I Want to Tell You a Story...

Another purpose of this blog is to express our anger at the daily instances of incompetency that affect veterans and surviving spouses receiving VA benefits. In many situations this does not create any lasting hardship for our beneficiaries, yet there seems to be an increasing number of claims coming across my desk with errors that should not have occurred. Ever. So yes, this blog is to vent, but perhaps it can also help build awareness of how inefficient and incompetent the VA can be.

For our first example: A veteran applied for pension benefits in May 2007. We received all the information needed to process her claim. She was found to be entitled to pension and rated to receive an Aid & Attendance (A&A) benefit as well. We granted her pension, using her assisted living costs as a medical expense to give her the maximum pension rate (we can only use assisted living expenses if the veteran has been rated for A&A). We did not, however, grant her the A&A benefit on her award. It’s a simple mistake, the VSR just didn’t put an “X” in a certain field while using BDN, and it certainly should have been caught by the authorizer. It wasn’t. The end result? The veteran was receiving about half of the benefits she was entitled to for close to two years.

The only reason we caught this was because the veteran’s son and daughter-in-law wrote us a letter stating that she was moving out of her assisted living facility and into a nursing home where she would be covered by Medicaid, and that she would need additional funds from us. In looking over her case, we realize what we did wrong previously and correct it, giving her a massive retroactive payment.

So it all ends well, right? Wrong! People are eligible for Medicaid when they do not have the financial means to pay for their own care at the nursing home. Medicaid takes all of the individual’s income (from Social Security, IRA disbursements, other retirement plans, and the VA to name a few), leaving the individual $45.00 each month for their own use. When this particular veteran received the nearly $20,000 payment to make up for what she was entitled to, she will be kicked off Medicaid for a few months, because she could then pay for her own nursing home care for two or three months.

The end result? Rather than receiving the VA funds she was entitled to when she was in the assisted living facility and could actually use them, now those funds must go to her nursing home care for three months until she again has no money, and will be eligible for Medicaid again.