Dad's file is the evidence. The VA does not decide an Aid and Attendance claim on a family member's description of his days. It looks for a physician's account of what he cannot do on his own, and that account has to rest on his actual medical records. Getting those records is clerical work. Whether your family does it or pays someone else is a decision about time, access, and who will keep calling when an office stalls.1

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 records have to show

The VA looks at function: whether Dad needs help with bathing, dressing, eating, getting up from a chair or bed, or staying safe, and how often that help is needed. Visit notes, discharge summaries, and the provider's own notes about those needs are what make a physician's statement credible. A stack of bills does not do this job. Before you request anything, ask the physician's office whether they will complete VA Form 21-2680 directly. The answer changes which records you need to pull.2

The request, step by step

Many providers have a release-of-information form of their own. Use theirs rather than a template you found online, because a records office will often reject a form it did not issue. Fill in Dad's full legal name and date of birth, the date ranges you need, each facility or office by name, and whether you want the complete chart or specific notes. Ask in writing how the records will be delivered, what they charge per page or per request, and how long the office says it takes. Keep the confirmation and a copy of exactly what you sent.

Check who is signing before you send anything. The request must come from Dad or from someone the office accepts as his authorized representative. Ask the office what paper it needs to see for that authority. If Dad cannot sign for himself, the office will tell you what it recognizes. Do not assume a family member's name on a form is enough.

What a paid service adds, and what it cannot do

A records service will send the requests, follow up with offices that stall, and sort what comes back. That work is real, and the fee pays for it. Before you agree to anything, ask whether the price is per record, per page, or flat. Ask whether you receive the complete records or only a summary. Ask who handles it when a facility rejects the release. Get the answers in writing.

A records service is not a claim representative. It cannot file the VA claim or advise Dad on it unless the person handling the claim is an accredited VA representative or attorney. The VA publishes a search tool for accredited representatives, and the name of anyone helping with the claim should appear there.3 A records vendor's contract does not give it authority to act for Dad with the VA.

How to decide

Do it yourself if the records sit with one or two providers, the offices answer by phone or portal, and someone in the family can make the calls within a week or two. Pay for help if the records span several providers, a facility has already refused once, or nobody in the family can take the time to chase the requests. Either way, confirm where the physician's completed form will be sent, and keep a copy of every request and every page you receive.

If you need someone in the St. Louis area to point you toward the right offices, the St. Louis office list covers who to call. For how the sources behind this guide are organized, see the Sources page.

[1] VA.gov, Aid and Attendance and Housebound benefits page.

[2] VA.gov, information page for VA Form 21-2680, Examination for Housebound Status or Permanent Need for Regular Aid and Attendance.

[3] VA.gov, VA-accredited representative search.