VA Aid & Attendance Pension Helps Veterans Cover the Costs of Long-Term Care


The U.S. Department of Veterans Affairs (VA) is probably most well-known for providing veterans with health care coverage and medical services, but the VA also offers a wide array of other benefits to servicemembers and their families. One such program offers qualifying vets a monthly monetary benefit to supplement their income. This benefit is known as the basic veterans pension.

An “improved” version of the basic pension called “Aid & Attendance” is available to veterans who have limited income and require the assistance of another person to complete activities of daily living (ADLs). These funds can help offset the everyday costs of living and the costs of long-term care, which can be provided in a veteran’s home or in a residential setting like an assisted living facility or a nursing home.

Eligibility Requirements for the Aid & Attendance Pension (A&A)

There are several eligibility requirements that veterans must meet in order to qualify for the A&A pension program. The first and simplest requirement is that a veteran must have received a discharge other than dishonorable. Because A&A is an “improved” version of the basic veterans pension, many of the qualifications are the same except for additional functional requirements.

Wartime Service Requirements

The veteran must have served at least 90 days of active military, naval or air service, with at least one day taking place during a recognized period of war. The VA recognizes the following wartime periods:

  • Mexican Border Period: May 9, 1916 – April 5, 1917, for veterans who served in Mexico, on its borders or adjacent waters
  • World War I: April 6, 1917 – November 11, 1918
  • 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 law or Presidential Proclamation

(Veterans who entered active duty after September 7, 1980, must have either served 24 months or the full period for which they were called into active duty with at least one day during a wartime period defined above.)

Financial Requirements

Because this pension is intended to supplement the income of financially needy vets, it makes sense that the VA requires applicants to demonstrate their financial need. There are both income and net worth limitations that must be met to qualify.

For 2018, a veteran’s annual income must not exceed the Maximum Annual Pension Rate (MAPR) of $21,962. For a veteran with a spouse, their income must not exceed $26,036. Income sources include earnings, disability and retirement payments, payments from annuities, and net income. However, a veteran’s countable income can be reduced by the portion of unreimbursed medical expenses that exceeds five percent of the MAPR for the basic veteran’s pension. For a single veteran this threshold is $659, and for a married veteran, it is $863.

For example, if a married veteran’s annual income is $30,000, one might think that their income prevents them from qualifying for A&A. However, let’s say that this couple also incurs $7,000 worth of unreimbursed medical costs over the course of the year. Their countable income is actually reduced by $6,137 (7,000 – 863 = 6,137) to equal $23,863, which is below the MAPR limit. This couple meets the income qualifications for the A&A pension.

When it comes to net worth limits, the VA’s method for determining eligibility is much more complex and a bit of a mystery. Applicants are expected to provide detailed information regarding all the bank accounts, property (except one primary residence) and investments they own. Based on the veteran’s age and life expectancy, the VA will determine whether these assets could reasonably sustain the veteran throughout the rest of their life. Those found to have “excessive net worth” are considered ineligible.

Functional Requirements

The VA enforces certain functional requirements for recipients of this pension as well to ensure that vets who are unable to work, whether due to disability or age, receive the financial assistance they deserve. An eligible applicant must meet at least ONE of the following criteria for the basic pension:

  • Be at least 65 years old.
  • Be permanently and totally disabled (non-service-connected).
  • Live in a nursing home.
  • Receive Social Security Disability Insurance (SSDI).
  • Receive Supplemental Security Income (SSI).

Because A&A is specifically intended to help ill, disabled and aging veterans pay for the high level of care they need, veterans must also meet at least ONE of the following criteria to qualify for the higher pension amount:

  • Require the help of another person to perform activities of daily living, such as bathing, feeding, dressing, toileting, adjusting prosthetic devices or protecting oneself from the hazards of one’s daily environment.
  • Have a disability that causes one to be bedridden apart from any prescribed course of recovery or treatment.
  • Live in a nursing home due to physical or mental incapacity.
  • Have eyesight that is limited to a corrected 5/200 visual acuity or less in both eyes.
  • Have concentric contraction of the visual field to 5 degrees or less.

Pension Amounts and Uses

Veterans pensions are paid out on a monthly basis, considered tax-free income and can be used however the recipient sees fit. For example, pension funds can help cover the costs of housing, food, medical expenses, in-home care services, long-term care, clothing, bills, transportation, etc. VA pension funds can even be used to pay a family caregiver to provide services using a personal care agreement.

Read: Personal Care Agreements: A Must for Caregiver Compensation and Medicaid Planning

As mentioned above, the VA sets Maximum Annual Pension Rates (MAPR) and adjusts them each year to account for changes in the cost of living. The amount that a veteran receives is calculated by subtracting his or her net countable income from their appropriate MAPR. For example, if an eligible vet’s annual net income totals $9,000, then he or she is able to receive $12,962 in pension funds (21,962 – 9,000 = 12,962). This amount is then split up into 12 equal monthly payments of approximately $1,080.

A veteran who is currently receiving service-connected disability compensation can still receive the Aid & Attendance pension as long as the disability compensation is less than the A&A benefit. If eligible, the VA will grant the difference up to the maximum allowable under Aid & Attendance. However, if the disability compensation is greater than the pension amount the applicant is entitled to receive, then no more money is available.

How to Apply for VA Pension

Although many veterans are eligible for pensions, navigating the filing process is often overwhelming and frustrating. If you think you or a veteran you know may qualify for a veterans pension, the first step is to locate discharge papers (also known as DD Form 214.)

Many veterans have misplaced their discharge records, but there are a couple of options for tracking them down. The first place to look is at the county courthouse where many vets filed their discharge records upon returning home. If you do not have access to or cannot find this document, it is also possible to submit an online request through the National Archives eVetRecs site or submit a request via mail or fax using a SF-180 form. Certain fees may apply for requesting replacement documents. Emergency requests can be made, but regular turn-around times can be as long as 90 days.

Veterans filing for the Aid & Attendance pension will also need to complete and gather the following:

  • VA Form 21-527EZ (Application for Pension)
  • Additional personal and household evidence including proof of income, net worth information, and all relevant medical records or where to find them (specifics are outlined in the beginning pages of the above form).
  • VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance)
  • A statement from an attending physician attesting to the veteran’s need for A&A care.
  • If the veteran is currently in a nursing home, he or she will also need VA Form 21-0779 (Request for Nursing Home Information in Connection with Claim for Aid and Attendance).

Where to Find Help Applying for VA Benefits

Including specific and comprehensive information in a VA application is crucial for timely processing and determination of benefits, but many families need help locating and compiling the necessary paperwork. Veteran service organizations (VSOs) like regional offices of the American Legion, Disabled American Veterans (DAV) and Veterans of Foreign Wars (VFW) can provide this assistance free of charge.

Once an application is submitted, there is a waiting period before a veteran will receive an approval or denial. The amount of time varies according to the backlog of claims the VA is processing, but the average wait time is usually a few months. However, longer waits are to be expected if a vet files an incomplete or incorrect application.

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Are you saying that my veteran brother, who CHOOSES to be homeless, can waltz right into the new veteran's facility in our town, show his discharge form, and receive housing and health benefits, including surgery and post surgery care, after I housed him and cared for him for a year prior to his applying for admittance into the facility, all the while caring for our 90 year-old veteran mother, as I've done for the past 16 years (I'm talking hospital orderly duties and more), and it will take an act of Congress to receive resources and compensation? Oh, and did I mention that my brother also received a free cell phone (free as in SOMEBODY'S paying for it, duh) while I continue to rely on my old dinosaur of a cell phone? I plan to pursue this issue 'til the "cows come home." Karen T.
This is a follow up to my comments last year. In October of 2010 they finally approved my father's benefits. We received two months of the 10 months of benefits we were owed. Then in January of 2011 we had to reapply and a rep of the VA had to come and meet with us. We were told then that the benefits would continue and we would receive the 10 months of back pay. My dear Dad passed away on February 28th 2011. Within a week after I notified them of his death they took back the February payment stating my Dad had to be alive the whole month of February and since he died the last day of the month he was not entitled to his benefits. We have also been told that we will not receive his back pay. I paid out of pocket for care for my Dad while I worked, over $9000 in the 10 month period, and I will never get that back. I would never do anything different because I loved and adored my Dad, but I will never forgive what the VA put us through and how they made my Dad's last months very stressful. I contacted our Congresswoman, our Senator, our city's mayor, and even wrote the President, and no one could do a thing. Next we are going to the media. It now is a matter of principal and I also am positive they are doing the same to other elderly vets. They should be ashamed.
yea, this might be easier said than done.