Hey Jim,

 I came across your website and figured I would send you an email since my family and me are completely lost when it comes to the VA. My dad was in Vietnam and from the Agent Orange he ended up getting really bad diabetes, heart problems, on dialysis, eye problems, you name it..he has it. 6 years ago, he had to stop working because the illnesses were getting worse so he applied and is considered 100% disabled and receives monthly disability compensation from the VA. He is now 62 years old and had a massive stroke 3 months ago.

 He is unable to speak or use his right arm (so he can't give himself insulin shots) and can only walk with assistance. If he was able to speak, it would be a lot easier for us because he seems to know the VA policies pretty well, but he can;t which is why I am contacting you.

 He just came home from rehab 2 weeks ago and right now my mom has been his caretaker. She was able to take a leave from work, but needs to go back soon. Everyone was telling us how the VA will help so much and already we see how long everything is taking. A nurse came last week to assess him and told us we should look into the "aid and assistance program". We have looked into it, but it seems like my parents combined make too much money...but then I looked at it again and it seems that if we are just trying to get more compensation and not the pension, that money doesn't matter?

 We are just so confused. My main question is if he is already receiving disability compensation from the VA (about $3800 a month), can we get more money for this aid and attendance program or is there something else we should be trying to do? Once my mom goes back to work, we calculated that a nurse will cost us about $4000 a month. Please let me know if there is anything we should be doing. We also don't want to file if it will make us lose the monthly amount he is making now. Thank you soooo much for your help.

 Reply,

 I'm sorry to hear about the problems that your dad is having. It's really wonderful that he has such a fine family to help care for him. You'd be amazed at how many veterans of our generation have nobody.

 He won't be at risk for losing anything if you apply for extra benefits. Don't worry about that. His condition is such that VA isn't very likely to consider lowering any current benefit.

 Just what benefits he may be eligible for with his newest health problems are varied so widely I won't try to address them all here. Let's just say that he should apply for everything. Far too many veterans waste time trying to ask if they're eligible for this or that when the only sure way to know is to apply. Any veteran can apply for any benefit. VA is required to adjudicate every application for any benefit. Once VA makes a decision, then you know if you are eligible.

 In this case, the process to apply is pretty simple. All you need to do is to write a letter for his signature. The letter has to come from him. You can write it, it must be his letter...don't write anything about his having some help.

 Once written, the letter must be delivered using certified mail, RRR. This is the only way to deliver these sorts of things to the VA so please don't fax it or hand deliver it.

 In the letter, you tell VA that "I am applying for increased disability compensation benefits, appropriate to my current physical condition. My condition has worsened due to a stroke. I believe that I am eligible for aid and attendance or housebound or a range of SMC ratings because of my current condition."

 In the letter, go on to briefly and accurately describe his physical limitations since the stroke. Be thorough. If he has any defect with speech, name it...and so on. It is important to address what are called "activities of daily living" or ADLs. An ADL is as simple as brushing one's hair (personal grooming) or as complex as cooking a meal for himself. Briefly talk about any ADL that he needs help with. Read http://en.wikipedia.org/wiki/Activities_of_daily_living

 I have provided some templates for how to write an effective letter to VA here http://www.vawatchdog.org/Letter_Templates.html

 The words above will trigger VA to schedule a C & P exam for him. http://www.vawatchdog.org/c---p-exams.html

 A word of caution. VA will question his competency to manage his own finances now that he's had a stroke. If VA determines that a veteran is incompetent to manage his own finances, they will begin a process known as a fiduciary appointment. This will appoint a person as a financial guardian for him to help manage his money.

 He will want to avoid all efforts by VA to appoint a fiduciary. VA may appoint a family member or a stranger such as a banker or lawyer who is somewhat local to him. Even if VA appoints a family member, the rules are impossible to follow and don't make any sense. His access to his money will be very restricted.

 The usual trigger for a VA appointed fiduciary comes when the C & P examiner asks him about how he pays his bills. If he answers, "Oh, my wife and daughter do all that for me", the examiner will note that he is "incompetent to manage his finances" and next thing you know, there will be a notice that a field examiner will visit him in his home to determine the best route for a fiduciary appointment.

 There are a number of things to do that should be accomplished before this can happen. First, the bank account where his VA deposit is made should be emptied of any other money. I advise that another account be set up without his name and SSN attached to it. All but a minimal amount of money should be left in his VA account.

 If he receives any Social Security money, that must go into the newly established account, separate from the VA deposit.

 The VA only has the authority to seize control of the VA money, but if it is mixed with other money, they will take control of the entire bank account and it will all be frozen.

 When the examiner asks about how and who pays his bills, his answer must be clear that he is in total control. Even if someone else writes the checks for him, it must be conveyed to the examiner that he signs each one and that he knows exactly what is happening to his money.

 I'm not suggesting that you lie or concoct a story that isn't true. If he isn't able to participate in controlling his money, you should **immediately** establish a guardianship through the probate court in your community. A family member who is in good standing so far as credit history and any criminal history should be appointed. You'll probably need a good probate lawyer to help you. I'll suggest that you want and need to do that now in any case. If his condition deteriorates, having this done now will help in the future.

 To have the guardianship, a valid and complete power of attorney and so on established will help to fend off actions by VA.

 I don't mean to alarm or frighten you but the VA fidu program is badly broken and isn't something that you want to happen if it can be avoided. I can promise that whether or not you apply for additional benefits (you should) that VA will eventually discover his increased disability and they will consider the appointment of a fiduciary.

 Please read more here http://www.vawatchdog.org/fiduciary-appointments.html

 If he receives any SSA funds such as SSDI (he should) the SSA will also consider appointing a guardian to manage his SSA money. However, the SSA program is entirely different than the VA program and it won't cause anywhere near as much trouble for him. If there is a state sanctioned guardian appointed, the SSA will usually go along with that.

 I'm sure this is more than you bargained for and it all sounds like a lot of trouble. However, this is all necessary and in my mind, it's exactly the way that one should handle the situation.

 Finally, this will take time. A lot of time. Many benefits applications are taking 2 years to process these day. We are calling this The Backlog and it is about one million claims strong today. There are many reasons for the backlog but it will affect you in that his claim will just get in line with all the others. There is no way to speed it up or to prioritize things. This is a terrible situation and all you can do is to properly complete all the things above and wait. Read https://www.vawatchdog.org/the-va-claims-backlog.html

 If you have any further questions, I'm usually around to answer pretty quickly. Don't hesitate to ask.