The Top 5 Reasons VA Denies Pension
Jul 8th, 2009 by rbuchanan
The VA’s own website (www.va.gov) confirms 75% of all applications for VA pension are denied the first time. Is this a conspiracy by the VA? Does the VA have a “quota” for approvals? Are they trying to save federal money? Do they know the proper regulations? In my 34 years with the VA, I even heard “that pension applications are only approved the last 10 days of the month”. NONE OF THESE ARE TRUE!
VA applications for pension are disapproved because they are not complete and well-documented. Yes, now that pension claims are worked in the St. Paul and Philadelphia Pension Centers only, the atmosphere for help and approval is far better, and applications are resolved more quickly (4 months instead of 9 months). Gone are the days when certain individuals in local Regional Offices (RO’s) WOULD DENY everything. Those of you who were forced to deal with the Phoenix and Alburguergue RO’s in the past know this is true.
I hope the following 5 reasons for denial will help you navigate the VA process. Yes, the VA’s “duty to assist” exists, but this is the one area where the VA responsibility continues to fail. If you are not inform, our represented by Elder Law Firms like JacksonWhite, you may be unprepared to deal with the VA and perfect your benefits.
Reason Numer 5: MISSING OR INCOMPLETE INFORMATION. The VA applications, VA form 21-526 (veterans) and 21-534 (widows), are multiple-paged and have many, many questions. Address and answer everyone of them. If the question is “non-applicable”, answer “N/A”; if the income is zero, answer with a “0″; and if you are tempted, NEVER, NEVER leave a space “blank”. Every blank space means a question & a letter from the VA, which delays the claim. If you do not have a copy of the veteran’s discharge, DON’T WORRY! Attach what you have, because the VA will ask the military for confirmation of the veteran’s service.
Reason Number 4: Failure to Respond to Clarifications. There are many areas on an application where the VA MUST clarify what you submitted or what you meant (REMEMBER: you can never tell the VA too much about a situation). ALWAYS answer their letters or phone calls as soon as possible, and if you need time to do so, send them a letter saying “I’m working on it”. Do not panic when they say “respond within 30 days”. You have at least 60 days by law, and can supply the information within 1 year and still have a valid claim. If you DO NOT know where to get any clarification, tell the VA and asked their advise (the duty to assist). There are always alternatives!!
Reason Number 3: Documenting Dependents. Who is a “dependent” for VA pension is often misunderstood. A “dependent” is less than 18 years old, where the veteran is the father, or the veteran is married to the mother, so step-children are fine. Grandparents MUST have court-issued adoption decrees. If dependents are under 23 years old, they MUST be in school full-time. Spouses are dependents, but their income also counts, as well as their Unreimbursed Medical Expenses. If the veteran or their spouse has previous marriages, document them with a death certificate, an annulment decree or a divorce decree. The VA MUST assure a “valid marriage”. HINT: divorce decrees are available from the County where the divorce was granted.
Reason Number 2: Documenting “Shortfalls“. If your Unreimbursed Medical Expenses, especially your Room & Board (R&B) figure for a facility, exceed your income, the VA WILL ALWAYS delay your claim to clarify this. So, you are going to anticipate this question!! If you are using “savings or assets” to meet this shortfall every month, explain this as an attachment to your application. If your assets are depleted, and a friend, sibling or family member is supplementing your R&B, explain this. To be absolutely sure the VA understands this, write a simple “loan agreement” and submit it, showing you are “borrowing” this shortfall every month, expecting to pay it back when pension starts.
And Finally, Reason Number 1: Failure to Document Income and Unreimbursed Medical Expenses. On the application, the VA can ONLY confirm the amount of your Social Security benefits independently. EVERYTHING else should be documented with a written explanation, this year’s award letter, or an annuity agreement. The VA can’t even confirm your Federal or Military Retirement without a letter. WHEN IN DOUBT, document it. Unreimbursed Medical Expenses should be documented on the VA form 21-8416. For most widows and veterans, their largest expense is the R&B they pay for a Group Home, Assisted Living or a Nursing Home. Simply provide the VA a letter from the facility confirming your Room & Board monthly figure. If you have any other “recurring, ongoing or continous” Unreimbursed Medical Expenses, document them.
With the VA, you CAN NEVER provide too much information. If they have to write you for clarification of any ONE point on the application, your claim will be delayed or denied. ALWAYS include your phone numbers, an EM address if you have one, and a Next-of-Kin’s contact information with every application.
If you have any questions, please contact us directly at (480) 464-1111, or pose a question to our blog.