Many veterans and surviving spouses may be eligible for a special monthly Aid and Attendance benefit if they have large medical expenses, including nursing home expenses, for which they do not receive reimbursement, even if their income is above the congressionally mandated legal limit for a VA pension. Although this is not a new program, not every veteran is aware of his/her potential eligibility. The A&A pension benefit may be available to wartime veterans and surviving spouses who have in-home care or who live in nursing homes or assisted-living facilities.
To qualify for this benefit a veteran must be incapable of self support and in need of regular personal assistance. The basic criteria for the A&A benefit is, first, that the need for A&A is established by a physician. It includes the inability to dress and undress without assistance, to feed oneself, or to take care of one’s own bodily needs. Veterans who are bedridden or need help to adjust special prosthetic or orthopedic devices may also be eligible, as well as those who have a physical or mental injury or illness that requires regular assistance to protect them from hazards or dangers in his/her environment. A veteran DOES NOT have to require assistance with all of these. There simply needs to be adequate medical evidence a veteran cannot function completely on his/her own.
For a wartime veteran or surviving spouse to qualify for this special monthly pension, the veteran must have served at least 90 days of active military service, one day of which was during a period of war, and be discharged under conditions other than dishonorable. Wartime veteran who entered active duty on or after September 8, 1980 (October 16, 1981 for officers) must have completed at least 24 continuous months of military service or the period for which they were ordered to active duty. Eligibility must be proven by filing the proper VA Form 21-534EZ for Surviving Spouse, or VA Form 21-527EZ for Veteran. The application will require a DD-214 or separation papers, medical evaluation from a physician, current medical issues, net worth limitations, and net income, along with out-of-pocket medical expenses.
If all requirements are met, VA determines eligibility for the Aid and Attendance benefit by adjusting for un-reimbursed medical expenses from the veteran’s or surviving spouse’s total household income. If the remaining income amount falls below the annual income threshold for the A&A benefit, VA pays the difference between the claimant’s household income and the A&A threshold. The A&A income threshold for a veteran without dependents is now $18,234 annually. It increases to $21,615 if a veteran has one dependent, and by $1,866 for each additional dependent. The annual A&A threshold for a surviving spouse alone is $11,715. This increases to $13,976 if there is one dependent child, and by $1,866 for each additional child.
How long does it take to process and get approved? Much of that depends on the VA Regional Office for the veteran’s area. On average, 6 to 9 months seems to be the normal approval time. Some approvals come through in as little as 6 weeks, but these are the exception. There are veterans who wait for an approval 12 months from the date of the filing. Bear in mind that if the benefit is approved, it is applied retroactively to the date of the application. If a veteran is over 90 years old, it is important to include a letter that the application be expedited. The VA is supposed to give priority to any application for benefits by a veteran 90 years or older. For convenience, applications can be submitted on-line at https://www.vabenefits.vba.va.gov/
Unfortunately, the VA does not recognize Power of Attorney (POA). If a veteran is capable of managing his/her own affairs, and a POA is held by a third party for emergency purposes, it is easier for the veteran to sign and handle the appropriate correspondence. If a veteran is not capable of managing his/her own affairs due to diminished mental capacity as in dementia or Alzheimer’s, the VA is going to rule the veteran is in need of a fiduciary. If notification is received from the VA that they find it necessary for a fiduciary to be appointed, a VA Form 21-4138 Statement in Support of Claim should be submitted.