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Veterans Aid and Attendance
Periods Designated As Wartime:
World War II -- December 7, 1941 through December 31, 1946
Korean Conflict -- June 27, 1950 through January 31, 1955
Vietnam Era -- August 5, 1964 through May 7, 1975; for veterans who served "in country" before August 5, 1964, February 28, 1961 through May 7, 1975
There must have been a non-dishonorable discharge. Single surviving spouses of qualified veterans are also eligible. If younger than 65, the veteran must be totally disabled. For Merchant Marine service, the veteran must have been stationed on a ship for at least 90 days of active duty between December 7, 1941 and August 15, 1945.
If age 65 and older, there is no requirement to prove disability. However, the veteran or spouse must be in need of regular aid and attendance due to: Inability of claimant to dress or undress himself (herself), or to keep himself (herself) ordinarily clean and presentable; frequent need of adjustment of any special prosthetic or orthopedic appliances which by reason of the particular disability cannot be done without aid (this will not include the adjustment of appliances which normal persons would be unable to adjust without aid, such as supports, belts, lacing at the back etc.); inability to feed himself (herself) through loss of coordination of upper extremities or through extreme weakness; inability to attend to the wants of nature; or incapacity, physical or mental, which requires care or assistance on a regular basis to protect the claimant from hazards or dangers incident to his or her daily environment.
Not all of the disabling conditions in the list above are required to exist. It is only necessary that the evidence establish that the veteran or spouse needs "regular" (scheduled and ongoing) aid and attendance from someone else, not that there be a 24-hour need.
Determinations of a need for the aid and attendance or housebound benefit is based on medical reports and findings by private physicians or from hospital facilities. Authorization of aid and attendance or housebound benefits is automatic if evidence establishes the claimant is a patient in a nursing home or that the claimant is blind or nearly blind or having severe visual problems.
No, and this is the primary reason that this benefit is so widely misunderstood. If you speak to a Veterans Service Representative in a regional VA office and ask them about the Veterans Aid and Attendance benefit, they will typically ask for your household income. When you tell them your household income, they will compare it to a chart and most often tell you that you earn too much income to receive the benefit. While the information they provide may be technically accurate, what they typically don't explain is the "income" for Veterans Administration purposes (sometimes called IVAP or "adjusted income") is actually your household income minus your recurring, unreimbursed medical and long-term care expenses. These allowable, annualized medical expenses are such things as health insurance premiums, home care expenses, the cost of paying a family member or other person to provide care, the cost of adult day care, the cost of an assisted living facility, or the cost of a nursing home.
To be able to receive the Veterans Pension with Aid and Attendance benefit, the veteran household cannot have adjusted income (i.e., household income minus unreimbursed medical expenses) exceeding the Maximum Allowable Pension Rate -- MAPR -- for that veteran's Pension income category. If the adjusted income exceeds MAPR, there is no benefit. If adjusted income is less than the MAPR, the veteran receives a Pension income that is equal to the difference between MAPR and the household income adjusted for unreimbursed medical expenses. The Pension income is calculated based on 12 months of future household income, but paid monthly.
The monthly award is based on VA totaling 12 months of estimated future income and subtracting from that 12 months of estimated future, recurring and predictable medical expenses. Allowable medical expenses are reduced by a deductible to produce an adjusted medical expense which in turn is subtracted from the estimated 12 months of future income.
The new income derived from subtracting adjusted medical expenses from income is called "countable" income or IVAP (Income for Veterans Affairs Purposes). This countable income is then subtracted from the Maximum Allowable Pension Rate -- MAPR -- and that result is divided by 12 to determine the monthly income Pension award. This award is paid in addition to the family income that already exists.
Filing a claim for the Veterans Aid and Attendance Pension Benefit is complex and time-consuming. If you want to do it correctly, it's important to get qualified assistance. Just knowing which form to fill out and how to complete it is a complex endeavor in itself. Even if the proper form is completed, failure to check a single box may result in a complete denial of your claim.
The application process involves: obtaining evidence of prospective, recurring medical expenses; appointments for VA powers of attorney and fiduciaries; and a thorough understanding of the application process. Typically, qualification for this benefit involves reallocation of assets and shifting of income in order to qualify, and these reallocations may have significant impact on Medicaid eligibility.
Given that many veterans who need the Aid and Attendance Benefit will eventually wind up also needing Medicaid, this process should not be attempted without the help of a qualified elder law attorney who thoroughly understands both the Veterans Aid and Attendance Benefit and the Medicaid program, as well as the interaction between these two benefit programs.
We assist Level 4 clients of our firm, at no charge, in completing the required paperwork and obtaining this benefit.
One of the document needed to commence a claim for this benefit is the Veteran's Discharge Documents (DD-214 Report of Separation). If you don't have an original DD-214, most veterans and their next-of-kin can obtain free copies of their DD Form 214 and other military and medical records by going to the following web site: http://tinyurl.com/getDD-214.
There is an asset test to qualify for the Aid & Attendance Pension Benefit. Any asset or investment that could be easily converted into income might disqualify the claimant. An asset ceiling of $80,000 is often cited in the media as being the test. However, the $80,000 has to do with VA internal filing requirements and is not an actual test. In reality, there is no dollar amount for the test and any level of assets could block the award.
Asset Exemptions:A primary residence, vehicles, and difficult-to-sell property are generally excluded from the asset test. However, some assets that are considered to be exempt by Medicaid (e.g., life estates) are considered to be countable by the Veterans Administration.
Asset Transfers:VA will allow assets to be transferred or converted to income in order to meet the asset test. There is no look-back penalty for transferring assets as there is with Medicaid. However, because the veteran or the surviving spouse might need to apply for Medicaid in the future, it is extremely important to consider future Medicaid eligibility when transferring assets or converting assets to income in order to obtain eligibility for Veterans Aid & Attendance.
The Farr Law Firm can help you avoid both Aid and Attendance rejection and Medicaid penalties associated with reallocating assets.