Citation Nr: 21008227 Decision Date: 02/12/21 Archive Date: 02/12/21 DOCKET NO. 18-28 277A DATE: February 12, 2021 REMANDED Entitlement to nonservice-connected VA survivor’s pension benefits is remanded. Entitlement to special monthly pension based on the need for aid and attendance is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1968 to April 1970. He died in in January 1988. The Appellant is his surviving spouse. She appealed to the Board from a September 2017 decision that denied her claim for survivor’s pension benefits at the aid and attendance (A&A) rate. In July 2019, the Appellant and her son testified before the undersigned Veterans Law Judge (VLJ) at a Travel Board hearing. A transcript is of record.   Entitlement to nonservice-connected VA survivor’s pension benefits, to include special monthly pension (SMP) based on the need for regular A&A, is remanded. The Board cannot at this time make a fully informed decision on the issue of entitlement to survivor’s pension benefits, including SMP based on the need for regular A&A. The record contains information on the Appellant’s income and medical expenses from February 2014 through 2018. However, the Board sees the Appellant has inconsistently reported her medical expenses and that evidence submitted in support of her claims is contradictory. For example, the Appellant reported on an October 2015 VA Form 21P-8416 (Medical Expense Report (MER)) that she had paid $3,554.43 for prescription copayments from January 2014 to December 2014 at a Del Carmen pharmacy, but on a June 2018 VA Form 21P-8416 (MER) she reported paying, instead, just $62.23 for prescription copayments from February 2014 to January 2015. However, a printed receipt received in June 2018 from the Del Carmen pharmacy shows payments totaling $162.23 from February 2014 through November 2014. So the amounts she reports are inconsistent with each other and with the receipts. The Appellant reported on June 2018 VA Forms 21P-8416 (MERs) that she had paid $25.50 from January 1, 2015 to March 1, 2015, $34.42 from March 1, 2015 to January 1, 2016 (totaling $59.42 for 2015), $57.60 from January 1, 2016 to January 1, 2017, and $10.50 from January 1, 2017 to January 1, 2018 to a San Carlos pharmacy. However, receipts from the San Carlos pharmacy show that she actually paid $59.42 in 2016 and $57.60 in 2017. The years/amounts that she reported are off by one year from the receipts. The Appellant submitted several certification statements from her pharmacists, including one from the Del Carmen pharmacy that four of her medications cost $144.00, $396.00, $48.00, and $165.50 for June 2015. But receipts from the Del Carmen Pharmacy show that, in June 2015, she actually paid only $1.00 for each of these medications. The biggest difference appears to be that she was prescribed name brand medications, but the pharmacist dispensed generics, for which she paid only $1. The Board consequently finds that additional information is needed to make a fully informed decision on the Appellant’s pension claim. Receipts from the Del Carmen and San Carlos pharmacies showing the amounts the Appellant paid for her medications are incomplete. Specifically, receipts from the Del Carmen pharmacy from June 19, 2015 to the present, and the San Carlos pharmacy from February 24, 2014 to December 11, 2015, and from January 18, 2018 to the present, are not associated with the record. Given the discrepancies in the record, as well as others upon review of the file, the Board finds these receipts should be obtained and associated with the record. There are still other discrepancies in terms of the amounts she and her pharmacists report compared to the receipts of the amounts she actually paid, so these also need to be reconciled. As well, the Board sees that, in a May 2018 statement, the Appellant’s pharmacist indicated the Appellant has both prescription and nonprescription medications and the cost of those medications. In light of the discrepancies discussed, including those noted above for June 2015 pharmacist statement, the Appellant should also submit receipts for payments made for nonprescription medications if those payments are not already included on her pharmacy receipts. During the July 2019 Board hearing, the Appellant indicated that there were additional medical expenses she had not included on her applications, including $600 per month for a caregiver, and that she would attempt to obtain a caregiver statement. To date, she has not submitted that statement. Upon remand, the Appellant should be invited to submit evidence showing the amounts paid to her caregiver and the type of care provided. Additionally, as the Appellant is not in receipt of aid and attendance benefits, she should submit evidence that her in-home caregivers were licensed health care professionals or a written statement from a medical care provider stating that she required the assistance the caregivers provided. Accordingly, these matters are REMANDED for the following actions: 1. Request the Appellant submit receipt printouts from (1) the Del Carmen pharmacy from June 19, 2015 to the present, and (2) the San Carlos pharmacy from February 24, 2014 to December 11, 2015, and from January 18, 2018 to the present, showing the amounts she paid for her medications. If the appellant paid for nonprescription medications that are not listed on the pharmacy receipt printouts, she should submit receipts showing the amounts she paid for those medications.   2. Request the Appellant submit evidence showing the amounts paid to her caregiver and the type of care provided, including evidence showing that her in-home caregivers were licensed health care professionals or a written statement from a medical care provider stating that she required the assistance the caregivers provided. 3. After completing the above, and any other development as may be indicated, the Appellant’s claims should be readjudicated based on the entirety of the evidence. If the claims remain denied, the Appellant and her representative should be issued a supplemental statement of the case (SSOC). An appropriate period of time should be allowed for response. Thereafter, the case should be returned to the Board for further appellate consideration, if otherwise in order. KEITH W. ALLEN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Owen, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.