Many wartime veterans and their surviving spouses are currently receiving long-term care or will need some type of long-term care in the near future. The Veterans Administration has funds that are available to help pay for this care. Unfortunately, many are not aware that these benefits even exist, and they are often overlooked by families with veterans or surviving spouses who need additional funds to help care for them.
These following three types of benefits are “pension benefits.” The veteran (or surviving spouse) does not need to have service-related injuries, but must meet certain eligibility requirements for wartime service, age and/or disability, and income/assets.
Pension with Aid and Attendance. This is the most widely known benefit and offers the highest possible monthly payment. It provides benefits for a veteran or surviving spouse who requires the attendance of another person to assist in activities of daily living (eating, bathing, dressing and undressing, cooking, etc.), is blind, or is a patient in a nursing home. Assisted care in an assisted living facility also qualifies. Currently, this benefit can provide up to $1,704 per month to a veteran, $1,094 to a surviving spouse, or $2,020 to a couple. An independent and well veteran who has an ill spouse with medical expenses that deplete their combined monthly income can receive up to $1,338 per month. A physician’s statement that verifies the claimant’s condition and need for assistance is required.
Pension with Housebound Allowance, which has a slightly lower benefit, will help those who do not qualify for Aid and Attendance, and who wish to remain in either their own home or the home of a family member. This pension requires that the individual needs regular assistance, but the criteria are not as limited as for those who would qualify for Aid and Attendance. Care can be provided by family members or outside caregiver agencies. A physician’s statement documenting the claimant’s medical needs is required.
Basic Pension is for veterans and surviving spouses who are age 65 or older or are disabled, and who have limited income and assets. No physician’s statement documenting a medical need is required.
Qualifying for Benefits
A veteran must first meet certain wartime service and discharge requirements before being considered for any type of pension benefit. Additionally, a surviving spouse must meet certain marriage requirements to the qualified veteran.
A claimant (the veteran or surviving spouse filing for benefits) must be 65 or older, or be permanently and totally disabled, which is defined as a) being in a nursing home; b) determined disabled by the Social Security Administration; c) unemployable and reasonably certain to continue so throughout life; or d) suffering from a disability that makes it impossible for the average person to stay gainfully employed.
Income and asset requirements must also be met. When determining eligibility, the VA looks at a claimant’s total net worth, life expectancy, income and medical expenses. A married veteran and spouse should have no more than $80,000 in “countable assets,” which includes retirement assets but does not include a home and vehicle. This amount is a guideline and not a rule.
Income for VA Purposes (called IVAP) must be less than the benefit for which the claimant is applying. IVAP is calculated by subtracting countable medical expenses from the claimant’s gross income from all sources. Countable medical expenses are recurring out-of-pocket medical expenses that can be expected to continue through the claimant’s lifetime.
Note: It is possible to reduce a claimant’s assets and income to a level that will be acceptable to the VA. For example, excess liquid assets (for example, cash or stocks) could be converted to an income stream through the use of an annuity or promissory note. However, because the claimant may need to qualify for Medicaid in the future, it is critical that any restructuring or gifting of assets be done in a way that will not jeopardize or delay Medicaid benefits. An attorney who has experience with Elder Law will be able to provide valuable assistance with this.
Applying for Benefits
It often takes the VA more than a year to make a decision, but once approved, benefits are paid retroactively to the month after the application is submitted. Processing time can be greatly reduced by having the proper documentation (discharge papers, medical evidence, proof of medical expenses, death certificate, marriage certificate and a properly completed application) at the time of application.
The secret for receiving a successful award from the VA is not in filling out the form but in knowing what documents and evidence must be submitted with the application. Knowing the secrets for a successful award – with the special case of long term care recipients – is 95% of the battle. A knowledgeable, accredited consultant can provide information to shorten the VA’s decision window of 6 to 12 months to possibly 3 or 4 months.
We are VA Accredited and we know how to help veterans get the benefits they have earned through their greatly appreciated service to our country.