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Income:
To qualify for the maximum award, GROSS household income from all sources (including that of the spouse if married) must be totally consumed by Unreimbursed Medical Expenses ("UME") which may include payments made to a family caregiver (other than the spouse). Payments to a caregiver must be evidenced (copies of cashed checks) and an affidavit signed by both the caregiver and the care recipient indicating the type of care being provided, the frequency of the care, and the amount of compensation must be submitted. As a previous poster suggested, payments for care to a family member may cause an issue with Medicaid eligibility and a properly drafted agreement between the family caregiver and the person providing care is recommended.
Assets:
There is no stipulated asset limit although many will incorrectly state that there is a limit of $50,000 for an individual and $80,000 for a couple. These numbers only apply to VA internal processing and have nothing to do with qualification. In determining an "asset limit" the VA looks at the family's "gross estate" (essentially everything except the homestead residence, automobile and personal effects) and asks the following question: "If the gross estate is divided by life expectancy, will the result cover reported unreimbursed medical expenses for the life of the claimant?". If the answer is "yes", no award. If the answer is "no" an award may be granted.
Other matters:
A partial award may be granted which seems to be the case here.
Awards can be increased upon new evidence.
Do not file an "appeal". The first step in adjusting or contesting a claim is to submit new evidence based on the original application. The next step would be the filing of a "Notice of Disagreement". The final step would be filing a formal Appeal. The last two take forever and you are better off filing a new claim. Once the new claim is filed and approved the claimant can seek benefits they may be entitled to for the previous 12 months.
Getting help with claims:
No-cost help with VA applications can be obtained at the federal, state and local level. It has been my experience that as well intentioned as those who staff these institutions and organizations may be, they cannot (or will not due to their mission) be able to help those who have but the simplest claims. Moreover, virtually none of them have expertise with respect to coordinating VA benefits with Medicaid. There can be tremendous value in seeking professional help when appropriate.
I think it is Veterans Independence Program or it might be Veterans In Place.
They will assess the Veteran and come up with a "budget" you will then be able to take this money and be able to provide care.
You can use it for paying for caregivers. (and since you are not a spouse you could be a paid caregiver.)
You can use it to have a lawn service, house cleaners, just to name a few.
The drawback is, at least while my Husband was on the program, I had to hire caregivers myself I could not go through an agency. The reasoning I guess is the agency charges ore so you would get fewer hours for the money in the budget. This may have changed as there can be problems when you do not have an agency.
You should also check with the VA about Homemaker service, they will have someone come into the house and help. This is dropped if you are on the VIP program.
I would contact the VA ask to talk to a Patient Advocate and find out all the programs that he may be entitled to.
Once he can no longer get out easily to the doctors there is also a Home Based Primary Care. The Doctor, Nurse, Social Worker, Dietitian will all come to him so he does not have to go to the VA.
Remove the knobs on the stove so he can not turn it on.
Instant oatmeal, an electric kettle for water, they shut off as soon as the water boils.
Microwave, leave prepared meals for him that all he has to do is "zap" them.
Is there a reason he has fallen? Remove carpets if possible. The VA also has a program that will help pay for modifications to a house to make it safe and accessible for him. Talk to a Social Worker at the VA able this it is a Grant. (not 100% on this I think it is a HISA Grant)
at 96 years old I made a call to the VA due to my brother taking care of a blind,incontinent,worsening Dad with no help or understanding
of the superb help that was given albeit too late as my brother was getting sicker and was financially strapped all due to a phone call
for a pension or some help and the call was answered by someone
who suggested the A&A unbeknownst to me, well I had just gotten my dads medical records and he had a brain hemorage three yrs prior and the gentleman pushed the A&A and my father received compensation and retroactive money for one year prior...so for three years until my brother his caretaker died suddenly he had money to be put in NH until his death 6 mos, after Charley had died that same year and the retroactive money was used,10,000
to pay for his funeral as my brother did not touch it...so the VA is wonderful if you qualify...….they continued his 900 disability A&A
THRU his NH stay with his SOC although I did not know that the VA will pay for his supplement...so we had to pay 10,000 until he qualified for Medicaid...….we simply did not know about this...as well as going to the VA doctors...there is all the info on the computer with the various downloadable forms bravo to the VA
because the aging of a senior with the fear...can I afford this is it the right move stuff is all so guilt ridden as well as the feeling that you are sending your DAD to his demise ...its very sad that the US hasn't gotten the Long Term Care aspect of seniors who are not
wealthy, together like other European Countries.Dad received the check 2 months after phonecall unheard of but great action and compassion on the VA's part...……..all with no lawyer or doctor..i just mailed the forms in with all the info.
The way the process works is someone comes to assess the Veteran and a "budget" is determined.
From this budget you can pay caregivers and I think one other service has to be selected. So housecleaning, yard service (mowing, snow removal) would be an example of 2 services.
Since you are a daughter not a spouse you could use the money to pay yourself. I strongly advise getting at least 1 other person to come in to care for him and give you a break.
Contact the VA and talk to a Social Worker and ask about VIP program.
There are other program the VA has that he would probably qualify for Homemaker, that would be a help. (limited to a certain number of hours per year though)
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