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VA Aid and Attendance Benefit

The Veterans Aid and Attendance benefit is a solution for veterans overwhelmed with the cost of long-term care.

A wartime veteran or their surviving spouse with limited income may be eligible to receive a non-service connected pension for care.

Determining eligibility for the Aid and Attendance Benefit is not easy, can be very confusing, and each case is ultimately decided by the VA.

Unique HomeCare Services is here to assist you. As a service to our veteran clients and their surviving spouses, we will assist you in determining your Aid and Attendance eligibility and your application at no cost to you.

With our experience, we can also cut the time needed for Aid and Attendance approval by the VA from 6 to 9 months to 1 to 3 months.

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VA Pensions

There are three levels of VA Pensions:

Basic Pension / Improved Income: For healthy veterans over the age of 65 with low incomes.

Aid and Attendance (A&A): For veterans over the age of 65 that require assistance with their Activities of Daily Living (ADLs) The need for care does not have to be related to their military service.

Housebound: For veterans with a disability rating of 100% that prevents them from leaving their home. The need for care does not have to be related to their military service.

The Aid and Attendance and Housebound benefits provide additional monthly income over and above the Basic Monthly pension. To be eligible for either of these benefits, one must also meet the requirements for the Basic Pension.

The Aid and Attendance benefit assists eligible veterans and their surviving spouses, or just the spouse in case of the veteran’s death, to pay for the in-home assistance they need with basic Activities for Daily Living such as eating, bathing, dressing, and medication management.

The Aid and Attendance benefit is often referred to by other names including:

• Improved Pension

• VA Assisted Living Benefit

• Veterans Elder Care Benefit

Veterans cannot receive both VA Disability compensation and the VA Aid and Attendance Pension. However, they can receive the higher benefit of these two programs.

Eligibility for the Aid and Attendance Benefit

The basic requirements for Aid and Attendance eligibility are:

• Active duty service for at least 90 consecutive days, including at least one full day during a time of war. Service in a combat zone is not a requirement.

• Qualifying for the VA Basic Pension.

• Meeting the clinical requirements.

• Meeting the financial requirements.

• Veterans cannot have been dishonorably discharged.

Widowed spouses of eligible veterans may also qualify if they meet the clinical and income requirements and have not remarried.

How Is Wartime Service Defined?

Congress defines the wartime dates that the VA uses to determine if veterans qualify for benefits such as Aid and Attendance.

These wartime dates are:

World War II: December 7, 1941 — December 31, 1946

Korean Conflict: June 27, 1950 — January 31, 1955

Vietnam Era: February 28, 1961 — May 7, 1975, for Veterans who served in the Republic of Vietnam during that period; otherwise August 5, 1964 — May 7, 1975

Gulf War: August 2, 1990, through a future date, to be set by Presidential proclamation or by law. For VA benefits purposes, this time of war is still in effect.

Service in a combat zone is not a requirement. To qualify for Aid and Attendance only 1 day of active service is needed during any of the above wartime periods.

Basic VA Pension Requirements

In addition to 90 days of active duty and at least one day of  wartime service requirements, eligible veterans must also meet at least one of these criteria to qualify for the Basic Pension:

A) Veterans or their surviving spouses must be at least 65 or officially disabled if younger.

B) Have a permanent and total disability. Veterans are eligible without a disability, but a higher benefit is available to those who are disabled.

C) Receive Supplemental Security Income.

D) Receive Social Security Disability Insurance.

E) Reside in a nursing home.

Veterans and their surviving spouses who meet the eligibility requirements for the Basic Pension must also meet the Clinical and Financial requirements to qualify for Aid and Attendance.

Clinical Requirements for Aid and Attendance

Veterans or surviving spouses must meet at least one of these clinical criteria:

A) Require help with some Activities of Daily Living (ADL’s) such as, but not limited to: bathing, dressing, eating, using the bathroom, etc. The need for this help does not have to be related to their military service.

B) Be bedridden except for medical and therapy appointments and treatments.

C) Have severe visual impairment, defined as eyesight limited to a corrected 5/200 visual acuity or less in both eyes, or concentric contraction of the visual field to five degrees or less.

D) Reside in a nursing home because of physical or mental incapacity, including Alzheimer’s and Dementia.

Financial Requirements for Aid and Attendance

The VA pays the benefit amount that makes up the difference between recipients’ countable income and the monthly upper limit.

• In December 2018, the VA set a clear upper limit for applicants’ net worth of $123,600, but not including the applicant’s vehicles, personal effects, and the value of their home.

• Assets, according to the VA, includes bank accounts, stocks, bonds, mutual funds, and property other than the veteran’s primary residence and their vehicles.

• Other items that can be excluded when determining net worth are household goods and furnishings, as well as personal items, such as clothing.

The VA also implemented a three-year lookback period to determine if assets were sold below market value or gifted to reduce the net worth below the upper eligibility limit. If so, this may delay, but not necessarily prohibit the start of VA pension benefit payments.

• Assets transfers made prior to 10/18/18 do not violate the new lookback rule.

• Another exception is if the applicant transferred assets, but never had a net worth in excess of $123,600 these transfers do not violate the lookback period.

There is an upper limit on monthly countable income minus expenses such as unreimbursed medical bills, prescription out-of-pocket costs, and Medicare and private health insurance premiums.

A veteran’s and their spouse’s joint countable income must be less than the pension amount for which they are eligible.

For example: if a married veteran in 2019 is eligible for $26,766 in pension; and if their countable income is $10,000, then they are eligible to receive an additional $16,766 / year in pension.

However, as the VA allows applicants to deduct certain expenses and forms of income from their “countable income”, the actual income can be considerably higher than the countable income to qualify for the Aid and Attendance benefit.

Veterans should deduct all of their unreimbursed medical-related expenses for themselves and their spouses that are greater than 5% of the Maximum Annual Pension Rate (MAPR).

For example: A married couple applying for Aid & Attendance, 5% of the MAPR is $1,338. Therefore, if a couple has an annual income of $30,000, and $25,000 in medical-related expenses, one would subtract $1,338 from $25,000, which means $23,662 of their medical expenses could be deducted from their income. Therefore, their countable income would be $6,338 versus their actual income of $30,000.

Medical-related expenses include the cost of care in skilled nursing, assisted living, adult day centers, and in-home care. 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 are also not included as countable income.

It is best to have Unique HomeCare Services prequalify you for Aid and Attendance at no cost to you. As a service to our veteran clients, we will assist you in determining your Aid & Attendance eligibility as well as assist you with your A&A application at no cost to you.

VA Retroactive Benefits and Loans

If a veteran or a surviving spouse is eligible for the Aid and Attendance benefit, they may also be eligible for the retroactive benefits pension.

If a veteran can prove their medical care expenses in a period up to a year prior to the month for which they will have received the first pension, they can receive the retroactive benefit for that period.

For example: if a veteran receives their first pension for the month of January 2019, they can receive the retroactive benefits pension for a period up to January 2018.

A veteran is eligible for the retroactive benefits pension only if they had already been granted the regular pension, and if they have proof that they had needed assistance in everyday functioning (ADL’s) before they started receiving the pension.

A&A loans are available to pay for care while waiting for your Aid and Attendance benefits to be processed by the VA.

Once approved for Aid and Attendance, the benefits are paid retroactively to you in a lump sum to your claim’s effective date. It is therefore easy to be approved for a loan that can pay for care during the A&A application processing wait time called the “determination period”.

Repayment of the loan can then be made from the lump sum benefit payment.

Aid and Attendance Eligibility For A Surviving Spouse

The surviving spouse must have met the conditions to be married under VA rules. This means the marriage is required to have lasted at least one year or a child was born as a result of the marriage regardless of the length of time married.

Under certain conditions, the VA will also accept common-law marriages or marriages where the couple held themselves out to be married and can prove that this was their intent.

• The surviving spouse must have lived continuously with the veteran while they were married unless they were separated due to the fault of the veteran. Evidence of any separation is required.

• The surviving spouse must have been married to the veteran when the veteran died.

• The surviving spouse cannot have remarried after the veteran’s death even if the surviving spouse is currently single.

There is one exception to this rule. If the surviving spouse remarried after the veteran’s death and that marriage was terminated either through death or divorce prior to November 1 of 1990 and then the surviving spouse has since remained single, that person is eligible under Section 38 CFR §3.55.

If the surviving spouse was married more than once, but the most recent marriage was to a veteran who served during a period of war and that marriage ended in the death of the veteran, and the surviving spouse did not remarry, then surviving spouse is eligible for a Survivors Pension based on this second marriage.

If a surviving spouse is receiving Dependents Indemnity Compensation (DIC) and needs assistance with his or her activities of daily living (ADLs), they can qualify for additional assistance of about $326 a month.

However, a surviving spouse cannot receive both DIC and a death pension on the same veteran.

About Unique HomeCare Services

Our headquarters in Norwood, Massachusetts serves the Greater Boston communities in Suffolk, Middlesex, Norfolk, Bristol and our office in Falmouth on Cape Cod serves Plymouth and Barnstable counties.

We provide private in-home care for elders, those with Alzheimer’s or Dementia, and people who are recuperating from illness, injury, or surgery.

We provide both short-term and long-term in-home care needs from as little as one 4 hour day a week to 24 Hour Care and Live-In Care.

We offer a full range of in-home personal care services including Bathing Assistance, Personal Hygiene and Grooming, Dressing Assistance, Toileting and Incontinence Assistance, Feeding Assistance, and Medication Reminders.

We also provide support services such as Case Management, Accompaniment to Appointments, Nutrition and Meal Management, Light Housekeeping and Laundry Services, Bed and Wheel Chair Transfers, and Shopping and Running Errands.

It is our pleasure to assist our veteran clients with VA Aid and Attendance Benefit approval at no cost.

To schedule a no cost and no obligation In-Home Assessment to determine the home care needs and get a quote, please call us to speak to a Case Manager at (800) 296-9962 or fill out our Free Quote Contact Form.