular A&A but with my wife needing A&A will they increase my A&A to a different rate and if this is true what do I need to do. I am gratefull to have you guys that are willing to help me and so many others that are not experieanced with the VA. I think you guys are doing an excellent job and I hope you guys can continue to provide this services to all of us that need it. Thanks.

[sixthscents]

Well first you will get the additional $126 (not much I know but there it is)... and it can be a MAJOR consideration when you go to the doctor for the evaluation. I would go to a doctor, family physician is fine and get a letter stating what you cannot do, that coincides with what the VA says you cannot do to need additional A&A, as shown below...

Further I would make CERTAIN that the doctor included on the letter that your spouse is disabled and unable to provide the care necessary for these things... I will be a consideration.

Basically I would get the doctor to SPECIFICALLY adress each of the following points:

The following will be accorded consideration in determining the need for regular aid and attendance (§3.351©(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.

Each one of these in a step by step format like:

1. The patient is unable to dress themselves without help

2. The patient is unable to bath or clean themselves without assistance

3. The patient is unable to cook or clean their household

4. The patient is unable to manage their medication without help

5. The patient is unable to put on orthopedic or other appliances without help

6. The patient is unable at times to ambulate without assistance

etc etc...

Like I said address what the VA states are the requirements...

Also, if you have Medicare this statement will also suffice for in-home care, at least in Tennessee. My mother-in-law has a round the clock nursing care due to her unsteady gait and inability to manage her medications...

I know its a bunch to ask of your doctor so you might want to have an example typed up... or a letter that he could just sign if he agrees with the conclusions...

Thats how I'd handle it anyway... doctors hate typing letters, and if hes a family doc he or she knows the care you need anyway, so should have no problem signing off on something that is factually correct.

If youd like I'll type up a letter, but you probably know your condition ebtter, and like I said it just needs to address what the VA wants...

That will put you in a MUCH higher Special Monthly Compensation catagory...

again look it up under www.va.goc the link I already supplied... its here :

http://www.vba.va.gov/bln/21/Rates/comp02.htm

and youd be looking at R1 or R2 if you do in fact need the care.

Anything else just ask.

[windy city]

Well first you will get the additional $126 (not much I know but there it is)... and it can be a MAJOR consideration when you go to the doctor for the evaluation. I would go to a doctor, family physician is fine and get a letter stating what you cannot do, that coincides with what the VA says you cannot do to need additional A&A, as shown below...

Further I would make CERTAIN that the doctor included on the letter that your spouse is disabled and unable to provide the care necessary for these things... I will be a consideration.

Basically I would get the doctor to SPECIFICALLY adress each of the following points:

The following will be accorded consideration in determining the need for regular aid and attendance (§3.351©(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.

Each one of these in a step by step format like:

1. The patient is unable to dress themselves without help

2. The patient is unable to bath or clean themselves without assistance

3. The patient is unable to cook or clean their household

4. The patient is unable to manage their medication without help

5. The patient is unable to put on orthopedic or other appliances without help

6. The patient is unable at times to ambulate without assistance

etc etc...

Like I said address what the VA states are the requirements...

Also, if you have Medicare this statement will also suffice for in-home care, at least in Tennessee. My mother-in-law has a round the clock nursing care due to her unsteady gait and inability to manage her medications...

I know its a bunch to ask of your doctor so you might want to have an example typed up... or a letter that he could just sign if he agrees with the conclusions...

Thats how I'd handle it anyway... doctors hate typing letters, and if hes a family doc he or she knows the care you need anyway, so should have no problem signing off on something that is factually correct.

If youd like I'll type up a letter, but you probably know your condition ebtter, and like I said it just needs to address what the VA wants...

That will put you in a MUCH higher Special Monthly Compensation catagory...

again look it up under www.va.goc the link I already supplied... its here :

http://www.vba.va.gov/bln/21/Rates/comp02.htm

and youd be looking at R1 or R2 if you do in fact need the care.

Anything else just ask.

That would be great if you can type me a letter. Another thing that I wanted to ask you I have problems with my lower extremities and can barely walk I have to use and AFO for my right foot and I am getting another AFO for my left foot. I also have to use knees braces plus I use a cane for my gait, I was thinking about applying for loss of use but I would not know how to write it. I do have Medicare and I am planning to see my old Doctor so see can send me to get a Home Excercies Program for my Physical Therapy since the Va clinic that I go to they refused to make me one there statement is that they dio not want to liable but they also do not provided Physical Therapy all they do is write you a program and you are on your own. They do not call you to see if you are progressing with the exercices. I hope you have time to respond back because I really need your input. Thanks.

[sixthscents]

OK I can help, and am willing to work both issues but I'll have to take a bit... I am working another claim right at the moment and the research on its going to take a while. I will get back to you tonight or tomorrow.. sorry for the delay, but I have to work this stuff in order unless theres an emergency... so check back late tonight or tomorrow during the day. I've actually got to get off Hadit and get busy with this as its something someone asked me to do today.

[windy city]

OK I can help, and am willing to work both issues but I'll have to take a bit... I am working another claim right at the moment and the research on its going to take a while. I will get back to you tonight or tomorrow.. sorry for the delay, but I have to work this stuff in order unless theres an emergency... so check back late tonight or tomorrow during the day. I've actually got to get off Hadit and get busy with this as its something someone asked me to do today.

Great, if you want to give me your E-mail, si I can write to you and let you know whats going on with me and talk about my disabilities for which it will give you some knowlede about my situations. Thanks brother and God Bless You.

[sixthscents]

Great, if you want to give me your E-mail, si I can write to you and let you know whats going on with me and talk about my disabilities for which it will give you some knowlede about my situations. Thanks brother and God Bless You.

Too easy: sixthscents@hotmail.com ... or sixthscents2@hotmail.com

I'll get on it tonight..

No problems its what I and others here do... so I am glad to be able to help. If you want to thank someone, thank T-Bird. This board has helped literally thousands of vets, and it is her baby. She brought us together, and manages to put up with some of the "squabbles"... so, rest easy we are here to help.

[Rich T]

My wife gets spousal A&A. It has nothing to do with your rating. Some VAMC's will send home heath care. Our's did in PA but here in FL they laughted at me when i asked they said that's what u get your comp for. Medicare sends a home care nurse for her but only for health care not light housekeeping, as in PA

[windy city]

My wife gets spousal A&A. It has nothing to do with your rating. Some VAMC's will send home heath care. Our's did in PA but here in FL they laughted at me when i asked they said that's what u get your comp for. Medicare sends a home care nurse for her but only for health care not light housekeeping, as in PA

Sixthscents,

Let me know if you recieaved my e-mail. I had to resummited this morning because I left the s out after thr t and it got kicked back to me. Thanks.

[windy city]

My wife gets spousal A&A. It has nothing to do with your rating. Some VAMC's will send home heath care. Our's did in PA but here in FL they laughted at me when i asked they said that's what u get your comp for. Medicare sends a home care nurse for her but only for health care not light housekeeping, as in PA

Rich T,

When your wife got approaved A&A, was she recieaving Social Security. How did the process once she placed her form requesting A&A. Let me know please.

[Rich T]

Yes, her SSDI started 12/1/99. We applied for A&A soon afterwards, they 'lost' her application for about 3 months. After the paperwork was 'received' they approved her within the month. She is thyroid CA, failed c5-c6 neck fusion, diabetes, arthritis, periphal neuropathy, and clinic depression. She has an interthical pain pump with diluded (7.3 mg/day) mixed with bupivacaine for the stenosis. Her diabetes (blood sugars) run about 350 - 600. She cannot walk and is in bed 24/7 on oxygen.

Edited April 11, 2007 by Rich T (see edit history)

[windy city]

Yes, her SSDI started 12/1/99. We applied for A&A soon afterwards, they 'lost' her application for about 3 months. After the paperwork was 'received' they approved her within the month. She is thyroid CA, failed c5-c6 neck fusion, diabetes, arthritis, periphal neuropathy, and clinic depression. She has an interthical pain pump with diluded (7.3 mg/day) mixed with bupivacaine for the stenosis. Her diabetes (blood sugars) run about 350 - 600. She cannot walk and is in bed 24/7 on oxygen.

To keep her encouraged I give away her Gospel album that she made before her illnesses began. I'll attach one song here, anybody who wants an album just e-mail me and I'll either attach all 10 to seperate e-mails, or mail you one USPS.

Rich T,

Thanks for answering back. Did your wife filed any for va forms and was she given a C&P exam for her A&A. Any information will help me and my wife with this subject. She was approaved SS as of DEC. 06.

[windy city]

Rich T,

Thanks for answering back. Did your wife filed any for va forms and was she given a C&P exam for her A&A. Any information will help me and my wife with this subject. She was approaved SS as of DEC. 06.

Can anybody tell me what are the proper steps for filing for spousal A&A and what is going to happened once she files for it.

[Rich T]

No C&P by VA. The PCP fills out the standard 21-2680 attached.

[Rich T]

No C&P by VA. The PCP fills out the standard 21-2680 attached.

21_2680.pdf

[windy city]

No C&P by VA. The PCP fills out the standard 21-2680 attached.

Rich T,

Thanks for the information, I got the form any my wifes Doctor filled it out. But section 2. which ask for the va file number do I need to put my ssn or my wifes ssn. Thanks.