Tuesday, June 30, 2009

Use of Trusts in Medicaid Planning

If an individual is age 65 or older, the individual cannot create and fund a Special Needs Trust or a Pooled Trust account without incurring a transfer penalty. This does not necessarily mean that making transfers to fund a trust under these circumstances is always a bad idea. However, since the creation and funding of any trust to preserve the individual's assets would involve a transfer without fair consideration in any case, the individual may wish to use his or her assets to fund a trust that is not required to repay the State of Maryland for Medicaid benefits the individual may receive during his or her lifetime.

The regulations on self-settled trusts are such that a trust created by the individual and funded with the individual's own assets (other than one of the trusts exempt under OBRA '93) will prevent the individual from qualifying for Medicaid in the future, unless none of the assets or income in the trust can possibly be distributed to the individual or for the individual's benefit.

However, the individual may be able to create an irrevocable trust for the benefit of his or her children or grandchildren and fund that trust directly with his or her own assets, if the trust provides that:

The childrens' or grandchildren's trust shares will be funded with all trust income and principal. None of the trust income or principal may be distributed to the individual or for the individual's benefit during his or her lifetime.

Since none of the principal or income in that trust could be paid to or for the benefit of the individual, that principal and income would not be available to the individual for Medicaid eligibility purposes. Further, the trust can provide for distribution of the assets accumulated in the trust share after the grantor's death according to the grantor's instructions. The funding of such a trust would result in a transfer penalty, but no more so than if the assets used to fund the trust were transferred outright as part of a gifting plan.

Many individuals planning for future Medicaid eligibility may not wish to deprive themselves completely of the benefit of excess resources, as would be the case if these resources were transferred outright as gifts to others. Using excess resources to fund a self-settled, non-exempt trust for the individual's own benefit is not a good option if the individual ever wishes to qualify for Medicaid. However, any trust that is funded by a third party, with the individual as the sole beneficiary, would be exempt from the rules regarding self-settled trusts, so long as the trust is not created or funded at the individual's direction or request.

The assets in such a trust would not be deemed available to the individual by Medicaid, so long as the individual cannot force distributions from such a trust; the individual does not have authority to exercise discretion as a trustee; and the individual never transfers his or her own assets directly into the trust. Thus, the trust would not delay the start of the penalty period for transfers of assets, once the individual is in a nursing home or receiving long term care services at home.

As a result, an individual can provide for himself or herself indirectly by making gifts of remaining excess resources to his or her children, who, in turn, could voluntarily use those assets to fund a third party special needs trust for the individual's sole benefit. That trust would allow the individual to qualify for Medicaid, once the transfer penalty or look-back period has expired; the assets in the trust could be used to pay for the individual's long term care expenses during the penalty period or look-back period, and for the individual's supplemental needs after the individual begins receiving Medicaid benefits; and assets remaining in the trust after the individual's death would not be subject to Medicaid liens, estate recovery, or the type of state pay-back requirements applicable to Medicaid exempt special needs trusts or pooled trusts.

It would be very important to be able to demonstrate that the trust was not created at the individual's direction or request. Therefore, it is advisable for practitioners to prepare a statement for the individual to sign at the time the individual makes his or her gift transfers. This statement should provide that any gifts the individual makes are given freely and with the understanding that the individual will no longer need the property transferred to provide for his or her support or other needs; that the recipient of the gifts is under no obligation to ever use the property transferred for the individual's benefit or to return any of that property to the individual; and that the recipient is under no obligation to set the gifts aside in any trust or other arrangement for the individual's benefit.

Of course, this strategy does carry some risk. The person to whom the individual makes gift transfers could change his or her mind and decide not to create or fund the trust. Therefore, this strategy should only be used when the family relationships and other dynamics indicate that the recipient of the gifts will actually go through with creation and funding of the trust.
Call us now for assistance (240) 453-0070.
We can help you!

At Senior Life Care Planning, LLC we are dedicated to giving our clients the power to be informed individuals and to give peace of mind. We provide honest ways to protect your home, loved ones and independence in times of great need. We understand the emotional burden, confusion, anger, hopelessness, sense of injustice, fear and loneliness that come with long-term disability and end-of-life issues.
Every day we help and support families and individuals who are in crisis. We work with our clients to provide peace of mind and quality of life.

Senior Life Care Planning, LLC
One Research Court, Suite 450
Rockville MD 20850
240.453.0070
www.seniorlcp.com

Monday, June 15, 2009

Elderly Who Transfer Assets at Risk

What do the following people have in common? {a} a woman who helps her granddaughter by paying $40,000 of her college tuition {b} a man who sells his home and donates 10% of the proceeds to his local church {c} a caring sister who gives $20,000 of her savings to help her needy sister stay in her home and {d} a widower who sends money to his daughter, a single mother, with two underage children, who is out of work due to an automobile accident. Answer: Each of them are at risk of being denied Medicaid eligibility if he or she is admitted to a nursing home within five years of making the gift.

On February 8, 2006 President Bush signed the Budget Reconciliation Act of 2005. The legislation changes several of the Medicaid rules.

The most significant change has to do with the manner in which the State will calculate the ineligibility period when the applicant has transferred assets for less than value. Gifts made prior to February 8 will result in a penalty period that will begin on the first day of the month in which the gift is made. So, if a single parent gifted $100,000 to her child on February 7, 2006 it would result in a 15 month penalty ranging from February 1, 2006 to April 30, 2007. If that parent had made the same gift on February 8, 2006, the penalty period would not begin until the parent entered a nursing home and was otherwise eligible for Medicaid benefits but for the penalty, which in Maryland means that she had spent all of her assets except for $2500. The Act also increased the look back period from three to five years for all transfers. Therefore, if the parent who gifted on February 8 goes in a nursing home prior to January 31, 2011, she will not receive assistance from the State under the Medicaid program until 15 months after her admission. The logical question is if the applicant is indigent and is faced with a penalty that renders her ineligible for government subsidization of nursing home care, who will pay?

The Statute does provide for hardship waivers where eviction of the nursing home resident would jeopardize health or life. But no one really knows how these waivers will work, particularly if the indigence resulted from gifting assets. Some critics of the Legislation have dubbed it the “Nursing Home Bankruptcy Act”, speculating that the nursing homes will take a financial hit. It is more likely that the nursing homes will screen applications for admission much more carefully, refusing to admit anyone who has no funds and who is ineligible for Medicaid due to gifting. So, it is vitally important that gifting be done only after diligent consideration of the risks associated with making such transfers.

It is, of course, best to make transfers at a younger age simply because the chance of making it through the five year look back period is better. If you are healthy, document it by seeing your physician at or around the time in which the transfer is made. Only transfers made for the purpose of gaining Medicaid eligibility will disqualify the donor. For example, if a gift is being made in conjunction with tax planning to reduce estate or capital gains taxes, ask the consultant to provide written instructions so that you may argue that the transfers were being made pursuant to the advice of your tax consultant. Remember, that the burden will be on you to prove that the gift was not made to receive Medicaid.

Even if a gift were made for Medicaid purposes, there are certain exceptions to the rule that such a gift results in a penalty. For example, there is no penalty when one spouse gifts to the other spouse. Neither is there a penalty when a parent gifts the home to a child who has lived with the parent for at least two years prior to the nursing home admission and who has provided a level of care which has kept the parent out of a nursing home during the two year period. No penalty is imposed where a parent gifts the home to a disabled child. In a case where two siblings hold title to their home together, there is no penalty if the sibling entering the nursing home transfers her interest to the other.

If you can afford and qualify for long term care insurance, consider purchasing a policy. According to one study, for every 1000 people in the United States, 7 will actually incur damage to their home which would be covered under their homeowner’s policy, 40 will be involved in an automobile accident and nearly 500 will require long term care. Do not rely solely on the advise of the insurance person selling you the policy. Seek advise from your attorney or accountant who has no financial interest in whether you purchase the policy under consideration. Ask the salesperson to provide you with a history of premium rate increases imposed by the particular company underwriting the policy. Make sure that the policy covers not only nursing home care, but assisted living facilities and in home health care personnel.

The federal government is clearly attempting to shift the paradigm from government subsidies for nursing home care to private financing. Toward that end, the government has encouraged people to purchase long term care insurance by providing certain tax advantages. Of course, long term care insurance is not the panacea the industry represents it to be. Many people do not qualify and/or cannot afford it. For those people, Medicaid eligibility can only be achieved by spending down their own funds. The chilling effect the new rules will have on gifting is intended to facilitate the conversion from public funding to private funding. The Legislation casts a wide net replete with traps for the unwary.
Call us now for assistance (240) 453-0070.
We can help you!

At Senior Life Care Planning, LLC we are dedicated to giving our clients the power to be informed individuals and to give peace of mind. We provide honest ways to protect your home, loved ones and independence in times of great need. We understand the emotional burden, confusion, anger, hopelessness, sense of injustice, fear and loneliness that come with long-term disability and end-of-life issues.
Every day we help and support families and individuals who are in crisis. We work with our clients to provide peace of mind and quality of life.

Senior Life Care Planning, LLC
One Research Court, Suite 450
Rockville MD 20850
240.453.0070
www.seniorlcp.com

Friday, June 5, 2009

A Guide to Veteran’s Benefits

WHAT’S INCLUDED IN THIS GUIDE:

Veteran’s Benefits – Introduction
VA Compensation and Pension Benefits
Veterans Benefits at a Glance
More Details…
The Benefits Available
Who can help you file a claim?
Official Dates for Periods of War
Other Active Duty Qualifications
VA help lines found to regularly provide wrong information
VA Benefits Checklist
Listing of Possible Medical Expenses
The Wrap-up: You made it to the end!

Veteran’s Benefits – Introduction

Most people think of veterans’ benefits as being only for service men and women who were wounded or disabled while serving in the armed forces. By and large, that is true. But—we have learned that there are substantial benefits that may be available to wartime veterans who are now senior citizens and are facing the burden of long term care due to a host of diseases such as Alzheimer’s, Parkinson’s, MS, Lou Gehrig’s Disease, and many others. In fact, the Veterans Administration estimates that millions of wartime veterans and their spouses may be eligible for Special Monthly Pension benefits, and not even be aware of it!

Wartime veterans, or their surviving spouses, become eligible for the Special Monthly Pension benefit when they are over 65 years of age, are permanently disabled and unable to work, are homebound, or need the regular aid and attendance of another—whether at home, in assisted/supportive living, or in a nursing home. The program is based on actual financial need for assistance, so there are income and asset limitations.

Unfortunately, there is widespread misunderstanding regarding how to determine qualification for this important benefit. It is the goal of this Nuts and Bolts Guide to give you a start in understanding the ins and outs and the ups and downs of the VA benefit maze commonly referred to as “Aid and Attendance.” Even though finding your way through the maze can be extremely difficult, it is worth the effort to assist wartime veterans and their surviving spouses during times of great need.

The maximum benefit available can provide significant help in paying for long term care costs, either for the homebound and/or nursing home veteran/surviving spouse.

There are only three types of persons who are authorized to provide a veteran with assistance filing a claim for veterans’ benefits:
1. An attorney licensed to practice law in your state
2. A veterans service organization such as VFW, American Legion, Amvets, etc.
3. A state or county official of the Dept. of Veterans Affairs in your state

Unfortunately, there are few attorneys who have knowledge in this particular area of legal practice due to the fact that it is illegal to charge a veteran a legal fee for providing assistance in filing a claim for benefits. Veterans Service Organizations (VSOs) are often hard-pressed to have sufficient resources to assist multiple generations of veterans, so it is often difficult for a veteran or his/her surviving spouse to get help in filing a claim. Sadly, the Knight-Ridder Newspapers reported on December 30, 2005 that “a veteran who turns to the VA for information about veterans benefits might want to get a second opinion. According to the VA’s own data, people who call the agency’s regional offices for help and advice are more likely to receive completely wrong answers than completely right ones.”

The only other common source of information regarding this benefit generally comes from annuity salespeople who often offer to consult with veterans and their families for free. This “free” offer is based on the strategy of counseling the veteran to meet the asset and income limitations of the benefit by buying an annuity and giving away their assets to their children. The offer is that the annuity sales organization will assist the veteran in filing for the VA benefit claim. They also promise to provide any necessary estate planning work at no charge. In reality, the annuity salesperson is being compensated by the annuity company for selling a financial product to the veteran. An annuity may be an excellent financial decision or a poor one, depending on the facts and circumstances. All we are saying is this: You should seek independent advice before making a decision to purchase an annuity.

A Medicaid Trap…
Another important factor that one must consider when thinking about trying to meet the VA asset limitation test is that giving away cash or other things of value can create terrible problems for senior citizens if or when they later need to apply for Medicaid to assist them with skilled nursing home care. Giving away assets can create a long penalty period of ineligibility for Medicaid benefits. Any senior facing long-term care needs to seek capable legal advice from an attorney who is skilled in the areas of estate planning, Life Care Planning, Medicaid, Medicare, income tax, and gift tax, as well as having experience regarding VA rules.

The big question for many families will be, “What will it cost me to seek advice in this area?” Although an attorney who chooses to actually file a claim for veterans benefits must do that portion of his/her work for free, the attorney may charge the usual fees related to any estate planning, financial planning options, Medicaid, Medicare, income tax, or gift tax work, as well as the determination of the financial suitability of filing for a veterans benefit claim. No one should pay an attorney fee unless receiving a fair return on his/her investment.

After reading this Guide, we strongly recommend that you contact an elder care attorney such as those at Senior Life Care Planning to determine if you qualify. An elder care attorney can assist you and your family by explaining many difficult-to-understand things about long term care. Qualification for a VA benefit is only one of several concerns that must be considered. As you struggle to provide dignified long term care for a wartime veteran and/or surviving spouse, we can help you understand the options. We are your advocates, and we want to help you stretch your hard-earned dollars further. VA benefits are only one part of the puzzle. We will hold your hand and guide you every step of the way as we consider all of your family’s resources and needs.

VA Compensation and Pension Benefits

There are many types of VA benefits available to veterans through the Veterans Administration for things such as education, life insurance, health care, home loans and burial benefits. Two major categories of benefits, however, are compensation and pension.

Service-Connected Disability COMPENSATION

Compensation is a benefit that veterans receive when the veteran has a disability caused by, or exacerbated by, military service. Disability compensation is available to a qualified veteran regardless of his or her level of income. Once a veteran can show disability due to military service, a level of disability is rated by the Veterans Administration (for example, 20% disabled) and the amount of compensation paid depends on the rating assigned. A veteran can apply for increases in the percent rating should the condition worsen. A rating above 100% disabled will qualify the veteran for special monthly compensation that could more than double the normal benefit. During 2009, monthly compensation payments ranged from $123 for a veteran with no dependents and a 10% disability rating, to $2,673 for a veteran with a spouse and a 100% disability rating. Special monthly compensation benefits can raise the maximum monthly payments.

Dependency and Indemnity Compensation (DIC) is paid to survivors of deceased veterans if the death was due to a service-related injury or illness. Eligible survivors include spouses who have not remarried and unmarried children under 18. Disabled children are also eligible, as are children up to 23 who are attending school.

Non-Service-Connected Disability PENSION

A pension is a benefit for veterans with low incomes who are permanently and totally disabled, when that disability is not related to military service. This is sometimes referred to as a “Special Monthly Pension” (or sometimes an “Improved Pension”). A veteran will be considered permanently and totally disabled if they are, (1) a patient in a nursing home for long-term care because of disability; (2) receiving Social Security disability benefits; (3) unemployable as a result of a disability that is reasonably certain to continue throughout their life; or (4) suffering from any disease or disorder that renders them permanently and totally disabled as determined by the Secretary of the Department of Veterans Affairs.

In 2009, the maximum disability pension rate for a veteran with no dependents is $11,830, or $985 per month. The rate for a veteran with one dependent, or for two veterans married to each other is $15,493, or $1,291 per month. Each additional dependent child adds $2,020, or $168 per month, to the pension.

The VA pays a death pension to low-income surviving spouses and unmarried dependent children of deceased wartime veterans. In order to be eligible, a spouse must not have remarried, and a dependent must be under age 18, or must be under age 23 if attending a VA-approved school. Dependents who are permanently incapable of self-support because of disability before age 18 are also eligible for the death pension. For 2009, the maximum death pension for a surviving spouse is $7,932, or $661 per month. If the spouse has a dependent child, the maximum pension is $10,380, or $865 per month. If the spouse has more than one dependent child, the benefit for each dependent child is $2,020, or $168 per month.

The amount of the Special Monthly Pension will be increased if the permanently disabled veteran is also housebound. A person is housebound if they are permanently and totally disabled and, either (1) have an additional disability or disabilities ratable at 60% or more; or (2) are substantially confined to their residence or the immediate premises due to a disability that is reasonably certain to remain throughout their lifetime. In 2009, the maximum pension for a housebound veteran with no dependents is $14,448, or $1,204 per month. If the housebound veteran has one dependent, the maximum pension is $18,120, or $1,510 per month. If a surviving spouse is housebound, the maximum pension is $9,696, or $808 per month. With a dependent child, the maximum pension is $12,144, or $1,012 per month. Again, each additional dependent will increase the pension $2,020, or $168 per month.

If the veteran is in need of regular aid and attendance, the maximum Special Monthly Pension is increased further to $19,736, or $1,644 per month if the veteran has no dependents. With one dependent, the maximum pension is $23,396, or $1,949 per month. If the surviving spouse is in need of regular aid and attendance, the maximum pension is $12,681, or $1,056 per month. If the surviving spouse has a dependent child the maximum pension is $15,128, or $1,260 per month. Again, each additional dependent will increase the pension $2,020, or $168 per month. To be in need of regular aid and attendance, the veteran or spouse must be permanently and totally disabled and (1) a patient in a nursing home; (2) blind, or nearly blind; or (3) needing the regular aid and attendance of another person to perform basic activities of daily living, such as dressing, bathing, and attending to the wants of nature.

Attaining age 65 – Service Pension

A low-income, wartime veteran who attains the age of 65 is also entitled to a pension, known as a Service Pension, whether or not they are disabled. The amount of the maximum pension is the same as the Special Monthly Pension.

Low Income and Net Worth Requirements

In order to be eligible to receive any of the above non-service connected PENSIONS, the veteran must meet income and net worth requirements. First, the annual maximum pension amount is decreased, dollar for dollar, by the veteran’s countable income. Income that is countable is, in general: all of the veteran’s income, including that of any dependents, MINUS unreimbursed medical expenses. Unreimbursed medical expenses include doctor’s fees, dentist’s fees, prescription glasses, Medicare premiums and co-payments, prescriptions, insurance premiums, transportation to physicians’ offices, and the costs of assisted living facilities or in-home aides.

So, for example, if a veteran has $20,000 in income and $10,000 in unreimbursed medical expenses, their countable income is $10,000. Their $10,000 in countable income is deducted from the maximum annual Special Monthly Pension of $11,181 for a benefit of $1,181. As another example, suppose the veteran is in a nursing home (and so qualifies for the additional pension for aid and attendance) and has an income of $50,000. If their unreimbursed medical expense for the nursing home are $5,000 per month, or $60,000, the veteran’s countable income is negative $10,000. Any negative income is counted as an income of $0 and the veteran will be eligible for the maximum annual Special Monthly Pension for aid and attendance of $19,736.

In addition to low income, the veteran must also have a limited net worth. The VA has not specifically defined “limited net worth”—however, a general guide is that the veteran must have a net worth lower than $50,000 if single or $80,000 if married. A veteran’s net worth is calculated by adding all the value of all personal and real property owned by the veteran (and his or her spouse), not including a home and car. Items included in the calculation of a veteran’s net worth would include things such as CDs, savings accounts and bonds.


Veterans Benefits at a Glance


The focus of this Nuts and Bolts Guide is the “non-service-connected pension” which may provide money to assist a wartime veteran or surviving spouse who now faces substantial medical costs due to Alzheimer’s, Parkinson’s, MS or other “non-service-connected” diseases.







More Details…
Who is eligible for the non-service-connected pension?
Honorably discharged veterans, surviving spouses, or children of any military, naval, or air service.

Also includes certain other special groups such as:
o Women’s Army Auxiliary Corps (WAAC)
o Merchant Marines from WWII
o U.S. civilians of the American Field Service
o Plus 30 more! See list later in this guide.

Served in active duty 90 consecutive days, one of which was during a period of war

At least 65 years old OR Permanently and Totally Disabled

“Permanently and Totally Disabled” is defined as:
Receiving long-term nursing home care; or
Receiving Social Security disability benefits; or
Unemployable as a result of disability reasonably certain to continue throughout the life of the person.

The veteran’s current disability does not need to have any connection to the veteran’s actual time in the armed forces. (Non-service-connected disability can be Alzheimer’s, Parkinson’s, etc.)

Other requirements:
This is a needs-based program with income and asset tests.
Income limitation
Gross income MINUS certain expenses
Unreimbursed medical expenses of veteran and his/her household
Certain educational expenses
After reducing gross income by the above expenses, net income must be lower than $7,933 to $23,396, depending on your circumstances
Net worth limitation
In addition to your house, car, life insurance, burial policies, and annuities in payout status, you can generally have between $50,000 and $80,000 in assets, including CDs, stocks, bonds, etc.
If your net worth is higher, consult with a qualified attorney for an appropriate tax analysis to see if transferring some of your assets may qualify you.


Who can help you file a claim?

 Recognized Veterans Service Organizations, like the VFW or American Legion
 An accredited agent
 A licensed attorney


Only accredited agents and attorneys can receive fees for their services.

HOWEVER, no one can receive a fee for filling out forms or actually filing a claim for you once you have decided to make a claim!

Senior Life Care Planning, LLC offers pre-filing and asset protection consultation to veterans who may qualify for a pension.

Our consultation is part of our overall long-term care planning practice.


Contact us today!

Phone 301 663 9230 Frederick Office
240 453 0070 Rockville Office

www.seniorlcp.com


Official Dates for Periods of War

Mexican Border: May 9, 1916 to April 5, 1917

World War I: April 6, 1917 to November 11, 1918
April 1, 1920 if served in Russia

World War II: December 7, 1941 to December 31, 1946

Korean War: June 27, 1950 to January 31, 1955

Vietnam War: August 5, 1964 to May 7, 1975
February 28, 1961 if served in Vietnam

Persian Gulf War: August 2, 1990 to [date not yet determined]



Other Active Duty Qualifications

If you belong to any of these groups and received a discharge by the Secretary of Defense, your service meets the active duty service requirement for benefits:


 Recipients of the Medal of Honor
 Women Air Force Service Pilots (WASPs)
 WWI Signal Corps Female Telephone Operators Unit
 WWI Engineer Field Clerks
 Women’s Army Auxiliary Corps (WAAC)
 Female clerical employees of the Quartermaster Corps serving with the American Expeditionary Forces in WWI
 Civilian employees of Pacific naval air bases who actively participated in defense of Wake Island during WWII
 Reconstruction aides and dietitians of WWI
 Male civilian ferry pilots
 Wake Island defenders from Guam
 Civilian personnel assigned to OSS secret intelligence
 Guam Combat Patrol
 Quartermaster Corps members of the Keswick crew on Corregidor during WWII
 U.S. civilians who participated in the defense of Bataan
 U.S. merchant seamen who served on block ships in support of Operation Mulberry in the WWII invasion of Normandy
 American merchant marines in oceangoing service during WWII
 Civilian Navy IFF radar technicians who served in combat areas of the Pacific during WWI
 U.S. civilians of the American Field Service who served overseas under U.S. armies and U.S. army groups in WWII
 U.S. civilian employees of American Airlines who served overseas in contract with the Air Transport Command between 12/14/41 and 8/14/45
 Civilian crewmen of certain U.S. Coast and Geodetic Survey vessels between 12/7/41 and 8/15/45
 Members of the American Volunteer Group (Flying Tigers) who served between 12/7/41 and 8/14/45
 U.S. civilian flight crew and aviation ground support of TWA who served overseas between 12/14/41 and 8/14/45
 U.S. civilian flight crew and aviation ground support of Consolidated Vultee Aircraft Corp. who served overseas between 12/14/41 and 8/14/45
 Honorably discharged members of the American Volunteer Guard, Eritrea Service Command, between 6/21/42 and 3/31/43
 U.S. civilian flight crew and aviation ground support of Northwest Airlines who served overseas between 12/14/41 and 8/14/45
 U.S. civilian female employees of the U.S. Army Nurse Corps who served in the defense of Bataan and Corregidor from 1/2/42 to 2/3/45
 U.S. civilian flight crew and aviation ground support of Braniff Airways who served overseas in the North Atlantic between 2/26/42 to 8/14/45
 Chamorro and Carolina former native police who received military training in the Donnal area of central Saipan and were placed under command of Lt. Casino of the 6th Provisional Military Police Battalion to accompany U.S. Marines on active, combat patrol from 8/19/45 to 9/2/45
 The operational Analysis Group of the Office of Scientific Research and Development, Office of Emergency Management, which served overseas with the U.S. Army Air Corps from 12/7/41 through 8/15/45
 Honorably discharged members of the Alaska Territorial Guard during WWII
VA help lines found to regularly provide wrong information
By CHRIS ADAMS
Knight Ridder Newspapers - Posted on Fri, Dec. 30, 2005

WASHINGTON - A veteran who turns to the Department of Veterans Affairs for information about benefits might want to get a second opinion.

According to the VA's own data, people who call the agency's regional offices for help and advice are more likely to receive completely wrong answers than completely right ones.

To see how well its employees answer typical questions from the public, VA benefits experts in 2004 called each of the agency's U.S. regional offices, which process veterans' disability claims. The so-called mystery callers, saying they were relatives or friends of veterans inquiring about possible benefits, made a total of 1,089 calls. Almost half the time they got answers that the VA said were either completely incorrect or minimally correct.

According to an internal VA memo on the mystery-caller program that's buried deep in the department's Web site, 22 percent of the answers the callers got were "completely incorrect," 23 percent were "minimally correct" and 20 percent were "partially correct." Nineteen percent of the answers were "completely correct," and 16 percent were "mostly correct."

The program also found that some VA workers were dismissive of some callers and unhelpful or rude to others. One caller, for example, said, "My father served in Vietnam in 1961 and 1962. Is there a way he can find out if he was exposed to Agent Orange?" The VA's response, according to the VA memo: "He should know if they were spreading that chemical out then. He would be the only one to know. OK (hung up laughing)."

The memo said the response was "completely incorrect" because it gave no information - and also was "rude and unprofessional."

The 2004 survey found improvements in some categories compared with a similar study with identical questions in 2002. Timeliness improved, but scores on "willingness to help" and "courtesy/professionalism" dropped. VA workers also used "too much jargon," confusing to many veterans, the memo said.

VA officials acknowledge that the agency needs to do better. Daniel Cooper, the department's top benefits official, said in a memo to the VA regional offices that the results of the mystery-caller program "are below expectations and are disappointing to the organization. ... We must be able to provide prompt service and give correct answers with the courtesy and professionalism that our customers deserve."

This week, VA officials said they'd taken steps since 2004 to improve their performance, among other things setting up a small pilot program to monitor employees silently as they answered veterans' questions. While the VA said the pilot program improved performance, thus far it's been used in only four out of 57 regional offices. Other offices are scheduled to begin the silent monitoring by the end of fiscal 2006. Beyond that, the VA said it was working to improve its service by boosting training and using role-playing exercises for some phone calls with the public. Other quality-improvement programs are expected to be put into place in 2006 and 2007.

Veterans across the country said their experience with VA call centers suggested that there was still significant room for improvement. "The VA needs a change of attitude," said William B. Jones, a veteran from Greenville, S.C., who's been butting heads with the agency for several years. Jones, a semi-retired physician, said he'd received bad medical information and repeatedly had gotten the runaround in his attempt to get compensation for ailments that he said were linked to his military service.

"I often get no answer at all," said Jones. "I call their 1-800 numbers and generally you get a computer and talk to no one. I've had that not once but probably a dozen times. When you do talk to somebody, you get frustrated because you can't really find out if the case is proceeding. They say they are working on it, but they don't give any details."

Responding to Jones' complaints, the VA said it "takes very seriously any frustrations veterans may experience when attempting to contact us. ... VA continues to work on ways to provide better access and quality customer service."

The mystery callers also judged the courtesy, willingness to help and promptness of the people who answered the VA's phones. They found that many VA offices were helpful and friendly - even as they provided bum information.

Bum information, however, is the biggest problem. One mystery caller, for example, asked about benefits after a Vietnam veteran died of lung cancer. Many conditions have been linked to the herbicide Agent Orange, which was widely used in Vietnam. But the VA regional office said lung cancer was "not one of the conditions related to Agent Orange."

According to the VA's evaluation, that answer was "completely incorrect (wrong information given - lung cancer is one of the conditions related to Agent Orange.)"

Another mystery caller asked about a grandfather who'd been injured in the Korean War. "When he dies, is he eligible for burial in Arlington National Cemetery?" the caller asked.

Response: "I can't answer for Arlington. You can call your congressmen. They love doing those kinds of things for their constituents."

The VA's evaluation: "Completely incorrect. ... Unprofessional; unwilling to help."

Another mystery caller asked whether her husband could get help from the VA for a back problem he'd had for years. "I don't know," the VA regional office said. "He just has to file a claim."

The evaluator found that the response was completely incorrect because it didn't give an answer, and the VA official was "discourteous" and "unwilling to help."


Source: VA memo on “2004 Mystery Caller” program.


VA Benefits Checklist


Items you'll need if you are a:

Veteran Only:
DD-214 or Discharge Papers
Annual Social Security Award Letter received in January OR other documentation to verify your income
A printout from your pharmacy of 3 months of expenses
Copies of all your latest financial statements

Veteran and Spouse:
All of the above for you and your spouse, PLUS
Marriage certificate
Death certificate or divorce decree if either spouse was previously married

Widow/er of Veteran:
The veteran's DD-214 or Discharge Papers
Annual Social Security Award Letter received in January OR other documentation to verify your income
A printout from your pharmacy of 3 months of expenses
Marriage certificate
Veteran's death certificate
Death certificate or divorce decree related to any previous marriages of either you or the veteran
Copies of all your latest financial statements

Additional forms that will need to be filled out and filed with the claim for benefits:
Statement of Attending Physician
VA Form 21-0779 – Nursing Home Information Report
Authorizations and Consent to Release Information to the VA
for each physician of the veteran or spouse
Care Provider Report
Claimant’s Certification of Out-of-pocket Expenses
Statement Regarding Claimant’s IRA


Listing of Possible Medical Expenses


These can be deducted from your gross income to determine VA benefit eligibility.



Medicare Premiums deducted from Social Security
Supplementary medical insurance (Part B) under Medicare
Abdominal supports
Acupuncture service
Ambulance hire
Anesthetist
Arch supports
Artificial limbs
Back supports
Braces
Cardiographs
Chiropodist
Chiropractor
Convalescent home
(for medical treatment only)
Crutches
Dental services
Dentures
Dermatologist
Eyeglasses
Food or beverages prescribed by doctor for treatment of illness
Gynecologist

Hearing aids & batteries
Home health services
Hospital expenses
Insulin Treatment
Insurance premiums (medical)
Invalid chair
Lab tests
Lip reading lessons
(in connection with disability)
Neurologist
Nursing services
Occupational therapist
Ophthalmologist
Optician
Optometrist
Oral surgery
Osteopath
Pediatrician
Physical examinations
Physician
Physical Therapy
Podiatrist
Prescriptions and drugs
Psychiatrist
Psychoanalyst

Psychologist
Psychotherapy
Radium therapy
Sacroiliac belt
Seeing-eye dog
Speech therapist
Splints
Surgeon
Telephone/teletype for deaf
Transportation expenses (20 cents per mile)
Vaccines
Vitamins prescribed by doctor
Wheelchairs
Whirlpool baths for medical purposes
X rays

Note: Most medical expenses must be prescribed by a physician to be deductible from gross income for VA benefit qualification purposes.
The Wrap-up: You made it to the end!


After reading this Guide, you may have enough information to file a claim on your own. If you do decide that you need the help of attorneys who are concentrated in the area of assisting senior citizens, then please contact us at Senior Life Care Planning, LLC. Our goal is to make sure that our clients make the most of their financial and family resources so that they are never out of money and never out of options for as long as they live. If you are like most people, then we believe that you will need guidance to apply the information in this guide to your life or the life of your loved one.

We are here to provide guidance to you in the following areas:
 Care options available in the local community for both the Veteran and spouse
 A comprehensive understanding of availability and extent of personal and financial, as well as family resources to pay for care
 Basic estate plan documents such as powers of attorney, wills & possibly trusts
 Basic analysis of any income tax, estate tax, and gift tax issues
 A review of Medicare and Medicaid as it applies to your circumstances
 Analysis of financial suitability of any asset protection tools
 Analysis of both positive and negatives of all tools and planning options
 A calculation of the actual dollar benefit and/or cost of any helpful idea that is discussed
 Possibly completing and submitting the VA claim form


David Wingate, Elder Care Attorney






Legal Disclaimer

This information has been provided for informational purposes only. It does not constitute legal advice. The receipt of this information does not establish attorney-client privilege. Proper legal advice can only be given upon consideration of all the relevant facts and laws. Therefore, you should not act upon any of the information contained herein without seeking appropriate counsel. Copyright © 2009 by Senior Life Care Planning, LLC. All rights reserved. These materials may not be reproduced in any way without the written permission of Senior Life Care Planning, LLC.

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About Me

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Maryland, United States
My life changed in the early to late 1990' My grandfather was living in Chevy Chase, Maryland. One night I received a call. I answered the phone, to hear that my grandfather, had fallen. Subsequently, he was taken to a nursing home. I was the attorney in the family, so everything was left to me. During this time, I had lots of questions: what options were available; what's a good nursing home, would he get good care; how are we going to pay for it? I tried to find answers to these questions. But I could only catch glimpses of the big picture. That research was my first act into the practice of elder law and life care planning. After granddad was in the nursing home. I researched this area and I started putting together what later turned out to be the beginning phases of my new life care planning practice and my calling.