What are valid expenses that reduce income to avoid exceeding the Veterans Aid & Attendance income limit?

debdaughter, I cannot tell you anything about using one of those agencies. I did not go that route. My younger sister is father's full-time, live-in, caretaker. Mother died in February and the recent VA audit was because I reported her death immediately. I was trying to get them to adjust the monthly amount before we ended up owing them a ton of money that would have to be repaid. The maximum amount for a single person is nearly $300 less per month than for a couple. Even though I reported mother's death immediately, they are still overpaying father and we owe them close to $2,000 now according to my calculations. I am father's federal fiduciary as he was declared incompetent to take care of his own business way back when I first filed for benefits a few years ago. I am the only one who is allowed to complete transactions on the VA account. Actually, since being the federal fiduciary makes me totally responsible for what happens to the money, I like it this way. The services issue you mentioned above was pretty much a non-issue because father and mother were living at home and my sister sold her house and moved in. I paid my sister the agreed upon monthly amount from mother and father's savings account until the additional VA money came through. VA paid father a larger retroactive amount initially. Father was already getting VA benefits, but only $109 per month initially. After my sister became the full-time caretaker, father began getting nearly the maximum amount and then paying my sister with it monthly. You are right though: You must incur and pay the expense before you can report it as a healthcare expense--thus the services issue. Thankfully, we were able to do that, and since father was already getting a small VA pension, it did not take nearly as long to review and raise it as it would have taken to start an application from scratch. My situation is also simplified as I am the POA and have been listed on their accounts and doing all their paperwork for several years now. Mom used to do it and was getting dementia and could not do it anymore. I have had full access to everything for several years now. It is best to keep the VA money in a separate account. You only have to account for the VA money if you are audited. If you mix the VA money with other money, you end up having to account for it all. My situation is simplified because the amount of money he gets each month is almost the same as the amount that I pay my sister for taking care of him 24/7. Incidentally, she also gets all her other living expenses paid except for her share of the groceries (all the household bills). So, she has no housing or utility expense--only pays for her health insurance, auto expenses, and cell phone/internet services. She intends to move to Florida when father has passed away so she was willing to sell her home as a step towards that goal. I think we are getting off topic here so I hope this answers your questions. Father does not go to any VA facility; it is too far away from his home.

Can veterans who get 100% service connected disability compensation also get Care and Attendence ?

Patriot, the vet can get a pension improvement if their income is not covering all the costs, and there are few assets to draw upon.

Patriot...the answer is "no", an eligible and otherwise qualifying veteran may apply for both and then select the higher of the two awards. Compensation and Pension cannot be received simultaneously A veteran retired from service can, however, receive regular military pension and Compensation or Pension. I have worked with many veterans receiving small Compensation benefits and if they are eligible for and qualify for Pension the choice is usually a "no brainer".

I know that you cannot get both Disability Compensation and Pension but I thought that Care And Attendance was a separate program and not a component of the Pension program.

Patriot...
There are three benefit levels to Improved Pension. "Basic", "Housebound", "Aid and Attendance" (in ascending order of benefit amount paid). Aid and Attendance requires a separate rating based on medical need. As an example, for 2016 the maximum monthly Basic Pension award for a single veteran is $1,072, with a Housebound rating $1,310, and with an Aid and Attendance rating $1,788.
If a veteran is rated 100% disabled there is potentially an Aid and Attendance benefit as well but it is a Compensation benefit not a Pension benefit.