What is “Aid and Attendance”?
As you may know, Aid and Attendance is a monetary benefit which helps eligible veterans and their dependents, usually a spouse, to pay for the assistance they need in everyday functioning due to their service-connected disability(s). This includes help with eating, bathing, dressing, and medication management. But what many don’t consider is the assistance with activities of daily living that may be affected by a veteran’s mental health condition.
Breaking down the need for Aid and Attendance due to Mental Health Conditions
When one thinks of requiring the Aid and Attendance of another person, their mind may automatically go to physical disabilities. Maybe one cannot cook their own meals due to knee pain when standing for prolonged periods of time, wash their own hair due to peripheral neuropathy causing numbness in hands, or even clean their house and change clothes during a debilitating migraine attack. However, many of the difficulties associated with the need for aid and attendance might apply to veterans with mental disorders, such as inability to keep oneself clean and presentable or the incapacity that requires assistance on a regular basis to protect oneself from hazards that may arise during daily living. Therefore, the grant of special monthly compensation can result in a much higher monthly compensation payment for some veterans with service-connected mental conditions.
How do you qualify for Mental Health Aid and Attendance?
- Does the Veteran’s mental health impairment cause danger to him/herself?
In other words, does the veteran experience suicidal ideation? If a caregiver such as a spouse was not around, would the veteran contemplate harming himself? Does the veteran experience lack of concentration that causes a loss of focus while driving?
- Does the Veteran’s mental health impairment cause danger to others?
Does the veteran experience homicidal thinking? Does the veteran have explosive anger that may lead to physical altercations? Has the veteran ever gotten into an argument that involved the police? How bad is the veteran’s road rage?
- Does the Veteran need the aid and attendance of another person in order to protect himself or herself from hazards or dangers incident to daily life because of a diagnosed mental health disability?
Does the veteran’s mental health condition affect long or short term memory? If the veteran were cooking are they likely to leave the stove on? Could the veteran’s lack of focus affect the ability to concentrate on cutting up vegetables for dinner and lead to an injury? Does the veteran go into “fight or flight” that could cause a dangerous reaction at the sound of a fire alarm or fireworks?
- Does the Veteran have severe impairment in judgment even for routine and familiar decisions, usually unable to identify, understand, and weigh the alternatives, understand the consequences of choices, and make a reasonable decision?
There are several questions the VA will ask when going through a mental health claim for Aid & Attendance, all pertaining to the veteran’s mental well-being.
Does the veteran dress improperly for the weather? Does the veteran neglect his/her hygiene? Does he/she need to be reminded to eat? Does the veteran inappropriately laugh at sad situations? Does the veteran lack the ability to identify dangerous situations such as running with a knife in the kitchen?
- Is any other incapacity, physical or mental, which requires care or assistance on a regular basis to protect the claimant from hazards or danger incident to his daily environment due to his/her diagnosed mental health impairment?
Does the veteran get lost even in familiar surroundings? Is the veteran impulsive? Does the veteran properly weigh the pros and cons to dangerous or risky situations?
Housebound and other examples
There are also other Aid and Attendance criteria that are included on the VA Form 21-2680; Examination for Housebound Status or Permanent Need for Aid and Attendance (also referred to as, A&A DBQ). Some examples include:
- Is the claimant able to feed him/herself?
- Is the claimant able to prepare own meals?
- Does the claimant need assistance in bathing and tending to hygiene?
- Does the claimant require medication management?
- Can the veteran mentally manage his own financial affairs?
How Mental Health Conditions Can Affect Your Daily Living
Sometimes mental health takes a toll on one’s ability to care for and about him/herself. Maybe the veteran isn’t eating regularly and needs someone to prepare their meals and remind them to eat. Declining mental health can correlate with rapid weight loss or weight gain, and some veterans need assistance with managing their consumption. A veteran struggling with depression may stay in bed for days at a time and neglect showering, changing clothing, and brushing teeth. If a spouse tracks how often you shower or reminds you to shave your beard every week, you may be neglecting your hygiene more so than you think. Many mental health patients may also require medication management if they experience memory loss or confusion due to their mental health condition or if they simply refuse to take their prescribed medication. Does your spouse lay out your medication or keep track of when you must take it? Do they inspect your mouth to ensure you swallowed your pills? If so, you may qualify for Aid and Attendance.
If you believe you qualify for Aid and Attendance due to your mental health condition, file a claim. Providing a completed Aid and Attendance Questionnaire, the VA Form 21-2680 mentioned above, by your mental health provider is a great first step to support your new claim. Buddy statements are also beneficial supporting evidence if they include information regarding the information above. A spouse, a best friend, or someone who is familiar with the effect your mental health condition is taking on your life are great candidates to attest to your need for Aid and Attendance.
