PREC 12-94    Accrued Benefits -- Evidence in the File at Date of Death - Unreimbursed Medical Expenses      WITHDRAWN    Citation: Vet. Aff. Op. Gen Couns. Prec. 12-94, VAOPGCPREC 12-94, 1994

QUESTIONS PRESENTED:

a)  For purposes of determining entitlement to accrued pen-sion benefits under 38 U.S.C. § 5121(a), where evidence submitted prior to a beneficiary's death provides sufficient basis for prospective estimation of unreimbursed medical expenses, may such evidence form the basis for an award of accrued benefits only in cases where unreimbursed medical expenses were actually deducted prospectively from the deceased beneficiary's income for purposes of determining pension entitlement during the beneficiary's lifetime?

b)  What criteria must be met in order to provide a suffi-cient basis for prospective estimation of medical expenses?

HELD:

a)  Accrued pension benefits may be allowed under 38 U.S.C. § 5121(a) on the basis that evidence in the file at the date
of a veteran's death permitted prospective estimation of unreimbursed medical expenses, regardless of whether unre-imbursed medical expenses were actually deducted prospec-tively from the veteran's income for purposes of determining pension entitlement prior to the veteran's death.

b)  Where a veteran had in the past supplied evidence of unreimbursed medical expenses which, due to the static or ongoing nature of the veteran's medical condition, could be expected to be incurred in like manner in succeeding years in amounts which, based on past experience, were capable of estimation with a reasonable degree of accuracy, such evi-dence may form the basis for a determination that evidence in the file at the date of the veteran's death permitted prospective estimation of medical expenses.  There may be situations in which medical expenses may be predicted with a reasonable degree of accuracy from evidence in the file at the date of the veteran's death on a basis other than the recurring nature of the expenses.