What is Aid and Attendance benefit for Veterans?
Veterans and surviving spouses who are eligible for a VA pension and who require the aid and attendance of another person, or are completely housebound, may be eligible for benefits that reduce the cost of senior care. This is an introduction to these pensions and the basic requirements needed. By no means is this an exhaustive discussion on the topic. Additional information can be found on the link listed below and future articles will likely discuss different details on Veteran related topics.
There are three levels of Aid & Attendance related VA Pensions-
Basic Pension/Improved Income: for healthy Veterans over the age of 65 with limited incomes.
Aid & Attendance: for Veterans over the age of 65 who require assistance with daily living (disability does not have to be related to military service).
Housebound: for Veterans with a disability rating of 100% which prevents them from leaving their homes (disability does not have to be related to military service).
The Aid & Attendance and Housebound pensions are paid in addition to the Basic Monthly pension and to be eligible, the Veteran or surviving spouse must also meet the requirements for the Basic Pension. Veterans and surviving spouses cannot receive both Aid & Attendance and Housebound benefits at the same time.
A Veteran or surviving spouse may qualify medically for Aid & Attendance if at least one of the following applies:
They are a patient in a nursing home or assisted living facility due to mental or physical impairment.
Their eyesight is limited to a corrected 5/200 visual acuity or less in both eyes; or concentric concentration of the visual field to 5 degrees or less.
They require the assistance of another person in order to perform normal, personal, everyday tasks such as bathing, dressing, adjusting prosthetic devices, feeding, using the restroom, or protecting oneself from the hazards of the daily environment.
Their disability requires them to remain in bed/be bedridden (outside of any prescribed course of recovery or treatment).
1) Age - Veterans or their surviving spouses must be at least 65 or officially disabled if younger.
2) Period of Military Service - Veterans must be considered “wartime veterans” meaning they served at least 90 days and served at least 1 day during the wartime dates below, but not necessarily in combat.
World War II: Dec 7, 1941 – Dec 31, 1946
Korean War: Jun 27, 1950 - Jan 31, 1955
Vietnam War: Aug 5, 1964 - May 7, 1975 (or Feb 28, 1961 – May 7, 1975 for Veterans who served in Vietnam)
Gulf War: Aug 2, 1990 – Undetermined
3) Discharge Status - Veterans cannot have been dishonorably discharged.
4) Disability Status – As noted above.
5) Marriage Rules: a surviving spouse must have been married to and living with the veteran at the time of their death and must not have remarried at time of claim.
The VA has both income and asset requirements for the additional pensions.
A Veteran’s AND their spouse’s joint, countable income must be less than the pension amount for which they may be eligible. The VA does allow applicants to deduct certain expenses and some forms of income from their "countable income", resulting in the applicants' actual income being considerably higher than their “countable income”.
For example, medical-related expenses, including the cost of care in skilled nursing, assisted living, adult day centers, etc., can be deducted from the actual income amounts. Medicare and other insurance premiums, as well as prescriptions not covered by insurance, should also be included as medical-related expenses. Income from Supplemental Security Income (SSI) and welfare benefits should not be included as “countable income”.
Worth noting- Veterans and their families seem to be unaware that VA Pensions can be used to pay a family member who serves as the caregiver of a Veteran or surviving spouse (with the exception of spouses). As mentioned above, care expenses can be deducted from the income, and this includes legitimate payments for caregiving made to family members, such as children or grandchildren. Veterans or their surviving spouses can then receive an increased pension benefit equal to the amount they have paid to their family member for care.
Unfortunately, this method does not work for the veteran’s spouse, as joint income is calculated as household income. Any salary the spouse received, even if for payment for legitimate caregiving, would be included as part of their household income, and therefore, could not be considered a deductible care expense.
To qualify for the pensions, the VA will look at the applicant’s overall assets and net worth in addition to their household income. A veteran’s net worth, according to the VA, includes assets in bank accounts, stocks, bonds, mutual funds and property other than the veteran's primary residence and vehicle. However, just as with the income requirements, the VA allows certain assets to be overlooked or deducted. The primary home, household items, personal effects, and regular vehicles can be excluded when determining net worth. VA pension eligibility is based on a verifiable estimate of the applicant’s future income and care needs.
There is no “look-back” period for Aid & Attendance. Assets are counted from the date of the application. For those familiar with Medicaid, the VA “test” differs from the Medicaid asset test, which has a current 5-year look-back period for any and all asset transfers made by an applicant. Presently, the VA does not have a look-back period, although legislation proposing a 3-year look-back period has been discussed repeatedly. Another difference is that the VA does not presently have a hardline asset limit needed to qualify. That being said, it is strongly recommended that if the applicant’s assets exceed $50,000, they should consult with a Veterans’ pension planner prior to applying.
A common question that comes up involves what happens if the homestead is sold. While the sale funds are clearly not “household income,” once the funds are deposited into a bank account they will be considered part of the net worth (and no longer deducted from the total as the homestead itself would be). If selling the home is a potential, it would be better to handle that prior to applying for the pensions as any money retained in savings accounts, in CD’s, IRA’s, etc., will all become part of the applicant’s net worth.
So, you have reviewed the information above and believe you meet all the requirements, now what? Well, now would be a good time to start gathering your “evidence” (sounds more exciting than “documents” doesn’t it?). The following is a list of documents you should work to gather-
Discharge/separation Papers (DD-214. If you need to request military records, please visit the National Archives to get a copy.
Copy of Marriage Certificate (for surviving spouse or when filing for both the veteran and spouse).
Copy of current Social Security award letter (Letter that SS sends at the beginning of the year stating what your monthly amount will be for the following year).
Net worth information, including bank accounts, CD's, trust, stocks, bonds, annuities, etc.
Proof of all income from pensions, retirement, interest income from investments, annuities, etc.
Proof of insurance premiums, medications, medical bills or any other medical expenses that are not reimbursed by insurance or Medicare.
Physician statement that includes current diagnosis, medical status, prognosis, name and address, ability to care for self, ability to travel unattended, etc. If the applicant is in a nursing home or assisted living facility, you will need to submit a Nursing Home Status Form and a Statement of Occupancy from the facility (the facility can provide this Statement upon request).
Banking information (for direct deposit of monthly payments).
List of all doctors and hospitals visited in the last year.
Now that you’ve got all your documents, it’s time to start the application and this is an important note- there are no charges to apply for or to enroll in a VA Pension. Veterans Benefit Advisors are actually prohibited by law from charging for assistance with the initial application. However, fees can be charged for assistance in the structuring of a client’s financial assets in preparation for the application.
It’s a good idea to make sure any attorney you speak to is VA Accredited and that they have experience with VA Benefit cases. Jami at Worley Elder Law is both VA Accredited and experienced at all levels of Veteran’s claims. Jami would be more than happy to assist you and your family with proper structuring of the assets and getting the application ready for submission. Please call (941) 448-1302 and let us know how we can help.
For more information and copies of the appropriate VA forms, please visit the Veterans Benefits Administration website at- Aid & Attendance Benefits