Veterans benefits – aid and attendance and housebound pensions
The VA offers two disability programs. Disability compensation is available only for veterans with service-connected disabilities, while the disability pension benefit is available to anyone who served during wartime and has a disability. The disability does not have to be related to military service.
Disability compensation benefit
If you have an injury or disease that happened while on active duty or if active duty made an existing injury or disease worse, you may be eligible for disability compensation. The amount of compensation you get depends on how disabled you are and whether you have children or other dependents. To determine your disability rating, which is used to calculate compensation, you may use this disability calculator. Click here to see the current compensation rates. Additional funds may be available if you have severe disabilities, such as loss of limbs, or a seriously disabled spouse.
Disability pension benefit
The VA pays a pension to disabled veterans who are not able to work. The pension is also available for surviving spouses and children. This pension is available whether or not your disability is service-connected, but to be eligible you must meet the following requirements:
- You must not have been discharged under dishonorable conditions.
- If you enlisted before September 7, 1980, you must have served 90 days or more of active duty with at least one day during a period of war. Anyone who enlisted after September 7, 1980, however, must serve at least 24 months or the full period for which that person was called to serve.
- You must be permanently and totally disabled, or age 65 or older. You will need a letter from your doctor to prove that you are disabled.
In addition, your income must be below the yearly limit set by law; called the Maximum Annual Pension Rate (MAPR). The MAPR for 2018 is below:
Veteran with no dependents
Veteran with a spouse or a child
Housebound veteran with no dependents
Housebound veteran with one dependent
$2,313 for each child
Your pension depends on your income. The VA pays the difference between your income and the MAPR. The pension is usually paid in 12 equal payments.
Example: John is a single veteran and has a yearly income of $8,015. His pension benefit would be $5,520 (13,535 – 8,015). Therefore, he would get $460 a month.
Your income does not include welfare benefits or Supplemental Security Income. It also does not include unreimbursed medical expenses actually paid by the veteran or a member of his or her family. This can include Medicare, Medigap, and long-term care insurance premiums; over-the-counter medications taken at a doctor's recommendation; long-term care costs, such as nursing home fees; the cost of an in-home attendant that provides some medical or nursing services; and the cost of an assisted living facility. These expenses must be unreimbursed. This means that insurance must not pay the expenses. The expenses should also be recurring this means they should recur every month.
Aid and attendance
A veteran who needs the help of an attendant may qualify for additional help on top of the disability pension benefit. The veteran needs to show that he or she needs the help of an attendant on a regular basis. A veteran who lives in an assisted living facility is presumed to need aid and attendance.
A veteran who meets these requirements will get the difference between his or her income and the MAPR below (in 2019 figures):
How to apply
You can apply for both disability benefits by filling out VA Form 21-526, Veteran's Application for Compensation or Pension. If available, you should attach copies of dependency records (marriage & children's birth certificates) and current medical evidence (doctor & hospital reports). You can apply online at http://vabenefits.vba.va.gov/vonapp.
Veterans of the United States armed forces may be eligible for a broad range of programs and services provided by the U.S. Department of Veterans Affairs (VA). In addition, their dependents and survivors may also be eligible for benefits. For more information about all the benefits available from the VA, see the VA booklet Federal Benefits for Veterans, Dependents and Survivors.
Consult with an accredited veterans attorney to see if you are eligible for these veterans benefits.
It is now harder to qualify for veterans benefits
The Department of Veterans Affairs (VA) has finalized new rules that make it more difficult to qualify for long-term care benefits. The rules establish an asset limit, a look-back period, and asset transfer penalties for claimants applying for VA pension benefits that require a showing of financial need. The principal such benefit for those needing long-term care is Aid and Attendance.
The VA offers Aid and Attendance to low-income veterans (or their spouses) who are in nursing homes or who need help at home with everyday tasks like dressing or bathing. Aid and Attendance provides money to those who need assistance.
Currently, to be eligible for Aid and Attendance a veteran (or the veteran's surviving spouse) must meet certain income and asset limits. The asset limits aren't specified, but $80,000 is the amount usually used. However, unlike with the Medicaid program, there historically have been no penalties if an applicant divests him- or herself of assets before applying. That is, before now you could transfer assets over the VA’s limit before applying for benefits and the transfers would not affect eligibility.
Not so anymore. The new regulations set a net worth limit of $123,600, which is the current maximum amount of assets (in 2018) that a Medicaid applicant's spouse is allowed to retain. But in the case of the VA, this number will include both the applicant's assets and income. It will be indexed to inflation in the same way that Social Security increases. An applicant's house (up to a two-acre lot) will not count as an asset even if the applicant is currently living in a nursing home. Applicants will also be able to deduct medical expenses — now including payments to assisted living facilities, as a result of the new rules — from their income.
The regulations also establish a three-year look-back provision. Applicants will have to disclose all financial transactions they were involved in for three years before the application. Applicants who transferred assets to put themselves below the net worth limit within three years of applying for benefits will be subject to a penalty period that can last as long as five years. This penalty is a period of time during which the person who transferred assets is not eligible for VA benefits. There are exceptions to the penalty period for fraudulent transfers and for transfers to a trust for a child who is unable to "self-support."
Under the new rules, the VA will determine a penalty period in months by dividing the amount transferred that would have put the applicant over the net worth limit by the maximum annual pension rate (MAPR) for a veteran with one dependent in need of aid and attendance. For example, assume the net worth limit is $123,600 and an applicant has a net worth of $115,000. The applicant transferred $30,000 to a friend during the look-back period. If the applicant had not transferred the $30,000, his net worth would have been $145,000, which exceeds the net worth limit by $21,400. The penalty period will be calculated based on $21,400, the amount the applicant transferred that put his assets over the net worth limit (145,000-123,600).
The new rules go into effect on October 18, 2018. The VA will disregard asset transfers made before that date. Applicants may still have time to get through the process before the rules are in place.
Veterans or their spouses who think they may be affected by the new rules should contact their attorney immediately.
To read the new regulations, click here.
Other types of veterans benefits for long-term care
The U.S. Department of Veterans Affairs (VA) provides health care benefits to veterans. The plan covers a number of health care services, including preventative services, diagnostic and treatment services, and hospitalization. The VA also offers a number of long-term care options through its health plan.
All enrolled veterans are eligible for the following services:
- Geriatric evaluation — provides either an inpatient or outpatient evaluation of a veteran’s ability to care for him or herself.
- Adult day health care — a therapeutic day care program that provides medical and rehabilitation services to veterans
- Respite care — provides either inpatient or outpatient supportive care for veterans to allow caregivers to get a break
- Home care — nursing, physical therapy, and other services provided in the veteran’s home
- Hospice/palliative care — provides services for terminally ill veterans and their families
Some services are limited to certain veterans: nursing home care and domiciliary care are not automatically available to all veterans enrolled in the VA health plan.
The following veterans automatically qualify for unlimited nursing home care:
- Veterans who are seeking nursing home care for a service-related condition
- Veterans with a service-connected disability rating of 70 percent or more
- Veterans who have a service-connected disability of 60 percent and are unemployable
A service-connected disability is a disability that the VA has officially ruled was incurred or aggravated while on active duty in the military and in the line of duty. The VA must rule that your illness/condition is directly related to your active military service, and it assigns each disability a rating. The ratings are established by VA regional offices around the country.
The VA may provide nursing home care to other veterans if space permits. Veterans with service-connected disabilities receive priority.
There are also state-run veteran’s nursing homes. The VA provides funds to states to help them build the homes and pays a portion of the costs for veterans eligible for VA health care. The states, however, set eligibility criteria for admission.
A domiciliary is a VA facility that provides care on an ambulatory self-care basis for veterans disabled by age or disease who are not in need of acute hospitalization and who do not need the skilled nursing services provided in a nursing home. Domiciliary care is available to low-income veterans with a disability.