O F V E T E R A N S A F F A I R S

Ragiona! Of f i ce
100 S W Main Street
Floor 2
Portland OR 97204-2825
I n reph. refer to:
I M P O R T A N T -- reply needed
Dear \-v WttB-
W'-i havereceived infonnation showing that becauseof \mir disabilities youmay need help in
handling your Department of Veterans Affairs ( VA) benefits.
This letter explains the evidence we received, what we must do with this information, the impact
on youand your VA pa\si f we decide that youcannot handle \our benefits, and when VA
will make afinal decision.
This evidence indicates that youare not able to handle your VA benefit payments becauseof
a phy.sical or mental condition.
What Wi ll We Do wi th Thi s Inf ormati on?
We propose to rateyouincompetent for V.A purposes. This means we must decide i f youare
able to handle your VA benefit pavments. \ will baseour decision on all the e\e we
already ha\ including any other evidence yousend to us.
Before we make allnal determination. \ouha\ theright to submit an\.
information, or statement that presents \our side of the casewithin the next 60 da\'s. Our
policy is to assist a person with his or her claimin every reasonableway. We want youto
have e\ery benefit that you are entitled to under the law.
What Happens if You A re Rated I nc ompet ent ?
I f VA decides that youare incompetent to handle your benefit payments. VA may appoint a
fiduciary (pa>ee) to manageyour VA payments. Al l >'Our VA payments will be made
directly to \our fiduciarx. This person or institution must use your VA pa\iTients for your
personal careand is responsible toVA for how the payments are used.
What Inf ormati on Di d We Re c e i v e ?
We recei\ed a report fromPortland \".\! Center on December 3. 2012.
Page2
A deiennination of incompetency wil l prohibit \u frompurchasing, possessing, receiving,
or transportingafireann or ammunition. I f you knowingl y \iol atean>of theseprohibitions.
}ou may befined, imprisoned, or both pursuant to theBrad\n ViolencePre\ention
A ct. Pu'b.L.No. 103-159. as implemented at 18. United States Code924(aK2).
I f wedecidethat you areunableto handleyour V.V funds. \ou may apply to this regional
officefor therel ief of prohibitions imposed by theBrady .Act with regards to thepossession,
purchase, receipt, or transportation of afirearm. Submit your request to theaddress at thetop
of this letter on theenclosed V.A Form21-4138. Statement in Suppon of Claim. VA wil l
determinewhether such rel ief is warranted.
What Shoul d You Do?
I f Y ou Aaree: Y ou do not need to do an_\thingi f you agreethat you need help managing
your V.A mone\ \\"ewil l makeour final decision, tel l you vshat uedecided, and who wil l
beyour fiduciar>. However, i f you want us to makeafinal decision without v\aitingthe ful l
60 days, pleasetel l us to do so on theattached V.A Fonn 21-4138. Statement in Support oi
Cl aim. Y ou should specifically state, " l do not ha\ an\ evidenceto submit and1 want you
to inakeafinal decision without waitingtheentire60-da>dueprocess period."
I f Y ou Disagree: ^'ou must send us medical e\e(such as adoctor's statement) that says
\ou areableto handle>our own financial affairs in aresponsiblemanner, i f you believeyou
areableto handleyour V.A benefits without anyone's help. Y ou should send us this
evidencewithin 60 da\ fromthedateat thetop of this letter.
Personal Hearinii: Y ou may request apersonal hearingwithin 30 da\ fromthedateat the
top oi'this letter to present evidenceor argument on an\t point in your cl aim. We
wil l arrangeatimeand placefor thehearing. Y ou ma\ bring witnesses who ha\ personal
knowledgeof thecircumstances. Wewil l consider their testimonv and keep it as pan of our
permanent records. Wewil l furnish thehearingroom. pro\idehearingofficial s, and prepare
thetran.script of theproceedings. Wecannot pay for other expenses of thehearing because
wehold apersonal hearingonh upon aclaimant's request.
Representation: .An accredited reprcsentati\ of a \eterans" organization or other service
organization recognized by theSecretary of Veterans .Affairs wil l represent you without
charge. .An agent or attorne\y also represent \ou. .An agent or attorney can chargeyou
for sePi'ices perfonned on or after thedateof afinal decision by theBoard of Veterans
Appeals (38 U.S.C. 5904(c)).
When Wil l We Make a Dec i s i on?
I f wedon't hear fi-om\ou within thenext 60 days, wewil l assumeyou haveno additional
evidenceand do not want ahearing. After those60 da\ wewil l makeour decision usingthe
ex idencewealread\eandtel l you our decision.
Regi st er Now for eBenefi t s
: i : e?;-;-:':* useryou can access personalized VA information, apply for
.;heck V.A claim status. For registration information;
and select option 7 or;
. .. -; -cnei"its.\a.-.:ov or;
-.iiit Lr.e% .A Regional Officeat theaddresslisted at thetop of thisletter
How Can You Contact Us?
you are looking for general infonnation about benefits andeligibility, youshould visit our web
silealfanp: WWAV.va.gov. Otherwise. >oucan contact usin several ways. Pleasegiveusyour
\ ' . \ number. j Mf l MMpwhen youdo contact us.
Call us at 1-800-827-1000. I f youuseaTelecommunications Devicefor theDeaf (TDD), the
number is 1-800-829-4833.
' Send usan inquiry using theInternet at https:' iris.va.gov.
Writeto usat theaddressat thetop of thisletter.
Welook forward to resolving your claimin afair and timely manner.
Sincerely vours.
K. Kalama
Veterans Serv iceCenter Manager
Enclosure: 21-4138
cc: OREGON DEPARTMENT OF VETERANS .AFFAIRS