Net Worth Denial Response
Net Worth Denial Response
The VA has a net worth limitation of $129,094. Net worth is defined as assets plus gross income minus unreimbursed medical expenses.
Despite this “bright-line” number, net worth denials still occur for any number of reasons.
When you receive a net worth denial from the VA, there are two possibilities: 1) net worth is now $129,094 or less, or 2) net worth is still greater than $129,094.
The following explanation applies to both situations. However, if net worth is still greater than $129,094, don’t submit the response. You must wait until net worth is $129,094 or less to prepare documentation and forms and to respond to the VA.
Step 1: Gather Financial Statements
Assuming the applicant is otherwise eligible. the VA will award benefits retroactive to the date that net worth fell to $129,094 or below. This is very good news. Quite possibly, you received the denial letter several months after the application was submitted. Net worth could have been within VA requirements months before you received the denial letter.
You must gather financial statements from the date net worth first dropped below $129,094. You need to submit all financial statements from this date. If the applicant has three bank statements and only two have been depleted since the application was submitted, you still need to submit statements for all three.
Example: Mom applied in January with three bank accounts totaling $140,000 and received a denial letter in June. Two of those bank accounts have the same balance as when the application was submitted. The third bank account decreased by $13,000 on March 15th. Therefore, on March 15th, Mom was eligible for benefits. You must show statements covering March 15th for all three bank accounts even though two of the accounts have not changed in value.
You should highlight the date on the bank statement where net worth decreased to $129,094.
Step 2: Complete VA Form 20-0995
This form is used to tell the VA you want them to review the decision. You must provide the VA new information along with this form. The financial statements described above are considered new evidence.
For question 13A, write: I am appealing the excessive net worth decision. See financial statements and included VA forms.
Step 3: Complete VA Form 21-4138
Don’t let the VA guess or figure out for themselves when the applicant’s net worth dropped to $129,094. If the applicant’s net worth dropped to $129,094 or below on March 15th, 2019 write this: I am requesting that the VA award benefits retroactive to March 15th, 2019, the date my net worth decreased to $129,094 or less.I’ve included financial statements showing the decrease in net worth. I’ve also included VA forms (then write the other forms the VA requested and you included).
Step 4: Complete Other VA Forms Requested
This step could be a bit of a moving target as the VA occasionally asks for different information even when circumstances are the same. If the VA has asked you to submit a form that is not listed below, please contact us.
Currently, for net worth denial, the VA is asking for an Eligibility Report and a Medical Expense Report. The Medical Expense Report is VA Form 21P-8416 and is the same for veterans and surviving spouses. The Eligibility Verification Report (or EVR) has one form for veteran’s (VA Form 21P-0516-1) and different form for surviving spouses (VA Form 21P-0518-1).
In theory, the VA will tell you in the denial letter the date range that these forms should be completed for. The first date will always be the date the VA received your claim. This is known as the effective date of the claim. The second date should be the end of the month that is 12 months from the effective date. For example, the VA letter may say: “Complete the following enclosed forms for the period of October 24, 2019 through October 31. 2020.”
Report current monthly income on the EVR
Report expected income for annual income on the EVR
Report Net Worth as of date net worth dropped below $129,094 on the EVR
The facility or home care aide must complete/sign the worksheet in the Medical Expense Report
Report annual medical expenses (facility, home care, etc…) on the Medical Expense Report
Step 5: Submit The Response
Please remember not to submit this response until net worth is $129,094 or less.
We recommend faxing the response to the VA. The VA fax number is 1-844-655-1604.
The current VA mailing address is:
Department of Veterans Affairs
Pension Intake Center
P.O. Box 5365
Janesville, WI 53547-5365