VA pension counts income, and some medical bills can be subtracted from it before the monthly rate is set. That subtraction can raise the payment, which is why the worksheet matters. It is also arithmetic that a family can often do itself, or pay someone to do. The law limits who may charge for help with the claim.
Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.
What the worksheet has to prove
Only some costs count. VA's rules separate deductible medical expenses from ordinary household costs and set out the documentation VA expects.1 Care that is medical in nature may qualify. General companionship hours and household help usually do not. Do not assume a bill counts because it was paid to a caregiver. Read the list VA publishes before you total anything.
When the family does it
A short list of bills, a few payees, and one clear paper trail make this a family job. Build a ledger with five columns: the date each bill was paid, the payee, the amount, the service it covered, and whether anyone reimbursed it. Attach the receipt or statement to each line. Keep the ledger in the same binder as the claim.
When a preparer makes sense
Hire out when the bills are many, when more than one person paid them, or when the family cannot separate medical costs from non-medical costs with confidence. Before you pay anyone, check three things.
First, accreditation. Help with a claim for a fee is restricted to people VA has accredited, such as accredited attorneys, claims agents, and representatives of recognized organizations. A bookkeeper or consultant without accreditation may not charge you for help with the claim itself. Totaling receipts is a gray area, so get that scope in writing. Look up any name on VA's accreditation search before you sign.2
Second, what you are buying. Asking someone to total receipts is different from asking them to argue the claim. Put the task list in the agreement.
Third, when the fee falls due and who approves it. For attorneys handling pension claims, fees are generally limited to the period after VA has made an initial decision, and VA must approve the fee agreement.2 Ask the preparer to show you that rule in writing before any money changes hands.
What to check before you pay
Ask for the accreditation number. Ask whether the fee is flat or hourly and whether it is due before VA acts. Ask who will review the receipts and who will sign for Dad. Keep a copy of every page you give them. If a preparer asks for an upfront payment to file a pension claim, stop and check the rule above.
For free help offices in St. Louis, see Local Help: St. Louis Offices.
1 VA.gov, pension income and deductible medical expense rules.
2 VA.gov, accreditation and fee rules for claim representation, based on 38 U.S.C. 5904 and 38 CFR 14.636.