Aid to Attendance benefit - What is needed to establish care besides doctors and patients part of paperwork?

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Can a CNA do this? I have seen the paperwork for this VA benefit but still unsure who can fill out the paperwork for the caregiver part. I have someone who I would like to use that I have started hiring privately, she is a licensed CNA and would be the one to give long-term care. Or does it have to be a agency? Lots of questions about this part of process and thought someone on here might have went through this process. I have been taking care of 91 yr old grandmother for 4 years but since she had stroke approx. 2 months ago she needs such a higher level of care that I need respite help, higher level of care is because needs observation or assist for all transfers and cannot help at all preparing her own meals and some memory and communication problems. From everything I have researched she has probably been eligible for this benefit for last 4 years but I did not have so much need for time away, now it is essential. Please help if you know anything at all about this, especially the part about establishing care and who can do that part of paperwork so VA is satisfied. Thank you

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The care is detailed on the 2680 form that her physician signs. The cost of service would be on the letterhead of the provider. Trying to do this "off the books" with a person who is not a licensed and insured AGENCY means you then become the employer, do withholding, pay comp insurance and submit tax reports to state and fed, and are very liable for the care.
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Thank you for info - I understand the physician part and that won't be a problem it is really just the establishing of care and care plan that I wonder about and if I have to already have a in- home care company taking care of her and for how long or is that even a issue? Also from what I understand they do not consider your home as a liquid asset when determining financial need, but I could be wrong. She will meet financial and medical need part if I understand things right it is just that caregiver part I am so confused about even after talking to people. Bottom line is I want to use a Licensed CNA for in-home care at almost 1/2 the price of a company, not only would it be 1/2 the price per hour but with this benefit I would be able to have more hours of in-home care. But will the VA recognize her the same way in applying for benefits that they do a established company? She is more than qualified as she has been doing this for one of those established companies for 7 years. Just want all info I can get before dealing with VA so there is not all that back and forth of wrong paperwork! I guess other part of the question is if I do have in-home care whether from her or a company how long do they need that care to be established before they think is enough time to determine is they are going to approve you for benefit to pay for this care?
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We used a benefits consultant, ERBC. Lots of paper work here especially the discharge papers for the Vet himself. I would not expect a CNA to know much about the details involved.
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Ah, dealing with the VA - this will be an experience.

There was a good thorough description of basic VA benefits by an elder law attorney in the post titled:

"Can my father-in-law get Veterans benefits if he was a World War 2 vet?" https://www.agingcare.com/questions/veterans-benefits-if-world-war-two-veteran-168006.htm

It's in the Money & Legal\VA\Questions\ subforum here.

It does somewhat address Aid & Attendance.

After dealing with the VA for years, and finding that (a) the routes to getting help can be circuituous, (b) which forms and data are necessary aren't always clear, and (c) this can be a frustrating process.... I would suggest calling the VA directly. The Help Resource Center at 877.222.8387. I've done this repeatedly.

Or as suggested in the referenced post, contact your county to find out if they have a VA office that assists in document preparation. They don't have to prepare the documentation for you, but they likely would be able to address the signature question. Our office here has been quite helpful and has even volunteered to help free of charge with document preparation.

Hopefully these links can remain in after posted as I think they would also help:

A&A site: http://www.veteranaid.org/apply.php. See the section with a link for "Physician Statement" to be downloaded.

I didn't download the form, so I haven't seen it. But from what I'm inferring, a doctor would have to complete the paperwork, which makes sense, because the VA would want validation from a qualified medical person, probably at a higher level than a CNA.

If you have any type of guardianship over your grandmother, you might be able to sign some of the other documentation, but I would really call the VA for this situation as you don't want to prepare the paperwork only to learn that the VA won't accept your signature.

We haven't gone through this yet (it's on the list of things to do) so I don't know how determination is made who can provide the care. I only personally know of one other person who tried to get A & A, the wife of a deceased veteran, but her application wasn't accepted because of income issues.

And don't forget to check the total assets guidelines; your grandmother might be qualified by income levels, but the VA does in fact use total assets as a determining factor as well.

Good luck.
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