Help With C&p For A&a Options

[windy city]

What is the maximum amount of A&A a vet can get? I am not sure the amount you get would ever pay for really extensive care for a person outside a nursing home. It would help defray expenses if a spouse is alread at home, but it would not compensate for a working spouse to quit their job and stay home to care for person really needing A&A who is bedridden or needs help going to the toilet, eating, bathing etc. If you hire someone qualified who is has liability insurance you will be paying 60$ an hour or more. Just the other day one of my old neighbors broke out of her house where half-ass caretaker had locked her in and died in a unlocked car.
The children of the old lady did not want to hire a genuine caretaker so they hired some housekeeper and the housekeeper locked the old lady in and went to church. This is what you get for small money. My wife quit work to stay at home with me to help me because I take meds that make it dangerous for me to drive. Can I get A&A of some sort? I am TDIU and to some extent housebound. I weigh over 200 lbs. My wife could never life me onto a toilet or something like that if I was really bedridden or helpless. I would end up in the happy farm. People always say they will never go to a nursing home, or relatives say they will not send one, but in the end they will have you put away. You can count on it unless you have very good long term care insurance.

My wife also had to quit her job because of me and the meds. I take put me in another world. She took almost an 800 hundred dollar pay and lost out health insurance through her job when she quit. She is my caretaker and also supervises my physical therapy the days the my physical therapist does not come. I am afraid to apply for a higher a&a because because of the va's crap I am undicided about this one. Need advice.

[john999]

What is the maximum amount of A&A a vet can get? I am not sure the amount you get would ever pay for really extensive care for a person outside a nursing home. It would help defray expenses if a spouse is alread at home, but it would not compensate for a working spouse to quit their job and stay home to care for person really needing A&A who is bedridden or needs help going to the toilet, eating, bathing etc. If you hire someone qualified who is has liability insurance you will be paying 60$ an hour or more. Just the other day one of my old neighbors broke out of her house where half-ass caretaker had locked her in and died in a unlocked car.
The children of the old lady did not want to hire a genuine caretaker so they hired some housekeeper and the housekeeper locked the old lady in and went to church. This is what you get for small money. My wife quit work to stay at home with me to help me because I take meds that make it dangerous for me to drive. Can I get A&A of some sort? I am TDIU and to some extent housebound. I weigh over 200 lbs. My wife could never life me onto a toilet or something like that if I was really bedridden or helpless. I would end up in the happy farm. People always say they will never go to a nursing home, or relatives say they will not send one, but in the end they will have you put away. You can count on it unless you have very good long term care insurance.

[windy city]

It sounds to me like you meet the criteria for A&A. I am also being considered for it, so if you have any kind of a C&P for it, please post your experience, so I may know what to expect.

Here is the criteria for A&A (It falls under 38 USC 1114(l), and is paid at the "L" rate for basic A&A, not a "higher level.":

TITLE 38--PENSIONS, BONUSES, AND VETERANS' RELIEF

CHAPTER I--DEPARTMENT OF VETERANS AFFAIRS

PART 3_ADJUDICATION--Table of Contents

Subpart A_Pension, Compensation, and Dependency and Indemnity
Compensation

Sec. 3.352 Criteria for determining need for aid and attendance and
``permanently bedridden.''

(a) Basic criteria for regular aid and attendance and permanently
bedridden.

[[Page 267]]

The following will be accorded consideration in determining the need for
regular aid and attendance (Sec. 3.351©(3): inability of claimant to
dress or undress himself (herself), or to keep himself (herself)
ordinarily clean and presentable; frequent need of adjustment of any
special prosthetic or orthopedic appliances which by reason of the
particular disability cannot be done without aid (this will not include
the adjustment of appliances which normal persons would be unable to
adjust without aid, such as supports, belts, lacing at the back, etc.);
inability of claimant to feed himself (herself) through loss of
coordination of upper extremities or through extreme weakness; inability
to attend to the wants of nature; or incapacity, physical or mental,
which requires care or assistance on a regular basis to protect the
claimant from hazards or dangers incident to his or her daily
environment. ``Bedridden'' will be a proper basis for the determination.
For the purpose of this paragraph ``bedridden'' will be that condition
which, through its essential character, actually requires that the
claimant remain in bed. The fact that claimant has voluntarily taken to
bed or that a physician has prescribed rest in bed for the greater or
lesser part of the day to promote convalescence or cure will not
suffice. It is not required that all of the disabling conditions
enumerated in this paragraph be found to exist before a favorable rating
may be made. The particular personal functions which the veteran is
unable to perform should be considered in connection with his or her
condition as a whole. It is only necessary that the evidence establish
that the veteran is so helpless as to need regular aid and attendance,
not that there be a constant need. Determinations that the veteran is so
helpless, as to be in need of regular aid and attendance will not be
based solely upon an opinion that the claimant's condition is such as
would require him or her to be in bed. They must be based on the actual
requirement of personal assistance from others.

rentaguy1
I recieave A&A at the L level but I am having physical therapy three times a week plus I have a nurse who comes once a week to see me should I apply for the higher level of aid and attendance?

[tdak]

Its ridiculous. I used to get "free" help from nieces and nephews and throw them a few bucks when I had it, but now when I ask its like pulling teeth, because they live 45 minutes away and the price of gas is so crazy it costs to much to just throw them a $20 to help me out for a few hours for the drive.

I have to have someone to shop with me, be home with me when I shower(sometimes help me wash my hair, depending how bad of a day I'm having). My family cleans, does 85-95% of all household chores. If I do things around the house I am down for about 3-4 days at a time, just for overdoing it, not to mention almost daily migraines (5-6-7 days a week).

How can I pay them to aid and attend me(help me) if the VA won't pay me to pay them?

It's a catch 22. I honestly think its because I "look" good on the outside, which is deceiving and totally unfair.

[Pete53]

A&A seems to be a judgement call. First your Doc writes up what you have and than the C&P or VARO checks into the loimitation and problems caused by your condition.

Being able to dress yourself, groom and bathe, prepare meals, do housework, be alone and how much help you need play heavily into the decision. I know that my C&P Doc was very interested in if I drove car and shopped and who I had to help me out.

The nuts and bolts are you have to show that you depend on help from others. Its seems that they don't care who.

I am wondering if you have A&A if VA will help pay someone to assist you in daily activities?

[tdak]

I got my award letter in todays mail. I was happy and sad all at the same time. I was awarded separately for my migraines, tmj and tinnitus, hooray, BUT I was denied SMC.

The funny thing is the way they stated it is,..."you no longer need the regular aid and attendance of another person."

Are they saying I needed it or had it before (they should have given it to me prior) and now I don't??? (like they are now taking it away...hmmm) This was on the front (1st) page, but the reason page just states that there was no evidence, which there was a dr. letter (Neurologist).

The VA claims that I never sent them back/replied the evidence letter from March, what crap.

They even called me and took a statement over the phone, what was that. The woman on the phone said she would take that statement too. Damn!, I forgot who I was dealing with.

Now I guess I have to appeal, which I have never done in my life and I have an American Legion Rep. who will probably won't be happy to hear that I want to appeal.

I have a year, but I go back to my Neurologist the end of June and he was the one who originally wrote the letter stating I needed daily assistance.

I will ask him to tweak the letter better for me to submit.

Any suggestion on tweaking.

[rentalguy1]

Like I said, neither the regs, nor the US code says anything about needing to be total or permanent. If they try this one on me for my A&A, that will be my argument on appeal. I need to search for some BVA and CAVC cases where it was granted without 100%.

[Pete53]

I think that the VA will pay a pensioner A&A on 60% or more. How someone can be on pension with 60% rating I do not know unless they are in nursing home and all their money offsets medical expenses.

The VA is very mysterious

[donews]

Yeah, I have seen conflicting information about the need for 100% to get A&A.

[rentalguy1]

Narrative: Once the existence of at least one permanent disability rated at 100% has been established, additional benefits may be payable if the veteran requires:

Well, that's a bunch of crap right there. Nowhere in the 38 CFR 3, or in 38 USC 1114 does it say that the vet has to have a disability that is either total (100%) or permanent. It only states that the need for regular A&A has to arise solely from a service connected disabilty (no percentage given).

[Rich T]

I found time to locate the exact exam questions that will be asked at the C&P go http://www.hcvets.com/data/va_news/compensation_exam.htm and click on Aid and attendance.

[tdak]

I will definitely keep you all posted. It is very confusing to read, but what isn't with the VA. (IMG:http://www.hadit.com/forums/style_emoticons/default/laugh.gif)

tdak

[donews]

Yes, please keep us posted as I have an application in for A&A also.

I am actually asking for a higher A&A based on me having a health aide and RN come to my house several days a week to assist me and for pain management.

I currently receive non VA hospice care, but that might go away at any time.

[rentalguy1]

It sounds to me like you meet the criteria for A&A. I am also being considered for it, so if you have any kind of a C&P for it, please post your experience, so I may know what to expect.

Here is the criteria for A&A (It falls under 38 USC 1114(l), and is paid at the "L" rate for basic A&A, not a "higher level.":

TITLE 38--PENSIONS, BONUSES, AND VETERANS' RELIEF

CHAPTER I--DEPARTMENT OF VETERANS AFFAIRS

PART 3_ADJUDICATION--Table of Contents

Subpart A_Pension, Compensation, and Dependency and Indemnity
Compensation

Sec. 3.352 Criteria for determining need for aid and attendance and
``permanently bedridden.''

(a) Basic criteria for regular aid and attendance and permanently
bedridden.

[[Page 267]]

The following will be accorded consideration in determining the need for
regular aid and attendance (Sec. 3.351©(3): inability of claimant to
dress or undress himself (herself), or to keep himself (herself)
ordinarily clean and presentable; frequent need of adjustment of any
special prosthetic or orthopedic appliances which by reason of the
particular disability cannot be done without aid (this will not include
the adjustment of appliances which normal persons would be unable to
adjust without aid, such as supports, belts, lacing at the back, etc.);
inability of claimant to feed himself (herself) through loss of
coordination of upper extremities or through extreme weakness; inability
to attend to the wants of nature; or incapacity, physical or mental,
which requires care or assistance on a regular basis to protect the
claimant from hazards or dangers incident to his or her daily
environment. ``Bedridden'' will be a proper basis for the determination.
For the purpose of this paragraph ``bedridden'' will be that condition
which, through its essential character, actually requires that the
claimant remain in bed. The fact that claimant has voluntarily taken to
bed or that a physician has prescribed rest in bed for the greater or
lesser part of the day to promote convalescence or cure will not
suffice. It is not required that all of the disabling conditions
enumerated in this paragraph be found to exist before a favorable rating
may be made. The particular personal functions which the veteran is
unable to perform should be considered in connection with his or her
condition as a whole. It is only necessary that the evidence establish
that the veteran is so helpless as to need regular aid and attendance,
not that there be a constant need. Determinations that the veteran is so
helpless, as to be in need of regular aid and attendance will not be
based solely upon an opinion that the claimant's condition is such as
would require him or her to be in bed. They must be based on the actual
requirement of personal assistance from others.

[Josephine]

I wish you the best.

Betty

[tdak]

Thanks Pete, RichT & Tanker,

My Neurologist was actually the one who wrote the letter stating I needed help with everyday activities. The Va also has me set up for 2 other C & P for hearing and dental (for my TMJ). I have gotten progressively worse since I had surgery and really do wish I had the extra money now to pay someone to help me daily rather than HAVE to always rely on family (I think it really wears on them). I give to those who help me out when I can, even though there is not much left after bills are paid.

I am just grateful that my family has been so strong and has stood by me. If I were them, I would have been sick of me already (real *itchy and moody and bossy, especially when I have migraines, which has been 16 days this month so far and counting).


thanks again, I will read all the the C & P exam notes.
Tdak

[Vietnam Tanker]

Good advice from richard and Pete, try to keep in mind what nit like on a normal day, not necessarily one of your better day's. You should then be fine and good luck with your claim.

[Pete53]

I took that C&P and it is fairly long with a few minor physical checks for your gait, how you walk, how you hear and see and maybe more but a lot of questions.

Remember you have to address these questions as if its a normal day not necessarily how you are feeling that day. From what you said in Post I am sure that you will get it.

Rich gave good advice.

My C&P Doc told me that I should ask for a consult with a neurologist and Mrs Pete was with me the entire time. Since I was awarded SMC I guess that my saying I think it was a fair exam is not a big help.

Good Luck

[Rich T]

On home page see do's and don'ts for C& P exams. Somebody should be able to find a page for you that has the exact questions that the doc has to ask you. Good luck.

[tdak]

Pete,
I believe it is already filed as per the VA, my last letter from them has it listed as SMC, based on aid and attendance as a deferred decision because they need additional information or evidence.

Then I got the C & P letter about 2 weeks later.

thanks,
tdak

[Pete53]

I think that you should apply for it. It may be a close call but I think that is what it is for.

[tdak]

Hi,
What does the VA consider for aid and attendance? I do not cook every meal for myself or my family depending upon weight and preperation of meal. I cannot shower unless someone is home. I have had to have my husband wash my back and hair quite often because I cannot. I do not do laundry because I cannot lift it, so again my husband or kids do the laundry, dishes, cleaning, help with shopping. Does this count?

I have my C&P Friday and I do not know what to expect. My doctor wrote a letter some time ago, but I never expected A&A. The VA actually just sent a letter stating deferred A&A, pending info.

Do I have a chance at getting A&A by what I stated? My doctor wrote I get help with daily activities.

I just wanted to put a quick note, I have loss of use (muscle weakness/ pins and needles daily) on the left side of my body from a brain stem hump and residuals from brain surgery.

Thanks.

This post has been edited by tdak: Mar 25 2008, 09:39 AM