VA Benefits for Veterans and Their Caregivers

Thanks for this great post. VA benefits are often underused and can be a great resource.

Best,
Bill

I applied for the Aid and Attendace Benefit for my mom. She has both Social Security and a small pension. Unfortunately, she needs 24 hour care. She had been on Hospice Care for 18 months and we have been struggling to take turns caring for her. I could not list medical expenses as Medicare paid the entire cost of hospice. I applied hoping the benefit would allow us to hire a Caregiver, but noe the VA wants a statement from the provider as to actual costs paid. Can I provide a proposed contract from the provider. Or will they deny the claim? This is a catch 22 indeed and I am fearful my efforts will be in vain.

Absolutely. The VA will consider prospective payments. Get a letter from the home care agency stating that you have contracted for care and the annual cost.

Make sure you have an updated physicians report indicating that care is required. If you have a good relationship with the doctor have the need made urgent. With my applications I include a personal letter from the caregiver outlining the entire situation, medically and otherwise, and include a recent picture of the applicant (not with a big smile!).

I urge you to contact your local Area Agency on Aging for support services. You may be surprised what is available. I also urge you to check into Medicaid diversion or waiver programs in your state.

Can you please tell me how my mother who has been taking care of her ex-husband my father, would go about answering the questions for the "countable income" for care givers expense.
She has been caring for him, he cannot care for himself at all, Dr. has clarified this. She is getting to where she can no longer care for him.
How does she give an amount for "assisting home care" if he has not paid for any, but now needs it?

Can you help me answer some of my questions please? My father is a Veteran, my ill mother is taking care of him. She cannot take care of him anymore. She has gotten worse.
She hasn't been down to the VA office because of the wait time and she cannot leave my father alone that long.
I do not live close and I have a special needs child at home that I care for.
Is there away to get an appointment, no one answers the phones at our local office. Thank you.

How do you claim caregiver expenses as "countable income" if your mother is caring for your father and they are divorced. She is his POA also. She hasn't taken a direct amount for herself for caring for him.
She has become ill now herself and can no longer care for him like she did.

I take care of my ex-husband who is 77 years of age. He is a veteran of the Korean war. I am 69 years of age and have had a heart attack myself. I still do ALL the work for him. I still am doing my yard work, including mowing the grass. He does absolutely nothing to help. He is still able to take a shower and eat by himself but it is getting more difficult for me to do all the work. Is there some way for me to get some monetary assistance with this. He cannot afford to go to a nursing home.

Perhaps I can help the two posters above with this response:

Eligibility and qualification for the VA Aid and Attendance Improved Pension are predicated on the following:

1. Service. The veteran must have served at least 90 days of continuous service, one day of which must have been during a time of combat as prescribed by the VA. If a surviving spouse is applying they must, with few exceptions, have been married to the veteran at his demise.

2. Medical Evidence. The claimant must provide evidence that he or she requires regular, ongoing, daily support (the "claimant" will be the veteran in the case of single and married veteran filings and the surviving spouse for survivor filings). This can be in the form of the cost physical assistance from another person, supplies or services, or the cost of care in a facility, as examples. Keep in mind the purpose of the benefit is to assist veterans with low income/assets and high unreimbursed medical expenses. The benefit is paid to the claimant by direct deposit every month. The claimant then disperses funds as required.

3. Income and Assets. The VA does not prescribe income and asset limits as does Medicaid. The "acceptable" amount of income is arrived at formulaically. The following description of the income and asset formulas are broad for the purposes of this discussion and should not be considered "the whole story".

Broadly speaking, to receive a full award the claimant's household net Income for VA Purposes (IVAP) must be zero ($0). To receive a partial award the claimant's household income must be below the maximum monthly pension amount which for 2010 is:

a. For a single veteran $1,645
b. For a married couple $1,950
c. For a surviving spouse $1,057

So, for instance, to receive a partial award of $1,950 per month, a couple's IVAP will have to be below $1,950 per month. To receive a full award, their IVAP would have to be $0.

To determine IVAP, again broadly speaking, the claimant is permitted to deduct from gross household income the cost of qualifying, unreimbursed, medical expenses including the cost of medically related insurance premiums.

For many families, once these deductions are taken, they find their income quickly falls below the maximum pension amount and they are eligible for at least a partial award.

With respect to "deductible" expenses, there are many, many items that are potentially deductible; including Rx co-payments, incontinence supplies, etc.; the VA's "overriding" criteria is the cost of keeping the claimant and the claimant's environment "...safe from the hazards of daily living". Quite a broad requirement.

In fact, the VA will permit household member's and/or other family member's compensation for care as a deductible expense. Evidence must be shown that compensation is indeed being made and that services are indeed being provided (a contract and canceled checks, for instance).

Hint: There is no penalty for listing every expense you can think of on the application. The VA will exclude ineligible deductions for you.

With respect to assets, the formula is thus: In essence, the VA asks itself "...if the 'estate' (VA term), is divided over the life expectancy of the claimant, will the result cover the cost of reported ongoing, unreimbursed, medical expenses? This is a somewhat subjective calculation. But it does establish this: Applicant's with the same income, assets, and expenses may be treated differently due to age.

What constitutes an asset? Everything except the personal residence, automobile, and personal effects. This includes investments, savings, and cash of all types (the VA does not exclude IRA principal as some states do for Medicaid eligibility purposes).

All said, from what you have described of your circumstances, there should be a way to obtain an award for at least some of the assistance you need.

To learn more about this benefit directly from the VA, visit here http://www.vba.va.gov/bln/21/pension/

To obtain free assistance, or for local help, find a County Veteran Service Officer here:
http://nacvso.org/modules.php?name=Content&pa=showpage&pid=10

Caveat: Because of my recent witness to several instances of what I can only describe as financial elder abuse, I am compelled to warn you to be wary of the profligate "we help vets for free" firms that are actually financial service companies, typically insurance brokers, looking to sell high commission annuities. My experience has been that most of these firms are woefully inexperienced in coordinating VA benefits with other public benefit programs and as a result future access to Medicaid may be seriously compromised. If you are going to seek assistance from other than a public source, better to pay a reasonable fee than to be pressured, or worst yet, deceived into the purchase of an unsuitable financial product.

Hi there,
I read Ralph Robbins CFP post of 10/6/10 regarding Eligibility and qualification for the VA Aid and Attendance Improved Pension. He noted that "In fact, the VA will permit household member's and/or other family member's compensation for care as a deductible expense. Evidence must be shown that compensation is indeed being made and that services are indeed being provided (a contract and canceled checks, for instance)."

I wondered, can these same kinds of unreimbursed expenses from caregivers OTHER than family be deductible and considered to lower the veteran's threshhold? My dad would qualify in every other way but he earns about $2,020 in SS and a small pension per month, but his caregiver bills (non medical assistance with cooking meals, cleaning, bathing, dressing, errands, transportation, adult diaper changes, basically all ADLs etc. as he cannot walk) total at least $500 per month, sometimes $600....

Any word on whether the household income limit might be raised in 2011?

Many thanks.

All of the expenses you mentioned are deductible from gross income to arrive at Net Income for VA Purposes (IVAP).

Caregivers can be professional (from an agency or private hire) or non-professional (family/friend).

Your father should have no problem qualifying for an award with a properly executed application.

There are no financial benefit/requirement changes on the horizon at this time for 2011.