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Patricia Grace
founder & CEO
Aging with Grace

Friday, September 25, 2009

VA Benefits: Top Reasons Claims are Denied

The VA’s own website (www.va.gov) confirms that 75% of all VA pension applications (commonly referred to as Aid & Attendance) are denied the first time. The main reason VA applications are denied is because they are not complete and well-documented.

Here are 5 things you should know to avoid having your claim denied:

# 1: Failure to Document Income and Unreimbursed Medical Expenses
. On the application, the VA can ONLY confirm the amount of your Social Security benefits independently. Everything else should be documented with a written explanation, this year’s award letter or an annuity agreement. When in doubt, document it. Unreimbursed Medical Expenses should be documented on the VA form 21-8416. If you have any other recurring, ongoing or continuous unreimbursed Medical Expenses (including R&B), document them!

# 2: Documenting Shortfalls. If your Unreimbursed Medical Expenses, especially your Room & Board (R&B), exceed your income, the VA will ALWAYS delay your claim to clarify this. So, anticipate this question! If you are using savings or assets to meet this shortfall every month, explain this as an attachment to your application. If your assets are depleted, and a friend, sibling or family member is supplementing your R&B, explain this. To be sure the VA understands what is happening, write a simple loan agreement and submit it with your application. This will prove that you are borrowing this shortfall every month.

# 3: Documenting Dependents. According to the VA, a “dependent” is younger than 18, where the veteran is the father, or the veteran is married to the mother (step-children are fine). Grandparents must have court-issued adoption decrees. If dependents are under 23- years- old, they must be in school full-time. Spouses are dependents, but their income also counts, as well as their Unreimbursed Medical Expenses.

# 4: Failure to Respond to Clarifications. Always answer VA letters or phone calls as soon as possible. If you need more time, send a letter saying “I’m working on it”. You have at least 60 days to respond and can supply the information within one year and still have a valid claim.

# 5: Missing or Incomplete Information. The VA pension applications are multiple-paged and have hundreds of questions. Address and answer every single one of them. If the question is non-applicable, answer “N/A”; if income is zero, answer with a “0″. NEVER, EVER leave a space blank.

With the VA, you can never provide too much information. If they have to write you for clarification, your claim will be delayed or denied. Always include your phone numbers, an email address and a next-of-kin’s contact information with every application.

1 comment:

  1. Thank you so much for sharing this information! I have seen too many families who gave up after having a VA benefit claim denied when they really should qualify. It can be a frustrating process, but by making sure to do it right, the extra money can increase quality of life for a senior veteran or spouse.


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