What you need to know before you file :
If you are new to the VA system or to our firm, there are some important details you'll want to know before you file a claim.
The Informal Claim
For most individuals, the first step in claiming a VA pension is to complete the informal claim statement. This informal filing puts the VA on notice that the claimant (the veteran or dependent) intends to claim the benefits which the veteran earned through military service during a period of combat. Filing of the informal claim does two important things/ First, provided eligibility is met at the filing, it starts the clock on your claim. What this means is that the informal filing establishes an effective claim date . From this date, you have on year to complete the formal application. If you complete the formal filing in that time, benefits may be paid retroactively to the first day of the month following your informal filing. In other words, if you file in April, you'll have a May 1st effective claim date. If the benefit is awarded in October, you may receive, in addition to the monthly pension amount, a lump sum deposit for May, June, July, August, and September. Secondly, the filing of an informal claim triggers the VA's internal fact-finding process.
The Fact Finding Process (or developing the claim)
The. filing of an informal claim triggers an automatic fact finding process at the VA. Piece by piece, the VA builds a claim to determine whether or not the claim is viable. Over a period of months, and even years, the VA corresponds with individual claimants to request one bit of information after another until the claim is either fully developed or discarded as unlikely to be awarded. Routinely, claimants die during the process and their claims remain unpaid because family members are unaware that accrued benefits may be posthumously available where there are debts related to last illnesses (including nursing home or assisted living expenses) and burial costs. Often claims are abandoned because families are unaware that surviving spouses can also collect on the deceased veteran's claim. The traditional VA fact finding allows for the VA to gather information about the claimant but often gives very little information to the claimant, leaving claimants unaware of exactly why the claim process is so lengthy or why the claim was denied. The great news is that the process of developing a claim does not have to move so slowly.
Fast Tracking a Fully Developed Claim
As of about 2000, the VA does have a process in place for managing claims that arrive fully developed. When a claim arrived with all of the fact finding completes and all of the requisite forms properly submitted, the claim is fast tracked. For obvious reasons, part of the VA's process, the longest and most tedious part, is circumvented. Claims that are recognized as fully developed upon receipt bypass the fact finding at submission and proceed to the VA's four stage reviewing and awarding process. Our accredited agents and their supporting staff develop claims at a fraction of the time it takes to do the same work at the VA. We gather all the information up front and have frequently created a fully developed claim before the VA even acknowledged receipt of the informal claim. Simply put, we have completed the VA fact finding process and the paperwork submission, often before the VA even starts the process!
How we make this work
We start by asking for enough information to address each aspect of benefit eligibility. We ask a lot of questions, usually in phone interviews and through questionnaires, to determine where eligibility is clearly evident and where we need to take special care to demonstrate to the VA that a claimant does indeed qualify. We fill out paperwork on your behalf, often sending it to you for review and signatures. We address any of those areas where eligibility may not be readily apparent to the VA with strategic legal and financial planning designed to shine a light on the real cost of care and the far-reaching impact of the claimant's medical and personal care needs. We get in touch with your doctors, your facility administrators (if that's where the claimant resides), and the family. Did I mention paperwork? We fill out a lot of paperwork on your behalf! Once all the claim development, legal work, and financial work is done and all the forms are filled out to completion, we send them back to you one last time for signatures before reviewing them (again!) and sending them off to the VA.
What we will do Free of Charge
VA accredited agents have an affirmative responsibility to file your informal claim at no charge. This means that we will file your informal claim absolutely free. Agents also have an affirmative responsibility to review your formal application and assist you in filing that paperwork. We will provide the paperwork to you, make sure you've completed the form properly, and submit the paperwork to the VA. This is a relatively simple process that can be completed quickly and easily. For those who meet eligibility without any additional services needs, we offer a straightforward Pro Bono packages that includes the necessary forms as well as a list of the supporting documents required for submitting a Fully Developed Claim (FDC).
What we cannot do for free
Unfortunately, we cannot develop the claim for you free of charge or restructure your assets if that is warranted. On average, we spend 30 hours on each case that comes into our office. The work we do includes a variety of professionals with specialized skills who do much more than simply filing your claim. For example, we review your Power of Attorney to verify that it meets the demands of any legal or financial actions required to meet eligibility and we provide Medicaid planning advice to assure that actions you take now won't impact Medicaid eligibility later, should that need arise. We often assist clients in finding care providers, facilities or financing for care. We frequently locate geriatric medical professionals for our claimants, provide them information about VA services unrelated to the Improved Pension claim like HISA grants, how to recover lost military records and medals, and how to go about being buried in a VA cemetery. Of course, we also fully develop your claim. Unlike volunteers at the VFW, or your regional VSO, we will contact your doctor. We will call your facility. We will speak to your family members and explain the process. We won't just review your forms for completion, we will tell you where eligibility is unclear and provide sound legal and financial strategies for clearing up any confusion that may lead to a delayed award or a denied claimb. All of this work, above and beyond the affirmative responsibility of an accredited agent, takes a good bit of expertise and, as mentioned above, a significant number of man hours.
Put another way, if your circumstance is such that, as a result of our review, we determine that you are fully qualified for the VA Benefit with the required care needs, necessary services, qualified care expenses, and asset base, then we offer you our pro-bono package of forms and directions, and offer to review the information for completeness and submission to the VA. There is no charge for this assistance.
If there are issues that need further development or advice, such as:
-Development of the physician statement around medical needs
-Development of care contracts and physician statements for Independent Living Communities
-Advice on repositioning of assets via direct gifting or Trusts and the attendant tax advice
-Providing advice and facilitating contact with attorneys or financial advisors around asset movement -------Advice on maintaining the veteran at home under family care contracts or home health care, the
consequences of vacating, selling or renting the home and it’s future impact on claims eligibility
-Advice on dovetailing the VA claim with potential “worst-case” Medicaid and other VA, Health and Human -Services and community benefits
-Consultation with our VA Compensation Advocate (who most recently worked at the VA Court of Appeals in Washington, DC) to help them better understand the impact of the Pension Claim on existing or future --VA Indemnity Compensation or Widow’s DIC benefits
-Related pre-planning of the VA claim to assure a fully developed, fast track submission
-Review by an Elder Law attorney of an existing POA to assure the presence of required provisions to allow for worst case end-of-life and legacy planning
-Advice and guidance on the fiduciary process
-Guidance on assuring that the family has access to the accrued benefit should the claimant die prior to the award
Then we have a fee structure designed around the complexity of the claim. As part of this package, we also offer our team’s time and knowledge base to completely take over the filing of the claim and provide our time to write letters to the doctors, secure facility statements, and completely assume responsibility for the accuracy, through a number of redundancy checks, and completeness of the claim so that it can be filed under the VA’s “Fully Completed” or fast track regulations; and finally, our team takes responsibility for “following” the claim at the VA to assure that it stays “on track,” which in most cases provides for the approval of the claim in a timely manner as compared to a “standard” undeveloped claim.
How we determine a fee
Our fees are determined quite simply, by the complexity of the claim and the number of hours a claim requires from our agents, advisers, and staff. We work hard to be able to provide the sound legal expertise of nationally recognized attorneys, Medicaid planners, and financial planners at a rate significantly lower than their routine hourly fees. Further, the professionals we work with are experts at helping you cut costs where ever possible both within the claim process and with issues regarding elder care planning generally.
If you feel that this benefit may apply to you or your loved one, we invite you to fill out an initial assessment to see just where you fall in each of the areas of eligibility. There is no cost associated with filling out the assessment and all your responses will be kept confidential. We will receive your information, evaluate it, and determine whether you meet the baseline qualifications. Once we've made a determination, we'll contact you and let you know what we determined. If you decide at that point, that this benefit isn't for you, we won't contact you again. If you'd like us to file the informal claim, guarantee Medicaid compliance, and offer access to all the services described above, we'll schedule a consultation to begin the fact finding process immediately so that we can get the claim through the VA as quickly as possible.