Veterans Aid and Attendance Benefit
ContentsWhat are Aid and Attendance benefits? Who's eligible for Aid and Attendance? What types of care does it cover? How to apply for benefits Gathering the paperwork Hiring an attorney or private VA company Questions to ask How long will the process take? Veterans Aid and Attendance benefit FAQs
If you are a Veteran, both you and your spouse may qualify under the Veterans Aid and Attendance program provided through the U.S. Department of Veterans Affairs. The Veterans Aid and Attendance benefit was created by the VA almost 60 years ago and, historically, is not readily known or understood by veterans and their family. By the end of this article, you'll have a better understanding of this benefit and whether or not you're eligible.
According to the United States Census Bureau, as of 2016, there were 18.5 million veterans living in the United States. Many of these veterans are eligible for the Veterans Aid and Attendance Benefit but it is neither a widely known benefit nor an easy benefit to apply for. Our goal with this information is to help you understand the Veterans Aid and Attendance Benefit and how we can help you learn if you and/or your spouse are eligible and help you navigate what can be both a daunting and complicated process of applying.
What are Aid and Attendance benefits?
The Veterans Aid and Attendance benefit is money that is paid in addition to a veterans monthly pension. It is designed to provide financial assistance when you need another person — such as a home health aide — to help you with what is known as “activities of daily living.” Activities of daily living typically include bathing, feeding, dressing and transferring and are used a measure of a person’s independence.
Its use, however, is not just limited to “hands-on” or long-term care. For example, if a veteran or his/her spouse needs help with paying bills, cooking meals, grocery shopping or going to errands or doctor appointments, the Aid and Attendance benefit can be used to pay someone for those types of activities.
The benefit can apply to a veteran or surviving spouse whether they live at home and need in-home care or reside in an assisted living facility or a group home providing personal care. In 2017, the maximum benefit for Veterans Aid and Assistance was:
- $1,830 per month for a veteran
- $2,170 per month for a veteran with a spouse
- $1,176 per month for a surviving spouse
- $2,846 per month for couples where both are veterans
Who's eligible for Aid and Attendance?
Qualified veterans and their surviving spouses are eligible for the benefit provided they meet a number of criteria. VA Benefits are based on a veteran’s income, assets, and needs for long-term care.
According to the Veterans Administration, the veteran or his/her surviving spouse must meet one of several conditions. The person must:
- Need the assistance of someone else in things such as bathing, using prosthetic devices and making sure the person is safe in their daily environment; or
- Be bedridden because of a disability; or
- Have limited eyesight in both eyes.
It’s very important to note that the requirement by the VA for the veteran or his/her spouse to need assistance with the Activities of Daily Living (ADL) does NOT have to be related to the veteran’s military service.
For veterans younger than 65, their disability must be total to qualify for the Aid and Assistance Benefit but for veterans 65 and older, the total disability threshold for benefits doesn’t apply. According to the VA, the definition of total disability is that the veteran under age 65:
- Must be a patient in a nursing home for long-term care; or
- Is receiving Social Security disability benefits; or
- Is unable to work due to a disability reasonably certain to continue throughout his/her lifetime; or
- Is suffering from a disease or disorder that the VA determines causes persons with that disease or disorder to become permanently and totally disabled.
In addition, the veteran must have served active duty during certain defined war periods which include:
- World War II (December 7, 1941, through December 31, 1946); or
- The Korean conflict (June 27, 1950, through January 31, 1955); or
- The Vietnam war (August 5, 1965, through May 7, 1975); or
- The Persian Gulf War (August 2, 1990, to date).
The veteran also must have been honorably discharged and served at least 90 days on active duty (including service during a time of war). The Veterans Administration does require that a veteran’s date of service be established so you will need a copy of your discharge papers. If you don’t have them, you can request them from the National Archives.
There are also other considerations dealing with assets, income limits and what type of medical-related expenses can be excluded from income limits.
The VA has established certain annual income limits that may not be exceeded for a veteran and his/her spouse to be eligible for the Aid and Attendance benefit. In 2017, those income limits (also known as the Maximum Annual Pension Rate) were:
- Veteran without any dependents: $21,531
- Married veteran: $25,525
- Surviving spouse: $13,836
While these numbers may look low, the VA permits a number of deductions when calculating your income. The amount calculated is known as IVAP (Income for VA Purposes).
Calculating this means knowing what income (for both the veteran and his/her spouse) is subject to being included and what expenses (again for both the veteran and his/her spouse) are eligible to be excluded.
Here are some examples of income that is required to be included in your calculation for annual income:
- Wages and salary
- Social Security monthly benefit
- Social Security disability benefit
- 401k withdrawals
- IRA withdrawals
There are a number of types of monthly or annual income payments that veterans are allowed to exclude when determining their annual income such as:
- VA pension benefit
- Life insurance payments
- Supplemental Security Income (income supplement which helps people with limited or no income by providing a monthly benefit to cover basic necessities)
- Money provided by family members to help the veteran maintain his/her home
- Proceeds from reverse mortgages (taking the equity in your home and converting it into payments to you as the homeowner)
Veterans can also deduct any number of expenses to calculate their annual income. This is an important component of the Aid and Attendance benefit because it may allow many veterans with higher annual incomes to be eligible for the benefit. Here is a good list to consider as a starting point for the expenses you may be eligible to deduct from your income:
- If you live in an assisted living facility, your costs for living there (typically your room and meals) may be excluded.
- If you currently have someone (a certified home health aide or a companion) caring for you, the amount you pay them is also deductible. (As a point of information, the difference between a Certified Home Health Aide and a companion is that a CHHA is able to provide hands-on care to you, such as bathing or dressing, while a companion provides assistance with things like light housekeeping, laundry, meal transportation and errands.)
- Unreimbursed medical expenses are also deductible from income. We talked before about the Maximum Annual Pension Rate (MAPR). Your unreimbursed medical expenses (UME) over 5 percent of your MAPR can be used to reduce your income. For example, if you have an alert monitoring service or have purchased medical equipment, those expenses may be deducted from income.
- Some expenses that don’t fit neatly into any of the above categories are also able to be deducted. If you pay Medicare premiums (and if you collect Social Security, these are typically deducted from your monthly payment), they can be deducted. Many seniors also buy Medical Supplemental Insurance and premiums for that can be deducted as well.
There is also an asset test used by the VA to determine eligibility for the Aid and Attendance Benefit. Fortunately, a veteran’s primary home, furniture, the value of a life insurance policy, personal items and vehicles do not count as assets. The types of things that are considered as assets (that could be used to pay for a veteran’s care) are money in bank accounts, stocks and bonds, and real estate (that is not the veteran’s primary residence).
The “unofficial” rule that appears to be used by the Veterans Administration when determining whether a veteran is eligible to receive the Aid and Attendance Benefit is that the veteran’s benefits should not exceed $80,000.
Understanding this and navigating through the complexities of it may be best left to a veteran’s benefits professional who is both familiar with understanding your unique situation and working with the Veterans Administration on applying for your benefit.
An important thing to remember when considering applying for Veterans Aid and Attendance is that a veteran cannot receive both a VA disability pension benefit and a Veterans Aid and Attendance benefit.
What types of care does it cover?
The Veterans Aid and Attendance Benefit can be used by individuals whether they’re living at home or whether they reside in a personal care home or an assisted living facility. For example, a veteran may need a Certified Home Health Aide (CHHA) to assist him/her with home care for such activities as bathing, dressing, errands or meal preparation. While a person residing in an assisted living facility does receive care from the staff, individual care is not provided on a round-the-clock basis and many people choose to also have additional help provided to them on a one-to-one basis by hiring a CHHA or personal assistant to care for them.
How to apply for benefits
There are a number of ways to apply for the benefit and many resources available to veterans who need guidance and assistance in applying.
If you plan on trying to apply for the benefit on your own, the veteran and his/her spouse will need to have their primary doctor complete the Examination for Housebound Status or Permanent Need for Regular Aid and Attendance form that can be found on the Department of Veterans Affairs website. Once you’ve gathered your information, locate your Veterans Administration Pension Management Center and veterans can mail in their application, submit it online (if you’re particularly computer-savvy) or bring it to one of the regional
Gathering the paperwork
First and foremost, documenting your income and expenses is paramount. The more detailed information you have to provide to either the VA directly or to an attorney specializing in VA benefits or one of the many private veterans’ assistance companies, the better your chance for becoming eligible to qualify for the VA Aid and Attendance Benefit program.
Beyond your financial information and the discharge papers mentioned above, there are lots of other documents you will need to present the VA with a complete and total overview of your medical condition and your financial health. Here’s a list of some of the types of things that you will need to gather to apply for benefits on your own.
- Marriage certificate (if the veteran is married)
- Death certificate (if the surviving spouse is applying for the benefit)
- Current Social Security award letter that indicates what amount of Social Security you will be receiving each month)
- All bank account records
- All other financial information (mutual funds, stock statements, annuities, etc.)
- The current annual statement on all sources of income you receive (for example, a monthly pension benefit, a regular distribution from an IRA or an annuity, or interest earned from any of your investments).
- A statement from your physician (as mentioned above) that provides all of your current medical information and why your condition makes you eligible for the Aid and Attendance benefit.
- If the veteran or his/her spouse resides in an assisted living facility, you’ll need a statement from that facility that documents that the veteran and his/her spouse is a resident and what their out-of-pocket monthly expenses are.
- All of your physician visits and medical expenses must be documented on the VA’s Medical Expense Form.
- Documentation of all of your out-of-pocket expenses for things such as medications, co-pays, or medical expenses not covered by your health care insurance or Medicare.
- If the veteran is under the age of 65, documentation of recent employment history.
Once you’ve gathered all of the above information and documentation, you’ll then need to complete another VA form called Application for Disability Compensation and Related Compensation Benefits. Only after all of this is done are you ready to begin filing.
Hiring an attorney or private VA company
Gathering all of this information and completing (or having others complete) the necessary forms can be extraordinarily daunting and time-consuming. For that reason, it may very well be to your advantage to consider working with an attorney who specializes in veterans benefits or one of the private veterans’ assistance companies. These experts can streamline the process and run interference, as needed, with the VA on your behalf.
When applying for the Veterans Aid and Attendance benefit, we think that taking advantage of professional help will not only relieve some of the
The easiest way to search for either an attorney or a private veterans service company is to go to the VA's website which allows you not only to be able to search for an individual or company by name (if you already have that information) but, more importantly, allows you to download a list of all individuals accredited by the VA and organizations recognized by the VA.
Questions to ask
After you’ve done your search and narrowed down your candidates, you should ideally set up either a phone or in-person interview to get information about how the individual or company works and to establish your comfort level with their knowledge and business practices. Here are some good questions to ask:
- Are you accredited by the Department of Veterans Affairs?
- If yes, how long have you been accredited (or recognized) by the VA?
- How long have you been practicing elder law and veterans’ assistance?
- Do you charge a fee for applying for the Aid and Attendance benefit? Federal law prohibits accredited or recognized individuals or companies from charging any type of fee.
- Do you work with any companies (for example, assisted living facilities or nursing homes or home health care companies) directly? It’s important to know what, if any, types of relationships the individual or company has so that if they are to refer you, you know it’s done based on the reputation of the facility or company and not just on any reciprocal arrangement between the parties?
- How long will it take you to determine if I’m qualified for the benefit?
- If the attorney is also a financial planner, ask if they are certified
withthe Certified Financial Planner Board.
- Are you licensed in good standing by the State Bar Association?
- If you are working with a veterans service organization (known as a VSO), ask if they are an Accredited Representative
withthe Veterans Administration. (An accredited representative has formal training and is recognized by the VA as able to advocate for and assist veterans and their spouses with their financial affairs).
How long will the process take?
Unfortunately, there is no good answer to this question. Typically, you should receive at least an acknowledgment letter from the VA within 45 days of your initial application but the time of a final resolution can vary depending on department workload and priority processing status. You can expect that it may take anywhere from 8 months to a year for your claim to be processed and approved.
Like many government agencies, the VA is likely overwhelmed and understaffed in processing claims but that is not of any help to the veteran or his/her spouse who is in need of the Aid and Assistance benefit sooner rather than later. (On the positive side, if your claim for the Veterans Aid and Attendance benefit is approved, you will be paid retroactively from the first day of the month after your claim has been submitted).
Because of this, it may be a good idea for you to consider working with one of the private veterans’ assistance companies. Here’s what some of they can do for you:
- They’ll determine if you qualify for the Veterans Aid and Assistance Benefit.
- They’ll help you obtain all the documentation you need to fill out the VA’s application.
- They can help you complete and submit to the VA your application.
- Because they work with home health care companies, they can help you get the care you need immediately, even while your application is still pending.
- They can provide you with the money (interest-free) to pay for that home care the veteran needs while the VA is reviewing your application.
- They work with the Veterans Administration to check on the status of your application and will help you provide any additional documentation that the VA may need to approve your application.
Veterans Aid and Attendance benefit FAQs
1. How long will it take me to be approved for the Veterans Aid and Assistance benefit if I am qualified?
Estimates vary depending on the source but the range suggested by many veterans’ advocates is that it could take 6-12 months to get approval provided that all of your paperwork and documentation are in order.
2. How will I pay for care (if I need it immediately) while I am waiting for approval of the Aid and Assistance benefit?
If you work with a veterans’ benefits advisor, they can provide a no-cost loan to the veteran and his/her spouse so that you can get access to home health care immediately.
If you own your own home, there are companies that offer elder care bridge loans to help provide some financial assistance with care for the veteran while the veteran’s application for the Aid and Assistance benefit is being processed. These bridge loans use the equity in your home to provide financial aid. One particular advantage of this type of loan is that multiple family members (who share the care and financial accountability for the veteran and his/her spouse) can apply. Because of this, the financial risk is spread among multiple people and can make it easier to obtain this type of loan as a short-term solution.
3. Can I use my Veterans Aid and Attendance benefit to pay a family member or friend who provides care to me?
Many people think that you must only use a certified home health aide (CHHA) or another professional person to provide care to you in order to be able to qualify for the Aid and Attendance benefit. This isn’t correct although there are certain qualifications that must be met if you have a family member or friend providing care to you.
If a veteran has a family member or friend providing care to him/her, there should be a simple personal care agreement in place to document what the family member or friend will be doing the veteran, how much they’ll be paid, how many days/hours they’ll work each week, etc.
These types of payments to a family member are then considered as UMEs (unreimbursed medical expenses) that can be deducted to reduce a veteran’s income.
It is important to note that if a family member or friend is paid by the veteran or his/her spouse for the care provided, that person must report that income to the IRS and the veteran or his/her spouse must include that not only on the initial application but on the verification report required to be submitted every year.
4. Am I required to re-qualify for the Veterans Aid and Assistance benefit every year?
The simple answer to this question is “yes”. The Veterans Administration requires that every veteran or spouse receiving the Aid and Assistance benefit must prove they are still eligible to do so by completing a form that documents their current income, assets and medical expenses.
To ensure that you stay eligible, it is important to keep records of all of the same expenses each year that you used when you submitted your original Aid and Attendance application. The Eligibility Verification Report instructions and form will explain what information you need to provide.
Proximity of care is very important when considering options
Research care options that are nearby when thinking about the next step for your loved ones.
Leona J. Werezak RN, BSN, MN is a registered nurse and adjunct nursing professor. She has 24 years experience working in a variety of healthcare settings including such remote locations as the Arctic Circle. Her research in early stage dementia was published in the Canadian Journal of Nursing Research and re-published in their 40th anniversary issue which showcased exceptional research published since the journal began. Her work in dementia care has also been published in the Journal of Gerontological Nursing. She currently teaches surgical nursing care on a thoracic/vascular unit to baccalaureate nursing students. Her clinical work with nursing students involves extensive work with older adults who have multiple chronic health conditions.