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"Secret Dollars": Veterans Aid and Attendance

Elder law attorneys can help clients who are wartime veterans facing substantial medical and care expenses: any veteran who is confined to home or needs assisted living care may qualify for underutilized benefits from the Veterans Benefits Administration.  

The U.S. Department of Veterans Affairs (VA) is reaching out to veterans and spouses to alert them to an underused benefit called Aid and Attendance (A & A). Tens of thousands of veterans across the country may not be receiving the VA disability benefits to which they are entitled. These benefits are one of the VA’s best-kept secrets and an excellent potential source of funds for long-term care for a non-service connected disability. 

Most VA benefits and pensions are based on a disability that was incurred during a veteran’s wartime service. The A & A benefit is available for individuals who are disabled due to the issues of old age, such as Alzheimer’s, Parkinson’s, multiple sclerosis and other physical disabilities. The benefit can be used for home healthcare or assisted living, but is not generally used for the cost of nursing home benefits.  

For those veterans and widows/widowers who are eligible, these benefits can be a blessing for the disabled individual who is not yet ready for a nursing home. This benefit can be as high as $2,169 per month for a married veteran, $1,830 for a single veteran and $1,176 per month for a widow/widower. 

VA benefits generally fall into two categories: service connected and non-service connected. This article focuses on non-service connected benefits, which are available to certain wartime veterans or their dependents who are disabled because of a non-service connected condition and who are in financial need due to their unreimbursed medical expenses. Once the veteran’s eligibility requirements are met, a family member may be able to obtain benefits based on status as the veteran’s dependent.  

The A & A benefit is part of the VA pension program and is available to a veteran who is not only disabled, but has the additional requirement of needing the aid and attendance of another person in order to avoid the hazards of his or her daily environment. In other words, anyone who needs assistance to prepare meals, bathe, dress and otherwise take care of oneself.  

It must be determined that the applicant is “permanently and totally disabled”; they must show the need for aid and attendance on a regular basis. An individual over the age of 65 who is housebound or in assisted living typically qualifies for the A&A benefit.  

This particular program does have substantial limitations related to the applicant’s income and assets. It is very important to meet with a knowledgeable veteran’s service officer or an experienced elder law attorney for a pre-filing consultation to determine eligibility for this benefit. The veteran’s service officer can also help review the estate planning work that may be done to qualify for this particular benefit. Countable income as measured by the VA can be confusing to determine. It may appear that anyone who has countable income in excess of $18,000 per year is not eligible for this benefit; however, the countable income for VA benefits is determined by taking an individual’s gross income and subtracting from that all unreimbursed medical expenses to determine a lower income.

In computing the income of the applicant, certain items can be deducted. Specifically, unreimbursed medical expenses (UMEs) paid by an individual may be used to reduce the applicant’s income. Home attendants or aides are an allowable medical expense deduction, as long as that attendant is providing some medical or nursing services for the disabled person. The cost of assisted living and even part or all of the cost of independent living care can be allowable medical deductions to reduce gross income to a much lower, qualifying figure.

To file a claim for this benefit, it is wise to seek the involvement of a trained veteran’s service officer, which can also assist with filing of the application. It is also important to seek the guidance of an experienced elder law attorney who is familiar with estate planning, disability, Medicaid and veterans benefits. These experts can guide the veteran and the veteran’s family with appropriate pre-filing consultations to determine the appropriate steps that must be taken to determine if it would be right to apply for this valuable VA benefit.  

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Benjamin Pearce is an expert in the senior living industry and dementia-related care. He has thirty-five years of experience working with over 200 communities in 36 states encompassing over $1 billion in annual revenue. Pearce has extensive experience as a published author of several books and as a public speaker for caregivers and supervisors. His book, Senior Living Communities: Operations Management and Marketing for Assisted Living, Congregate and Continuing Care Retirement Communities is the go-to handbook for effective senior residential facilities. It has also been converted into an online classroom for the certification of assisted living administrators in several states. He is also the author of 27 eBooks on Amazon Kindle and iTunes covering industry related topics. He is a frequent contributor on senior living for publications such as Provider, Contemporary Long Term Care and Assisted Living Success. Pearce also serves as an expert witness for assisted living and skilled nursing litigation. Pearce shares his expertise as an adjunct professor for Johns Hopkins University and New York University, while teaching a variety of courses about senior living development and operations. He is also a professor at the Institute for Senior Living Education, based in Connecticut, an instructor for the Executive Director Certification Course and an instructor for EasyCEU.com, a continuing education provider. Pearce has received a number of awards including the Contemporary Long Term Care Order of Excellence, awarded to recognize outstanding operators and an elite fraternity whose members have been judged by their peers to be the nation's best.