Citation Nr: 18140969 Decision Date: 10/09/18 Archive Date: 10/09/18 DOCKET NO. 18-17 159 DATE: October 9, 2018 REMANDED The propriety of the termination of nonservice-connected death pension benefits effective March 1, 2013, reduction effective February 1, 2015, and termination effective January 1, 2017, is remanded. Entitlement to aid and attendance and/or housebound benefits is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1943 to April 1946. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from decisions of the Regional Office (RO). The Veteran died in April 1991. The Appellant is his surviving spouse. The Board notes the nonservice-connected pension benefits were originally terminated effective January 1, 2016; however, in September 2017, the RO reopened her death pension benefits effective January 1, 2016, and terminated them for excess income effective January 1, 2017. The issue has been recharacterized accordingly. 1. Entitlement to aid and attendance or housebound benefits is remanded. The Appellant seeks aid and attendance and/or housebound benefits. The Board notes that an aid and attendance examination was last conducted in January 2016; however, the Appellant contends that since that examination she is now legally blind. See VA Form 21-8146, Medical Expense Report received February 2017. The matter must be remanded to schedule her for a new examination to determine her need for regular aid and attendance or housebound status. 2. The propriety of the termination of nonservice-connected death pension benefits effective March 1, 2013, reduction effective February 1, 2015, and termination effective January 1, 2017, is remanded. The Appellant disagrees with the propriety of reduction and termination of her nonservice-connected death pension benefits between March 1, 2013, and January 1, 2017. In pertinent part, the Appellant disputes the determination regarding unreimbursed caregiver expenses for purposes of calculating her income. The Appellant has identified caregiver expenses for 2015 in the amount of $7,200.00. See January 2016 medical expense report. The RO denied reimbursement for caregiver expenses on the basis that aid and attendance had not been established. Where VA has not rated the Appellant as entitled to aid and attendance or housebound status, expenses paid to an in-home attendant are deducted only if the attendant is a licensed health professional. Even if she did pay a licensed professional, documentation of the caregiver expense in the form of a receipt bill, statement on the provider’s letterhead, a computer summary, or other form which specifies the amount paid, date of payment, purpose of payment, and other information is needed to corroborate such expense. As the claim for aid and attendance or housebound benefits has been remanded for further development and adjudication, the propriety of the reduction and termination of nonservice-connected death pension benefits is inextricably intertwined. Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). Further, the Appellant has not presented documentation of the license status of her caregiver or the caregiver expenses and such must be obtained. The matters are REMANDED for the following action: 1. Schedule the Appellant for an appropriate examination to determine her need for regular aid and attendance or housebound status. Each of the Appellant’s disabilities should be evaluated, and the examiner is asked to describe the nature of the Appellant’s disabilities and the effect of her disabilities on her ability to perform daily functions, specifically addressing the following: a. Is the Appellant blind or so nearly blind as to have corrected visual acuity of 5/200 or less in both eyes or concentric contraction of the visual field to five degrees or less? b. Is the Appellant unable to dress or undress herself and keep herself ordinarily clean and presentable? c. Does she require frequent adjustment of any special prosthetic or orthopedic appliances that cannot be done without aid? d. Is she unable to feed herself through loss of coordination of upper extremities or through extreme weakness, or unable to attend to the wants of nature? e. Does she have incapacity, physical or mental, that requires care or assistance on a regular basis to protect her from hazards or dangers incident to her daily environment? f. Does she have any disability that requires that she remain in bed? g. Is she substantially confined to her dwelling and the immediate premises, and if so, is it reasonably certain that the disability or disabilities and resultant confinement will continue throughout her lifetime? When the examiner makes his or her determination with respect to the above questions, the examiner should specify which disability(ies) or a combination thereof that would cause the Appellant to be housebound or to depend on another for regular aid and attendance. A complete rationale for each opinion offered must be included in the report. If the examiner is unable to reach an opinion without resort to speculation, he or she should explain the reasons for this inability and comment on whether any further tests, evidence or information would be useful in rendering an opinion. 2. Contact the Appellant to determine if the caregiver expenses listed for 2015 were performed by a licensed health professional. 3. Ask the Appellant to provide documentation of the caregiver expense in the form of a receipt bill, statement on the provider’s letterhead, a computer summary, or other form which specifies the amount paid, date of payment, and purpose of payment. 4. After completing the above, and any other development deemed necessary, readjudicate the Appellant’s appeal based on the entirety of the evidence. E. I. VELEZ Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K. L. Wallin, Counsel