Wartime Veterans & Survivor Spouse In-Home Care And Nursing Home Benefit

Diana Law

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Elder Law Attorney - Aurora, IL

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1

What is Aid and Attendance?

The VA's Aid and Attendance program is designed to help aging veterans pay for the high cost of medical care when they are suffering from memory problems, Parkinson's, Lou Gehrig's disease, or a host of other chronic healthcare problems. Only honorably discharged veterans who are over age 65 or permanently disabled may qualify for this needs-based program. The veteran must have served at least 90 days of active duty, one day of which must have been during a period of war.

2

Who is allowed to help you obtain this benefit?

The only people who are legally authorized to provide information to veterans about benefits are: -Federal Veterans Administration employees and employees of state Departments of Veteran's Affairs; -Authorized representatives of Veterans Service Organizations like the VFW and American Legion, among others; and -Attorneys licensed to practice law in the veteran's state and accredited by the VA. Attorneys are authorized to provide veteran's benefit information. However, federal law prohibits a lawyer from charging a fee to assist a veteran in helping them understand the VA claim for benefits.

3

What Types of Veterans Can Qualify for Aid and Attendance?

Luckily, the Aid and attendance benefit includes many lesser-known areas of service. If you or your loved one belong to any of these groups and received a discharge by the Secretary of Defense, your service meets the active duty service requirement for benefits (this is only a partial list): Recipients of the Medal of Honor; Honorably discharged veterans, surviving spouses, or children of any military, naval or air service; Women's Army Auxiliary Corps (WAACs); Merchant Marines from WWII (Ocean-going service); US civilians of the American Field Service; Women Air Force Service Pilots (WASPs); WWI Signal Corps Female Telephone Operators Unit; WWI Engineer Field Clerks; Female clerical employees of the Quartermaster Corps serving with the American; U.S. civilian female employees of the U.S. Army Nurse Corps. Please note that it makes no difference for eligibility purposes whether the veteran served in the US or abroad.

4

What periods of war does the benefit cover?

In order to qualify for benefits, your loved one must have been honorably discharged, and must have served 90 consecutive days of active duty, including at least ONE DAY that falls within one of the following date ranges: Official Dates for Periods of War: World War II: December 7, 1941 to December 31, 1946; Korean War: June 27, 1950 to January 31, 1955; Vietnam War: August 5, 1964 to May 7, 1975; February 28, 1961 if served in Vietnam; Persian Gulf War: August 2, 1990 to [date not yet determined]

5

What if my loved one wasn't injured in the Service?

This guide is focused on benefits for veterans with Alzheimer's, Parkinson's, dementia, or a host of other chronic diseases. It is not for those wounded in battle. Most people think of veteran's benefits as being only for servicemen and women who were wounded or disabled while serving in the armed forces. By and large, that is true. But - there are substantial benefits that may be available to wartime veterans who are now senior citizens and are facing the burden of long term care due to a host of diseases such as dementia, MS, Lou Gehrig's Disease, and others. The most important thing for you to know is that the maximum benefit available can provide significant help in paying for the long-term care costs of veterans/surviving spouses who are homebound or in a care facility. The wartime veteran has earned possible eligibility for this assistance simply by serving our country, even if their current disability is not connected to their military service.

6

What does "permanently disabled" mean to the VA?

This benefit is for wartime veterans (and their surviving spouses) whose disabilities are not caused by their service become eligible for the Special Monthly Pension benefit when they are over 65 years of age; are permanently disabled and unable to work; are homebound; or need the regular aid and attendance of another - whether at home, in assisted/supportive living, or in a nursing home. The program is based on actual financial need for assistance, so there are income and asset limitations. Now, when you read the above paragraph and discover that you must be "permanently disabled" in order to qualify... you might be thinking that you felt a little "creaky" getting out of bed this morning, but you don't think you are permanently disabled. It might surprise you to find out, however, that if you are at least 65 years old, the VA automatically presumes you meet the disability test. So fear not! With the right advice, qualifying for benefits might be easier than you'd think.

7

Why haven't I heard of this benefit before?

From the Veterans Administration point of view, they can truthfully tell you that there's no such thing as "VA Aid and Attendance Benefits." The reason for this is they don't call it by that name. The public and the media refer to the benefits as either "Aid and Attendance," "widow's pension," or "widow's award." Unfortunately, many people have been denied an opportunity to file a claim because they did not know that the VA refers to these benefits as either a "Special Monthly Pension", "Death Pension" or even a "Non-Service Connected Pension." When you talk to the VA, you've got to speak the right language! You need to use the proper terms when dealing with the VA. If you do not know how to speak their language, then you need a 'translator.' The only translators that can help you are: Veterans Service Organizations, like the VFW or American Legion; An accredited agent, such as an employee of the State; or A licensed attorney who is accredited by the VA.

8

How do I calculate if my loved one has too much money to qualify?

The Aid and Attendance program is a needs-based program. But there's a secret to understanding how the VA actually looks at your income. "Unreimbursed Medical Expenses" -- are those expenses that you and your loved one are paying out of your pockets (also referred to as "UME"). This is a key factor to help you determine if a veteran may qualify for a pension! The formula the VA uses to calculate your real income is below: Wartime Veteran & Spouse (if any) Gross household annual income Minus: Unreimbursed medical expenses (UME) - for one year. Equals: Net income for Veterans Benefits purposes. Consider that the household annual income includes anything the veteran earns, as well as his/her spouse or dependents. From that number, you would subtract UME's - which include doctors' fees, Medicare premiums and copayments, and caretaker's fees. But there's much more - take a look below to see everything that qualifies!

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What qualifies as an Unreimbursed Medical Expense?

Partial Listing of Possible Medical Expenses: Medicare premiums deducted from Social Security, Supplementary medical insurance (Part B) under Medicare, Ambulance hire, Arch supports, Artificial limbs, Dental services, Eyeglasses, Gynecologist, Hearing aids & batteries, Home health services, Hospital expenses, Insulin treatment, Insurance premiums (medical), Lab tests, Nursing services, Occupational therapist, Optometrist, Oral surgery, Physical examinations, Physical therapy, Podiatrist, Prescriptions and drugs, Psychiatrist, Seeing-eye dog, Speech therapist, Surgeon, Vitamins prescribed by doctor, Wheelchairs, and X rays. Depending on what your income is and what your medical expenses are, you may qualify, even if your gross monthly income seems too high. If you have questions about anything in the list above or aren't sure if an expense you incur is "unreimbursed" or not, go ahead and give us a call at 630-585-5200.

10

Can my loved one simply give away assets in order to qualify for this benefit?

This is a perfect example of what NOT to do when you're trying to get your loved one to qualify for VA benefits. Make sure consult with a professional so you understand what you're doing before you make any changes to someone's assets. Ordinarily, the VA takes a very dim view of individuals transferring their assets to qualify for this benefit. Giving away cash or other things of value can create terrible problems for senior citizens if or when they later need to apply for Medicaid to assist them with skilled nursing home care. A housebound or assisted living facility resident has perhaps a 90% probability of needing to go on to skilled nursing home care within two to three years. The cost of skilled nursing home care can run from $5,000 to $10,000 per month. The veteran could be in the nursing home for several years prior to death. It is highly likely that the veteran's family will need to apply for Medicaid benefits to pay the nursing home costs.

11

What information do I need to have handy when I apply?

Veteran Only: DD-214 or Discharge Papers; Annual Social Security Award Letter received in January OR other documentation to verify your income; A printout from your pharmacy of 3 months of expenses; Copies of all your latest financial statements. Veteran and Spouse: All of the above for you and your spouse, PLUS Marriage certificate; Death certificate or divorce decree if either spouse was previously married. Widow/er of Veteran: The veteran's DD-214 or Discharge Papers; Annual Social Security Award Letter received in January AND other documentation to verify your income; A printout from your pharmacy of 3 months of expenses; Marriage certificate; Veteran's death certificate; Death certificate or divorce decree related to any previous marriages of either you or the veteran; Copies of all your latest financial statements.

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Additional forms that will need to be filled out and filed with the claim for benefits:

Statement of Attending Physician; VA Form 21-0779; Nursing Home Information Report OR Care Provider Report; Authorizations and Consent to Release Information to the VA for each physician of the veteran or spouse; Statement Regarding Claimant's IRA; VA Form 8416 Medical Expense Report

13

How much might a veteran receive?

Special Monthly Pension rates paid to veterans age 65 or older OR permanently and totally disabled. If the veteran is still alive, use this information: **Situation - Permanently and totally disabled veteran: Maximum Monthly Check - $985 ($11,830 per year)** **Situation - With one dependent spouse or child: Maximum Monthly Check - $1,291 ($15,493 per year)** **Situation - Permanently and totally disabled and also housebound: Maximum Monthly Check - $1,204 ($14,457 per year)** **Situation - With one dependent spouse or child: Maximum Monthly Check - $1,510 ($18,120 per year)** **Situation - Permanently and totally disabled and in need of regular aid and attendance: Maximum Monthly Check - $1,644 ($19,736 per year)** **Situation - With one dependent spouse or child: Maximum Monthly Check - $1,949 ($23,396 per year)** **Increase for each additional dependent child: Maximum Monthly Check - $168 additional ($2,020 per year)**

14

How much might a veteran's surviving spouse qualify for?

2011 Death Pension Rates Paid To Veteran's Surviving Spouse (use this information only when the wartime veteran has died): **Situation - Surviving spouse: Maximum Annual Pension Rate - $7,933 Maximum Monthly Check - $661** **Situation - With one dependent child: Maximum Annual Pension Rate - $10,385 Maximum Monthly Check - $865** **Situation - Surviving spouse is permanently housebound: Maximum Annual Pension Rate - $9,696 Maximum Monthly Check - $808** **Situation - With one dependent child: Maximum Annual Pension Rate - $12,144 Maximum Monthly Check - $1,012** **Situation - Surviving spouse is in need of "regular aid and attendance": Maximum Annual Pension Rate - $12,681 Maximum Monthly Check - $1,056** **Situation - With one dependent child: Maximum Annual Pension Rate - $15,128 Maximum Monthly Check - $1,260** **Situation - For each additional dependent child; Maximum Annual Pension Rate - $2,020; Maximum Monthly Check - $168 additional**

Additional Resources

Law ElderLaw, LLP is here to provide guidance to you in the following areas: Basic estate plan documents such as powers of attorney, wills, and possibly trusts; A good idea of whether or not a client may qualify for VA benefits; Care options available in the local community for both the ill senior and spouse; A review of Medicare and Medicaid as it applies to your circumstances; and A comprehensive understanding of available personal or family resources to pay for care. This legal guide reveals part of what you need to know to qualify. To find out more, please visit www.WartimeVeteran.com/law to get the whole story.

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