The VA website http://www.va.gov confirms that 75% of all applications for VA pension are denied the first time. This is not a conspiracy to save federal money or an attempt to meet quotas of which there are none. Applications for pension are disapproved because they are not complete and well-documented. 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. Gone are the days when certain individuals in local Regional Offices would deny everything. 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 email address if you have one, and a next-of-kin’s contact information with every application.
The following 5 reasons for denial will help you navigate the VA process:
1. 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 every one 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 and 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.
2. 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. It is their duty to assist where possible. There are always alternatives.
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. Divorce decrees are available from the County where the divorce was granted.
4. Documenting Shortfall. If your Unreimbursed Medical Expenses, especially your Room an Board (R an B) figure for a facility, exceed your income, the VA will always delay your claim to clarify this. So, you need 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 an 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.
5. 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 an 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 an Board monthly figure. If you have any other recurring, ongoing or continuous Unreimbursed Medical Expenses, document them.