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Note that the Priority Group rating pretty much leaves the bulk of those with service related issues out of the co-pay arena and those in the copay arena pretty much have money and nothing wrong with them from their service days.
Now that doesn't mean the rest of us aren't paying into the VA, just we do it through our private health insurance. I'm in Group 1 but the VA will still bill my private insurance for any care not service related.
Note that the Priority Group rating pretty much leaves the bulk of those with service related issues out of the co-pay arena and those in the copay arena pretty much have money and nothing wrong with them from their service days.
Now that doesn't mean the rest of us aren't paying into the VA, just we do it through our private health insurance. I'm in Group 1 but the VA will still bill my private insurance for any care not service related.
Wish there was a class in how to be the squeaky wheel. My husband has an 80% disability, soon to be determined 100%, and he is in a care facility for a condition related to his service connected disability. I pay $7K a month for his care and the wait list for admission to the appropriate care unit at the VA home is two years. If he lives that long, we will be impoverished by his care expenses. He is not eligible for A&A because his active duty service was in peacetime.
How do I make the right amount of noise to get some help before we're destroyed financially?
I don't know enough from your post to address your specific issue, I offer this as an attempt to help:
Aid and Attendance is either a Special Monthly Compensation (SMC) or Pension (SMP). It has nothing to do with wartime service--wartime service is linked to eligibility for Non-SC Pension and Survivor Pension--not Disability Compensation. If your husband is receiving VA compensation, he is eligible for A&A SMC if one or more of his SC disabilities require aid and attendance of another person. It is rare, not impossible, for a veteran rated below 100% to receive A&A--guidelines are in the M21-1 for raters, but it is rarely granted below 100%.
If your husband is receiving a VA pension, his eligibility for A&A SMP is already established in the grant of the pension, because wartime service would already be conceded in a pension award. A grant of SMP for A&A results in raising the Max Allowable Pension Rate (MAPR), which means a greater pension payment.
Pension is income and asset based; compensation is not. VA assigns non-SC ratings to disabilities for pension purposes, but those ratings are not SC. A veteran can have both NSC and SC disability ratings. The VA pays the higher benefit if the veteran has been granted both comp and pension benefits.
The most common mistakes made on completing the A&A form for SMC is the doctor listing disabilities that are not SC or leaving the diagnosis block empty.
Location: Somewhere gray and damp, close to the West Coast
20,955 posts, read 5,555,871 times
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Quote:
Originally Posted by WVREDLEG
I don't know enough from your post to address your specific issue, I offer this as an attempt to help:
Aid and Attendance is either a Special Monthly Compensation (SMC) or Pension (SMP). It has nothing to do with wartime service--wartime service is linked to eligibility for Non-SC Pension and Survivor Pension--not Disability Compensation. If your husband is receiving VA compensation, he is eligible for A&A SMC if one or more of his SC disabilities require aid and attendance of another person. It is rare, not impossible, for a veteran rated below 100% to receive A&A--guidelines are in the M21-1 for raters, but it is rarely granted below 100%.
If your husband is receiving a VA pension, his eligibility for A&A SMP is already established in the grant of the pension, because wartime service would already be conceded in a pension award. A grant of SMP for A&A results in raising the Max Allowable Pension Rate (MAPR), which means a greater pension payment.
Pension is income and asset based; compensation is not. VA assigns non-SC ratings to disabilities for pension purposes, but those ratings are not SC. A veteran can have both NSC and SC disability ratings. The VA pays the higher benefit if the veteran has been granted both comp and pension benefits.
The most common mistakes made on completing the A&A form for SMC is the doctor listing disabilities that are not SC or leaving the diagnosis block empty.
I do not work for the VA.
Thanks for this explanation. This is all so overwhelming. My husband always took care of all of this and I never had to until he had such a rapid decline in his cognitive function, this fall. When the stress of 24/7 caregiving lifts, I'm sure I'll find this all easier to understand. I'm sure that making this information easier for dumb wives to understand is not a huge priority! LOL!
Thanks for this explanation. This is all so overwhelming. My husband always took care of all of this and I never had to until he had such a rapid decline in his cognitive function, this fall. When the stress of 24/7 caregiving lifts, I'm sure I'll find this all easier to understand. I'm sure that making this information easier for dumb wives to understand is not a huge priority! LOL!
Thank you for serving.
Your not dumb ma’m. Just not totally informed. The VA like any government agency is difficult at best. I’m a disabled veteran 70 years old and it’s hard for me to navigate through it all. Best to you and your husband.
Location: Somewhere gray and damp, close to the West Coast
20,955 posts, read 5,555,871 times
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Quote:
Originally Posted by jeffdoorgunner
Your not dumb ma’m. Just not totally informed. The VA like any government agency is difficult at best. I’m a disabled veteran 70 years old and it’s hard for me to navigate through it all. Best to you and your husband.
Thanks for your well wishes and I wish you the best in dealing with your disability. And thanks to everyone on this forum who has directed me towards the information I need. It takes a while to get used to the vagaries of the system but I'll get it.
Thanks for this explanation. This is all so overwhelming. My husband always took care of all of this and I never had to until he had such a rapid decline in his cognitive function, this fall. When the stress of 24/7 caregiving lifts, I'm sure I'll find this all easier to understand. I'm sure that making this information easier for dumb wives to understand is not a huge priority! LOL!
Thank you for serving.
I doubt you are a "dumb" wife, and all the work you are doing gives us hope that someone we love will stand up for us when we cannot fight our battles alone anymore. So I say THANK YOU for taking care of your veteran.
The paperwork and supporting documentation can seem daunting, but a VSO worth their salt knows how to navigate the claim process and educate the claimant along the way. Aid and Attendance is probably the most misunderstood benefit, and unfortunately, the source of much frustration for veterans and families trying to access VA benefits.
I doubt you are a "dumb" wife, and all the work you are doing gives us hope that someone we love will stand up for us when we cannot fight our battles alone anymore. So I say THANK YOU for taking care of your veteran.
The paperwork and supporting documentation can seem daunting, but a VSO worth their salt knows how to navigate the claim process and educate the claimant along the way. Aid and Attendance is probably the most misunderstood benefit, and unfortunately, the source of much frustration for veterans and families trying to access VA benefits.
This is VERY key to a claim being done properly...……." A VSO WORTH THEIR SALT" you may have to feel out more than one to handle your case aggressively.
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