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My father in law was admitted to the hospital with three compression fractures of the lower bac! After two days he was transfered to rehad....case worker is telling us he us not eligible for an in home hospital bed through Medicare because he did not have surgery (he is 89) he is a World War 2Vet with an honorable discharge...is there ant way he can get benefits through the VA? If so how do I go about getting in touch with them? Thank you for your input!

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Your question focuses on the need for medical equipment for at home care.

Your description of your father's medical condition indicates he should qualify for a VA Aid and Attendance pension. If a veteran was honorably discharged and served ninety consecutive days active duty, with at least one day during war time, the veteran (and spouse) can be be eligible.

The Aid and Attendance benefits can be combined with Social Security and other pension income, to make at-home long term care possible for the veteran (and/or spouse).

The current maximum pension Aid & Attendance amount for a single veteran is: $21,107 / year ($1,758 / month).
Source: http://benefits.va.gov/PENSION/current_rates_veteran_pen.asp

To decide whether to award the pension, the VA looks at your father's assets and his monthly income. If his total assets are not likely to sustain him and his unreimbursed medical expenses (this is the key concept in the application for the pension) are equal to or greater than his income, he is entitled to the maximum Aid & Attendance benefit.

Unreimbursed Medical expenses include at-home care if the applicant cannot be left alone at home. If the applicant lives in an assisted living facility because he or she cannot live alone, the assisted living rent can also be covered by Aid & Attendance.

Family members (not including a spouse), can be paid to provide care. Here are other examples of unreimbursed medical expenses:
Medicare part A or Medicare part B premiums,
prescription drug co pays, and over the counter drugs if directed by a physician,
home health care aides
transportation for medical purposes
dentist visits
other regularly occurring medical expenses

After deducting the Unreimbursed Medical expenses, the VA calls the remaining net income amount “Income for VA Purposes” or “IVAP.”

Again, the key to understanding how the pension works is how an applicant’s health care costs offset their income. Without significant medical expenses (meaning expenses that are paid for out-of-pocket by your father and not reimbursed by Medicare or health insurance) the veteran or spouse cannot qualify for Aid & Attendance. The unreimbursed medical and health care expenses offset the income amounts.

It sounds like you may be preparing an overall plan of at-home care for your father. Keeping the plan and the expenses consistent is important. One veteran, who was receiving Aid & Attendance to reimburse him for the cost of home health aides, was not capable of understanding the important link between income, expenses and the pension. The veteran needed home health aides to assist him, because of dementia and health problems. The VA awarded him the full pension amount to pay for the care. Then one day the veteran decided to terminate the home health care services. Because the VA audits Aid & Attendance payments every year, they saw that the veteran no longer had unreimbursed expenses for the home health aides. The VA terminated his pension!

If you want to coordinate sources of payment such as Medicare, Medicaid and Aid & Attendance, an elder law attorney can help you consider all the options.

If you are focused only on the VA pension and there is a local veteran's agent or agency, they can help you prepare the Aid & Attendance application.

Best wishes to you and your family, and thank you for taking care of your father!
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Excellent answer above!
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Excellent and thorough answer.

I'd just like to emphasize the "total assets" aspect of application for VA benefits. The VA addreses not only income, but household assets (which include bonds, stocks, mutuals, IRAs as defined in the application form) as well.

The VA also looks at any service connected disability in making its determination.

One thing I would specifically avoid is involving any financial advisors or other so-called "VA benefits specialists" to assist you.

When we went through various nursing homes, I found that there are a number of so-called "VA qualification specialists" who purport to assist veterans and/or their families in applying for benefits. They frequently provide free "seminars" at nursing homes and assisted living facilities to tout their services.

It's my understanding that by law they cannot charge for this "assistance", but what they do is "evaluate" the veteran's asset portfolio. This is where the reps with whom I spoke became edgy and vague when I pressed for answers on why they become involved and how they gain financially if they can't charge for their services.

I suspect they make recommendations to reallocate various aspects of the asset portfolio and get a "foot in the door" to handle the portfolio.

If you do need assistance in preparing the documentation, check with your county to see if it has a VA assistance office as Mr. Roberts recommended. These people have no stake in reallocating the veterans' portfolio.

You can also call the VA directly; I've gotten help from calling the VA Help Resource Center at 877.222.8387. They'll tell you which form(s) you'll need and the VA office closest to you.

This is a good source for varous information on VA benefits as well: http://themilitarywallet.com/, and more specifically: http://themilitarywallet.com/veterans-benefits-guide/.

Another caution I would recommend is not getting meds through the VA, even if yourFIL does qualify. Our experience was that the VA assigned "primary care" doctor was a research doctor, not a clinician, and did not truly understand that meds prescribed by clinicians who seek patients on a more regular basis are more appropriate for given conditions.

The VA doctor arbitrarily changed and ordered an alternate medication which our treating doctor did not want used. I fought the VA for a few months and finally gave up and ended up paying for a medication which we couldn't use.

Good luck. Dealing with the VA is quite an experience.
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