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Mom needs 24-hour-care. She has Social Security and a small pension. I applied for the Aid and Attendance Benefit, hoping we could hire a caregiver, but the VA wants a statement from the provider listing actual costs paid. Can I provide a proposed contract from the provider?

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Absolutely. The VA will consider prospective payments. Get a letter from the home care agency stating that you have contracted for care and the annual cost.

Make sure you have an updated physicians report indicating that care is required. If you have a good relationship with the doctor have the need made urgent. With my applications I include a personal letter from the caregiver outlining the entire situation, medically and otherwise, and include a recent picture of the applicant (not with a big smile!).

I urge you to contact your local Area Agency on Aging for support services. You may be surprised what is available. I also urge you to check into Medicaid diversion or waiver programs in your state.
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Yes the VA will help. But you will need the discharge papers and all the miltary paper you may have. It does take a while for the befits to start. There are forms at the veternas. I went on my own they filled out the forms and the nursing homes has to complete a special form. The dept of elder care is the one that help me out and started on everything two years ago. The VA does work with VA and also nursing homes. Hospice is a little differrent. patrica61
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It takes a long time before benefits kick in. I'm glad that you qualify. you may have to show payment first and then the VA will re-imburse you.
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Thank you for your help. Yesterday, I was told that by the VA that "Care must be in place prior to applying." I am so close...after 6 months of waqiting for help, and praying for anything, I have only 2 weeks to submit the bills and receipts that I have." I have none. I am going to do as Mr Robbins suggested and send an updated letter from the doctor, the hospice that provided her care (paid for by Medicare) and an agreement from the proposed caregiver. That's all I have. It seems sad that because we have no money for care, we can not recieve money for care. Worse, we are saddened that my father, the vet, still owes Medi-Cal over 32,000. I am saddened that after all of this time we will be denied, especially if it takes 6 mos for approval...how do they think a 91 year old can pay out money for care for 6-8 mos while the application is sitting in que... I have never worked so long and hard for anything...I'llletyou all know the final outcome...especially if it can help any one else.
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Mr. Robbins, I think that you may be mistaken. The VA will not pay out on the possibility of care or a proposal for care. The care has to already in place. I pity the family with the 91 year -old who is waiting for the VA to respond. I'd look elsewhere for help. Does anyone think that we should all look into the possibility of setting up a fund? We could all kick in some money, and anyone who needed some could draw upon it.........just a thought.
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All I can tell you is that following the procedure above for my clients has resulted in many, many, A & A awards (and no denials).

I appreciate your response, but given the crisis caregivers face, don't you think they should let the VA make the determination?

By the way, I am curious on what basis you make the claim that the VA will not act on a proposed contract for care.
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I agree the VA can help with your bills, you do need all the VA paper that is required. And you need to be the spouse or the power of attorney. If it is for a spouse of veternan they must have not re-married and where together at the time of the vets death. I also was my moms full caregiver, Durable power of attorney and also legal rep. Paper work also needs to completed by yourself and also the place of which the person is staying. If it is assiting living your benefits will be greater than a nursing home. Get all the miltary paper work together especially the dischared papers plus others and contact elder care they will get you in touch with the local veterrnans adminstaration office near you. You will be meeting with a Veternans officer at the near by agency office. Also the doctor taking care of your loved one has to fill out the paper work also. It does take time for the final approva sometimes up to 8 to 10 months. If it is the veternan themself the process goes a little faster. You see they have to check out a lot of things to make sure there is no fraud. There can be no assets, if you have all the orignal paper work it is easier on you. It took myself from 1/22/2009 after my first meeting after meeting with elder care from the state and my mom being check out and interviewed. The first Va pension check I received was Oct 1, 2009 for only two months of care Feburay and March and my mom passed away Oct 5, 2009 this was done by the Va to help out the cost of expenses to help out the assisting living she was at. I am still working with them now on a current basis. I did receive several checks after her death but they were returned I went directly to my officer in charge of moms case. As soon as my mom did pass away I went out to the VA to let them know with the death cert. The assisting living needs now to fill out several forms and I also can get paid for the funeral cost that was paid out by myself. Since mom was buried in New York with my dad at the veterans cementary there was no cost to change a get a new tombstone or opening of the grave site, since I had all the orignal paper work. Hope this may help. patrica61
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I am the daughter of the 91 year old woman and would like to clarify my question and concerns. I completed the Application for the Aid and Attendance Benefit (VA 21-534) for my mother in May. At the time, I sent in all of the required supporting documents, Marriage, Death Certificates, Dischare, Social Securit Starement and the Physicians Statement. In the Medical Costs, I estimated the cost for her care after talking with the proposed Agency. I also wrote a statement which mother signed stating that she had no other financial assests other than her home and that if awarded the benefit,the money would ne used to hire that agency. The VA has had the Claim for 6 mos and each month they send a "Working on It Staus" to mom. On December 1, 2009 , The VA sent her a Request for Information and Response. In it , they ask for that her Doctor complete a report that supports her claim . They also ask that Form 21-2680, Examination for Housebound Status or Permanent need for Aid and Attendance. (I am assuming that this is the report they want for the doctor.) They already have his statement from April. Then, they state that "in order to count in-home care as an expense, we need to know about the care you are receiving. " They ask that the caregiver complete the answers . It requests details as to the care she is receiving, the type of care, the a the date the care began, the amount paid, and the amount the patient pays from his her funds. They ask if any medical or nursing services are provided, licenses etc. They want the rate paid etc.
They then ask whether or not to we want them to decide the case without waiting 30 days, or if should give then the full 30 days to deciding the clain...(December 30. 2009)
It is the information that is requested from the caregiver that I can not provide as it is not in place. She was on hospice care from 5-08 -10/09 and her family has tried to share the burden. We stated ion the application that if awarded the benefit we would utilize the services of an agency at the figure provided by the agency. Since time is of the essence, I will ask the doctor to complete the report and ask the agency to send a statement of proposed costs. I also have a statement from the hospice that although was discharged from their care due to stabilization, she requires 24 hr care. I will send the picture recommended by Mr. Robbins.
I hope and pray that I have done a thorough job and the case will be decided in her favor. Obviously, time is of the essence.
I can't thank you all enough for your help, your advice and willingness to assist. I am most appreciative. I will keep you posted as to the outcome.
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Regarding the Va benefits it takes a long time even if you have all the paper work and did everything you were asked to do. Your story sounds just like what I went through. My first face to face meeting with a VA officer was in JAN 29, 2009. I filled out the forms and gave them all mom forms and even went to the nursing home and back to the VA the same day with the note from The assisting living and the doctor. Well I received the first check Oct. 1, 2009 , I deposit it into the special account set up Personal Rep account at the bank. That was on a Sat. Oct 2, 2009. My mom passed away on Monday Oct 5, 2009. I went out to social security on that tues called the VA and went out for a meeting. The officer had to make a call and I was informed that money was for the expenses that I had occured since I was taking care of her first that check I could pay the bills with. However since a final decesion was not madde by the VA and the power of attorney stops after death everything stop, and they were still working on her paper work but since I had proof of the money I spent that is why I received a small check. They required a copy of the death cert, of which I did not have yet, but did give them the full police report and firedept report. After I received the death cert I went out to the VA offic and spoke to the officer assigned to the case and gave them a copy. The officer at the VA told me to let the nursing home fill out a total expenses report of what was owed them and to give to me asap. I received a total of ten ten letterr and made calls that just repeated the same info ( we are working on it) Just like you. Well in Nov and again in Dec I received checks of which I had to give back. It is funny in a way today I have a meeting with the VA officer so I can be reimburse for the funeral expenses through the VA and he is going to give me the address for the assisting living to follow up. I have tried several times to let them know if it goes through me it will be faster, but no one has done nothing. I would set up a meeting with a VA office in your area and bring all the paper work with you. I wish you luck everyone told me it takes at least six to eight months. But when the check came after her death I was very upset. I don't know how they are going to handle the VETS when they come home. It hard enough taking care of someone,but to wait and wait and told the same thing it is not fair. My mom was buried with my dad in the VA cementary up north in New york I did not have to pay for the opening of the grave or a new tombstone. patrica61
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I want to thank ALL of you for your advice, suggestions and support. I am the originator of this question .My mother received her benefits yesterday. I must tell you that I feel a wonderfull sense of accomplishment and RELIEF. I do not remember ever spending as much time or energy on anything, It took some time to gather all the required documents and current VA forms. I found that some of those on the internet were outdated. Once they received the package, it took almost 9 months for the VA to process the information and award the benefit. We received several "working on it" statuses until they requested some supporting information in December. From that date, it took approproximately 60 days. I am most appreciative for all that each of you did to help make this happen. To pay it forward, I would be more than willing to help anyone who is going through the process. Please feel free to contact me. My gratitude to ALL!!!
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The problem with being rich, not filthy rich, but just well-healed, is that you do not qualify for medical assistance from the VA, the State Gov. ( Medicaid), the Fed ( the medical subtraction on Schedule A), nor any other agency designed for assistance. There is no way that I could ever "pay down" my assets in order to meet the qualification standards.
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