AID & ATTENDANCE FAQ
Aid and Attendance (A&A) is part of the VA's Improved Pension, which consists of 3-tiers. A&A is the highest level awarded to a veteran or surviving spouse who requires assistance with their daily living such as dressing, bathing, cooking, eating etc.
The applicant must show that while they may not need assistance for everything they cannot function completely on their own.
(Note that you do not have to be in a facility to be eligible for this level. The care can be provided in the home by either outside agencies or family members.)
The other two levels of the Improved Pension are Housebound and Basic.
All three levels should be applied for by using form 21-527EZ for the veteran, and 21-534EZ for a surviving spouse.
Housebound is the 2nd level of Improved Pension. The criteria is basically the same. The applicant is not as limited in their need for assistance as someone meeting the needs for Aid & Attendance, but still requires help with daily living activities.
The other two levels of the Improved Pension are Basic and Aid and Attendance.
All three levels should be applied for by using form 21-526 for the veteran, and 21-534 for a surviving spouse.
Basic Pension is the first level of the Improved Pension. Once a veteran reaches the age of 65, the VA considers and classifies them permanently and totally disabled regardless of their physical fitness.
The other two levels of the Improved Pension are Housebound and Aid & Attendance.
All three levels should be applied for by using form 21-526 for the veteran, and 21-534 for a surviving spouse.
You can submit a one-page VA Form 21-0966 (INTENT TO FILE A CLAIM FOR COMPENSATION AND/OR PENSION, OR SURVIVORS PENSION AND/OR DIC) which will get the claim into the system. You can get a copy of the form by clicking here.
This is a difficult question to answer. Much depends on the VA regional office for your area. On average, 6 to 9 months seems to be the normal approval time at the moment. Some approvals come through in as little as 6 weeks, but these are the exception. We know of people still waiting for an approval 12 months from the date of filing.
Keep in mind that if the benefit is approved, it is applied retroactively to the date of application. Also, if the applicant is over 90 years old, include a letter requesting that the application be expedited. The VA is supposed to give priority to any application for benefits by a veteran 90 or older.
Currently, there is no "look back" period, as with other government programs, such as Medicaid. The VA looks at the value of assets on hand at the time of Aid & Attendance application.
If you are currently receiving disability compensation from the VA, you cannot receive both the compensation and pension. What you can do is to file for the Improved Pension based on non-service connected health issues. If the application is approved, the VA will pay whichever benefit has the highest dollar amount. If you are receiving compensation for a service-connected injury, that compensation would not be counted as income. However, you should include VA Form 21-4138 Support of Claim (click here for the form) that specifies that you receive compensation, but you want the VA to pick which benefit will pay the most.
If you are receiving compensation you need to make certain that you are receiving the maximum possible dollar amount for your condition BEFORE filing for the Improved Pension.
Note--health issues can be a secondary condition related to your service-connected disability. You should speak with a qualified Veterans Service Officer before filing for Improved Pension.
If you are service-connected, you might also be eligible for SMC (Special Monthly Compensation) SMC is a rate paid in addition to or in place of 0% to 100% combined degree compensation.
To qualify for SMC a veteran must be disabled beyond a combined degree percentage or due to special circumstances. You would need to speak with a Veteran's Service Officer to assist you in determining if you are eligible.
If you need additional information on Special Monthly Compensation, click here.
- Discharge/separation Papers (DD-214. If you need to request military records, please visit www.vetrecs.archives.gov 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 you are a veteran in a nursing home, or a family member of a veteran in a nursing home, you use this form as a certification of that status. Nursing Home Status Form
- Banking information for Direct Deposit of monthly payments (include a voided check).
- List of all doctors and hospitals visited in the last year.
Never send originals and ALWAYS send all correspondence "Registered Return Receipt" as well as keeping a complete copy of everything for your own records. If you are in the process of completing an A&A claim, the VA states "It is not necessary to request a duplicate copy of a veteran's discharge or separation papers solely for the purpose of filing a claim for VA Benefits. If complete information about the veteran's service is furnished on the application, the VA will obtain verification of service." In spite of what the VA says, we recommend including a copy to avoid any imposed delay.
Unfortunately the VA does not recognize POA or DPOA. If your loved is capable of managing their own affairs, and you hold POA of DPOA for emergency purposes, it will be easier for them to sign and handle the appropriate correspondence.
If your loved one is not capable of managing their own affairs due to diminished mental capacity as in dementia or Alzheimer's, the VA is going to rule that they are in need of a fiduciary. Holding POA or DPOA does not grant this authority to you.
Once you receive notification from the VA that they find it necessary for a fiduciary to be appointed you should submit Form 21-4138 and include the following statement:
Please be advised that (parent's name) and I have no issue with the VA finding of incompetence and wish to proceed with the appointment of a fiduciary. We wish to appoint myself (her/his insert your relationship to the veteran) as fiduciary. I understand that I must be interviewed prior to that appointment and would appreciate such an interview be scheduled as soon as possible.At this point both (whoever is asking to be appointed) and the applicant will have to be interviewed by a VA Field Agent who will determine if you are an appropriate person to assign fiduciary to.
Note: Due to the overwhelming needs for interviews such as this, it can take months before you are contacted to schedule an appointment. You may need to be proactive in calling and "requesting" that an appointment be scheduled. You should allow at least 30 days before following up with contact.
If your situation is one that the delay in payments will create an extreme financial hardship, you can include the following statement as a way of expediting payment:
I respectfully question the withholding of my (parent's name) benefits, pending the appointment of a fiduciary. Referencing a VA policy: Pursuant to VA Manual M21-1, Section 17.15: Procedure Upon Receipt of Evidence of Incompetency, your manual states "Do not routinely suspend direct payments to a beneficiary pending development of an issue of incompetency or certification of a fiduciary." The manual further states: "If entitlement to benefits has been established but no payment has been made or if increased benefits are payable, make a determination as to whether or not benefits should be paid directly pending certification. The determination should consider if delaying the payment of the benefits would cause undue hardship for the beneficiary. If the evidence of record shows that delaying payment would create a hardship, properly annotate the award, referencing the evidence reviewed and the justification for paying benefits directly to the beneficiary." I think if you reference (parent's name) claim, you will see that withholding his/her payment does constitute a hardship for him/her. I would like to request that he/she receive payments during the fiduciary appointment process.
If the VA rules that the applicant is entitled to Aid & Attendance or Housebound benefits, then ALL costs are deductible. The VA's Operating Manual states:
"Allow all reasonable fees paid to the facility as long as the facility provides some medical or nursing services for the disabled person. These services do not have to be furnished by a licensed health professional."
If my parents sell their home before moving into Assisted Living, do they need to count that money as income?It does not count as "income", BUT the moment that money is deposited into the bank, it will automatically become part of their net worth. If plans are to sell the home, it would be best to handle this matter before making application for A&A. It may be advisable to speak with a Financial Advisor so that they can determine the best way to disperse the money from the sale. Any money that is retained in savings accounts, put into CD's, IRA's etc, will become part of their net worth.
Remember that there is no "look back" period for Aid & Attendance. Assets are counted from the date of application.
The VA's income-based programs are intended to give beneficiaries a minimum level of financial security. They are not intended to protect substantial assets or build up the beneficiary's estate for the benefit of their heirs.
The purpose of this program is to help those in financial need.
Generally the answer to this question is no. However, if the divorce was due to physical abuse or extreme mental cruelty, the VA has been known to consider these circumstances and consider the application.
There would have to be documentation and unquestionable evidence supporting the claim of abuse in order for this to be applicable. Even if this is the case, the VA is not bound to consider the application. If you feel that your circumstances would qualify, you should speak with the VA or a Veteran's Service Officer in your area for additional information.
My mom needs to move to an ALF, but dad is still capable of staying at home. Can we file for her based on dad's service?The veteran has to qualify in order for the spouse to be eligible, so no you cannot file based on her need. However, a vet with an ill spouse can file for "Basic" Pension if all of her medical costs wipe out their monthly income. The application process is the same as if the veteran were filing for Aid & Attendance. The current rate of Basic Pension is $1,290.00 per month.*
My father died and my mom remarried a non-veteran, who has died. Is she eligible to apply based on my father's service?Unless she was already receiving death benefits after your father died, she would not be eligible to make an application based on his service.
My loved one died before payments were made on an approved application; is anyone entitled to the accrued funds?If your loved one passes during the application process prior to funds being released, you are entitled to file against those accrued benefits for expenses associated with the "Last Illness." This is not limited to just the out of pocket expenses incurred for final arrangements not covered by pre-existing arrangements or policies, nor is it for the last ambulance ride.
EXAMPLEMost would assume, based on the form letter you will receive from the VA informing you that the file has been closed since the applicant is now deceased, that there is no other recourse, when actually there is.
You made application on March 15, 2008 for Aid & Attendance. The application was approved, but the VA delayed payments due to incompetency issues such as dementia pending a fiduciary being approved or appointed.
Your loved one passes on August 25, 2008 leaving 5 months of accrued benefits that were never paid out.
Click here for Form 21-601 - Application for Accrued Amounts due a Deceased Beneficiary
We suggest that in addition to closely following the directions for completing Form 21-601 that you include a copy of your birth certificate indicating you are a legal heir. You will also need to list all siblings who may also be entitled to file.
In the case of a sibling or other legal heir who has been excluded from entitlement, you need to include a copy of the Last Will & Testament validating that fact.
Key Points to Remember:
- You only have 1 year to file for reimbursement.
- You should anticipate 6-12 months for the claim to be processed and check(s) issued.
- An application has to already be on file with the VA that has been approved.
The formula for "Countable Income" is not very difficult. However, you should be able to document how you arrived at your figures.
For detailed information on how to calculate Countable Income, click here.