A Place for Mom's Family

Over 80% of the care that eligible senior veterans or surviving spouses receive is delivered in their own home by a non-dependent family member. Absolutely you can file a claim. There is NO reason to wait and I assume you already have begun the process.

The Adjudicator's Manual, the one used at the claims processing center, makes reference to two numbers.  It states that a married couple can have NO MORE THAN $80,000 and a single vet or spouse can HAVE NO MORE THAN $50,000.  However, it clearly goes on to state that the number that a particular veteran can have is determined by their age, actual life expectancy (considering age and health and not related to tabular life expectancy), their assets and their income and expenses (which are, of course, used to determine eligibility in the first place).

In other words, the amount any given veteran or spouse may keep is arbitrary.  In its description of an example, the manual goes on to say that a married couple in certain circumstances could be allowed to have more than $80,000 AND that a married couple with less than $80,000 could be denied for having too many assets - even though the previous paragraph clearly stated that no couple could have more than $80,000.  It makes a similar statement regarding a single veteran or spouse regarding the $50,000 limit.  They could be denied with less than $50,000 or approved to hold more than $50,000.  Look at it this way:  a Vietnam War veteran who is 66 years old and needs care will likely need that care for a much longer period of time than a 92 year old WWII veteran.  If they were both short the same amount of money each month, which would be allowed to retain more assets?

The last thing you want to happen is to be denied and have to appeal or wait a year because you left too much in the name of the veteran.  Since there is no look-back consideration, changes on how money can be held for the benefit of the veteran can be made without penalty.  Why risk a denial because you didn't have the money placed in trust or held by the children.

I always consider how much liquidity (the money necessary to pay any foreseen expenses - including the amount needed to pay for care while awaiting claim approval) and flexibility (the ability to get to the money to pay for increases in costs or levels of care - must take the possibility that Medicaid may become an issue and reverses planning will need to be done in order to qualify) is needed for a particular case considering the age, health (diagnosis and prognosis), amount of assets, and income as well as other resources that can be used to pay for increased care levels.  We also want to pre-arrange funerals (funeral trust funds are exempt from consideration for both VA and Medicaid) and deal with real estate issues. 

The secret to a fast and successful claim filing is in the preparation of the claim paperwork.  We have seen over a dozen cases submitted this year wherein the claim has been awarded in less than a month.  We don't submit the paperwork unitl we know we have everything that is needed.  The VA system is still antiquated in that they maintain paper files and if something is missing, that missing document must find its way to the paper file before the claim can be reconsidered.  If a VCAA Action Notice is issued demanding more information, the claim is generally delayed by 3 to 4 months. 

If you would like a copy of the page out of the Adjuciator's Manual (the people who actually process the claim), email me at kevinw@amerivets.com and I will be happy to furnish it.

Kevin Wedmore

If you filed a Third Party Authorization you can call to check on his claim.  Call 800-827-1000 to find the pension center that is processing his claim.  If he has ample resources based on his medical expense to income ration and his life expectancy his claim is not given priority.  Did you have an Accredited Agent or Veterans Service Organization assist you?  If not you may want to appoint one as his representative so they can help you.  You can search on www.va.gov for one in your area.

Does the surviving spouse need to be married to the vet. Or can they be divorced?

A divorce negates the benefit, unless, of course the spouse has re-married for at least a year and the eligibility requirements apply to her last husband.

Divorce generally negates obtaining the benefit  . . . that statement is true in about 90% of the cases.  There are circumstances, however, where a divorced spouse can receive benefits and they are important to note. 

Two considerations:  When did they get divorced and why did they get divorced.  The when has to do with divorces prior to Novemeber 1, 1990.  If the divorce occurred prior to that date and the spouse is not currently married, a benefit is obtainable. The second (or third or fourth) marriages could have ended because of the death of those spouses or because of a legally obtained divorce.

The why question doesnt' involve any specific dates but addresses the question of spousal abuse.  If the marriage ended due to spousal abuse (it must be documented with police reports, court orders of protection, etc.), then the spouse is eligible for benefits regardless of when the divorce occurred.  Of course, if the spouse is currently married, the benefit is not available.

Remarriage rules contain some little known or utilized exceptions as well.  A surviving spouse can have married after the death of her wartime veteran husband (or wife) and still make a claim on the veterans service if he or she is not currently married and he or she was married to the veteran at the time of their death.  There are a few other rules and regulations that come into play, but again, it is possible to receive benefits under these circumstances. 

While many VSOs and veterans advocates use the mantra that 'divorce equals zero', that is a pat answer that doesn't take into consideration any exceptions to the rule.  If we are truly trying to help veterans, their spouses, and their surviving spouses get benefits, we have to be willing to look for the exceptions and tackle the tough cases. 

I forgot to add that if you want a copy of the remarriage and divorce rules (obtained from the adjudicator's manual), please email me at kevinw@amerivets.com.

Well, Kevin, since there are dubious scoundrels out there that are not "truly trying to help veterans and spouses" why don't you handle all of the exceptions? I am sure that most families would enjoy going through the complete remarriage and divorce rules from the adjudicator's manual and to have a self-appointed marriage investigative expert, such as yourself, examine their marital history. Thank you for the erudite clarification.

And one more thing I forgot to add, Kevin. Is there a reason that you are not listed in the VA's Office of General Counsel official web-site, the national data-base verifying VA Accreditation, as either an Attorney, a Claims Agent or a VSO Officer as required by Federal Statute? Surely, you must know that?

David, thanks for the post.  My effort was not to insult you in any way but to add to the discussion the fact that there are exceptions to the rule.  The question posted by the consumer was a simple one . . .does divorce disqualify her mother from receiving benefits?  The answer is 'probably' but not definitely 'no'.  If I offended you in any way, I offer my public apologies.  I have also emailed you privately expressing the same.

 As for your most recent post, you will find the names of my two on-staff VSOs and my accredited claims agent in the list on the VA website.  While I am not personally accredited, I also don't personally assist in the presentation and prosecution of claims.  We also have two accredited attorneys on staff as well.

I agree with you that there are organizations and individuals out there that are in violation of the federal rules.  I rile against them all the time.  They make our jobs more difficult and often confuse the public about who is eligible to apply, access to the claims process, etc.  The vast majority are individual financial planners who are interested only in selling product, have no accreditation, and often don't work with families unless there is money to be moved.

While I own a wholesale financial firm that specializes in products designed for the VA and Medicaid planning markets, I work with over 1500 financial planners, 450 elder law attorneys, and a couple of hunder CPAs around the country that service these markets.  We are very strict in our dealing with these individuals and how they interact with the public.  I also own a local firm, Hoosier Senior Solutions, that serves the public in the Indianapolis, IN area on these matters and this is where our accredited staff resides. 

I will state that I had visited your website prior to this exchange (as I have many of the organizations that work in this field) and found it to be credible.  I have no reason to make disparraging remarks about you or your organization.  I am not certain why you felt it necessary to attack, but I am certain you are as frustrated as I am about organizations that are in violation of federal law. 

Kevin: How can you say, with a straight face, that you do not "personally assist in the presentation and prosecution of claims?" That's ALL you do in these Forums for A Place For Mom! You are giving advice, you are counseling people, you are offering to forward the Adjudicators Manual! You even offer your personal e-mail, which is a direct link to your Financial Planning business! You even state that you own a "wholesale financial firm that specializes in products designed for the VA and Medicaid planning markets." You run a Financial Planning business, that is obvious. It does not matter to the VA that you have VSO's on "staff" somewhere. You are not personally accredited; therefore, the information you are putting forth on this A Place For Mom Forum is a direct violation of Federal Law. I don't "attack," I just point out the truth. Your goal is to cherry-pick the veterans and spouses that need assets re-positioned because that is the only way you can make money, unlike a legitimate 501 (3) c Public Charity like Senior Veterans, Inc. that relies on benefactors.

David:  If you want to have a public discussion on this in an open forum, I am all game. 

 First of all, I believe in full disclosure.  That is why I posted the history of what I do.  I have been in the financial services industry for over 38 years most of which I specialized in Medicaid planning.  As I stated earlier, I added VA planning about 8 years ago because I saw a conflict with the way it was being done.  Planners would qualify someone for the Aid and Attendance program and make the client ineligible for Medicaid when and if their level of care and costs increased.  If you do any research on the subject, you will find this is a topic of conversation within the legal and financial community.  Coordinating benefits is essential. 

Second, you have no idea how our business operates.  I can state emphatically that most of the cases our accredited agents handle are people with no or little money.  I don't 'cherry pick'.  Every veteran who seeks help is helped. 

And, I would point out that providing information to a veteran about their benefits does not require accreditation . . .presenting and prosecuting claims does.  I teach the VA accreditation course required for attorney accreditation.  As you are aware, the course is a 3 hour CLE one that any attorney requesting accreditation must take.  There are ample opinions from the VA General Counsel to refute your statements.  On the other hand, once someone states that they want to file a claim, then an accredited agent or attorney should step in.  Providing advice is not in conflict with the VA rules.  And, selling product is not the only way we make money.  As I have stated, we have elder law attorneys on staff.  Legal fees associated with updating client wills, creating trusts, POAs, healthcare directives, etc. are all chargeable expenses.  If such work is done, money comes in the door.  Plus, you must remember that my main specialty is and always has been Medicaid planning.  The product development done over the years has helped develop a nice following of attorneys and financial planners who use those products and on whom I receive overrides.  In fact, we do well over $50 million of Medicaid planning work per year.  That is and will be our main source of revenue.

And finally, I was reading the transcripts of the report from the GAOs investigation about firms that hide behind a 501 (3) c to legitimize their assistance with claims . . .whether they are accredited or not.  Their concern is that the use of a non-profit designation s being used to mislead the public about the true nature of their intent.  Like the 'bait and switch' tactics you callously alluded to earlier, the use of a 501 (3) c designation is, in their eyes, just as if not more sinister.  As I stated earlier, I view sites around the web all the time and then research who the founder is of organizations such as yours.  Many are found to be created by financial planning firms that create the non-profit but only to recruit financial planners to sell product.  I guess I will have to spend more time doing research on your firm.

And, since you brought up the subject of how we make money  . . . how does your firm make money?  A non-profit sounds nice, but it still has to have cash flow to operate.  Do you charge fees?  Do you sell products or services?  Do you refer veterans to other financial professionals?  How do you assist them in qualifying for benefits?  Are all of your staff members accredited (you are not a one-man shop)?  If you are going to raise your concerns about my operation, yours, too, must become transparent. 

If you want to continue this discussion, I would suggest we do so in private as I have in reaching out to you by personal email.  If you want to continue the discussion on this forum, I am up to the challenge.  What you serve to do is put doubt about any organization's purpose in helping veterans.  This will have an adverse effect on those needing assistance who don't know who to turn to get assistance.  You should know something about the people, their integrity, their mission, and their operational philosophy before you make statments that are patently false.  While I appreciate your generalizations about financial firms that have popped up in the past few years who specialize in 'cherry picking', you have chosen the wrong terms to describe my purpose.  I did not pop up in the past few years, and we don't cherry pick.  It makes some of my associates mad when I suggest they work with everyone, but word of mouth creates a lot of referral opportunities to do other financial work with relatives, friends, the adult children (who need to review their own long-term care alternatives), etc.  If you were to ask the communities and healthcare people we deal with, you would find that our reputation is just the opposite of what you state.  Again, you should not make generalizations about organizations of which you know nothing about.

And can you believe that all this started because I offered to give some additional information to someone who asked a simple question on this forum?  Why that piece of information offended you is hard to fathom.  If the purpose is to assist veterans with the process, why wouldn't you, who says you are a legitimate organization trying to assist, provide the complete answer?  In your accreditation studies you surely reviewed the section on divorce, remarriages, etc.  Right?   I address those subjects in all of the classes I teach.  Again, my offer is simple . . if you would like a copy of the section in the adjudicator's manual that deals with divorce, remarriage, death, etc., I will be happy to provide it to you as I would anyone else reading this forum.  My goal is to educate people on this benefit, the exact same stated goal that show on your website.

 

"the U.S. Senate Special Committee on Aging held a hearing intended to expose what they called “pension poachers”, i.e., financial advisors and attorneys who ostensibly game the system to qualify otherwise well-to-do veterans to receive the benefits of the VA’s Aid and Attendance program.  " So begins the report from the GAO (Government Accountability Office).  The following link is the report: http://www.alfa.org/News/2526/Senate-Committee-Hearing-on-VA-Aid-and-Attendance

Aid and Attendence along with Home Maker benefits have been available to our qualifying veterans for sometime. I STRONGLY encourage ANYONE who is interested in applying for Aid and Attendance read the report from the GAO. There has been so much fraud and misrepresentation associated with these two benefits that the agency of veterans services ALONG with the senate is now looking at ways to prevent vulnerable seniors and their families from paying thousands of dollards for advice that may or may not be needed.  

I always recommend contacting the a Veterans Service officer, FIRST. here is a link to find a Veteran Service Officer in everyone state: http://www.nacvso.org/modules.php?name=Content&pa=showpage&pid=10

 As always, Investigate and be informed...BEFORE you sign up for any trusts, annuities or other advice.

Thanks for posting.  I watched the entire proceedings on the internet and found interesting input from both the VA and the Senate Special Committee.  The end reusult is that changes will be made in the way in which veterans will be able to qualify for benefits.  The major points are that there will most likely be a look-back consideration similar to Medicaid since this is a means-based program and the other that the VA will take a more active role in investingating the financial situation of any given applicant.

While the issues you raised were talked about in the hearing, the Senate Committee's take on the situation was that the VA had created the current climate and thus needed to take the lead in cleaning it up.  With no look-back and no financial overview of an applicant's resources (only the applicant's statement), the system was ripe for fraud.  Having been in the Medicaid planning field for over 38 years, I have needed to adjust to all of the rules as they come up and we are all better off because of the changes.  Just as in VA planning, there are too many people who are willing to take advantage of the system, the applicant, and financial well-being of their clients.

We, too, recommend they talk to a VSO.  However, there are three types of VSOs out there.  There is the politically appointed VSO (Veterans Service Officer) at the county level.  Most counties have one . . .some have a staff . . .and some share their VSO with other counties to reduce costs.  These folks are usually ex-military with many having retired from the service.  Some are good and know the benefits that are available, how to apply, and provide services to get things done; many do not have knowledge of some of the most basic programs and run an inefficient office.  The VA's own internal audit showed an error rate that was exceedingly high, sometimes as much as 80%.  We recommend the ones we know that can handle the process and direct other applicants to one of the other two types if the local VSO does not perform.  I have spoken to too many families who contacted the local VSO first and were told their mother or father wouldn't qualify only to learn that the reason they were told that was because the VSO only asked how much income they had coming in and not subtracting the cost of care to adjust the income.  I have recently met with a family who was told by a county VSO that they shouldn't apply for a benefit for their aged mother (93) because she would probably die before she was approved for the benefit.  That's not help . . .that's laziness.

The second type of VSO (Veterans Serice Organization) is a non-profit organization chartered to benefit veterans and their families.  Major ones are the VFW, American Legion, Korean War Vets, Marine League, etc.  Others are more specific in mission.  Generally speaking, the ones that are created to help veterans and spouses apply for benefits are more knowledgeable about these programs than the major ones listed above.  That is because the major ones do not concentrate on benefit application and genrally appoint someone from within to coordinate veteran's benefits.  This appointment is usually only for a year or so at a time as people work through the ranks of the various positions within the organizaiton.

The third and final type is an accredited VSO who has met the stringent proficiency requirements that the VA outlines to become an independent accredited VSO.  These people take a course, must pass a proficiency exam, and must pass an interview process with the legal department of the VA.  These are the only VSO who must prove to the VA that they know what they are doing and what the rules and regulations are.  Even a VA accredited attorney does not have to undergo this rigorous of a process.  There are only a couple hundred of these VSOs in the country. 

Any of the three types of VSOs can be used . . .in some areas the  county VSO is fine . . .in others someone at the VFW Post would be a better choice, and in areas where there is an accredited VSO, they would probably be the best choice.

What the elder law attorney and the financial planner bring to the table is the necessary information to meet qualification requirements without conflicting with Medicaid issues.  There may or may not be a need for a trust, annuity, etc.  That can only be determined on a case-by-case basis.  There must be consideration of not only the resources that an applicant may hold, but also how they hold those resources, whether funds will be needed for a surviving spouse at a later date, other expenses (such as a spouse living at home while the other is in care and money being needed to maintain the home, pay for food, gas, utilities, etc.), and the estate planning wishes of the family.  If documents need to be updated, an elder law attorney would generally be a good fit since the family will most likely deal with continued care as well as estate planning concerns.

I guess all of this is to say that families should investigate the options they have in their community to assist them in applying for benefits.  The options will be different from community to community and from family to family.  If you have a competent local VSO you can refer familes to first, that is great.  Unfortunately, that is not the case in many communities and elder law attorneys, accredited VSO, knowledgeable (and trustworthy) financial advisors, and other professionals may be the best option.  It appears as though you have a local VSO who is assisting your residents and getting results.  Please understand that not everyone reading these posts will be so fortunate.  Regardless of who they talk to first, if the result is a verbal denial, seek a second opinion.