 Veterans Affairs Aid and Attendance Benefits
What Are Aid and Attendance benefits?
Aid and Attendance is a benefit paid by Veterans Affairs (VA) to veterans, veteran spouses or surviving spouses. It is paid in addition to a veteran's basic pension. The benefit may not be paid without eligibility to a VA basic pension. Aid and Attendance is for applicants who need financial help for in–home care, to pay for an assisted living facility or a nursing home. It is a non–service connected disability benefit, meaning the disability does not have to be a result of service. You cannot receive non–service and service–connected compensation at the same time. Aid and Attendance benefits are paid to those applicants who:
• Are eligible for a VA pension
• Meet service requirements
• Meet certain disability requirements
• Meet income and asset limitations
Who is Eligible for Veterans Affairs Basic Pension and Aid and Attendance?
A pension is a benefit that the VA pays to wartime veterans who have limited or no income and who are at least 65 years old or, if under 65, are permanently or completely disabled. There are also "Death Pensions," which are needs based for a surviving spouse of a deceased wartime veteran who has not remarried.
What are the Service Requirements for Aid and Attendance?
A veteran or the veteran's surviving spouse may be eligible if the veteran:
• Was discharged from a branch of the United States Armed Forces under conditions that were not dishonorable AND
• Served at least one day (did not have to be served in combat) during the following wartime periods and had 90 days of continuous military service:
o World War I: April 6, 1917, through November 11, 1918
o World War II: December 7, 1941, through December 31, 1946
o Korean War: June 27, 1950, through January 31, 1955
o Vietnam War: August 5, 1964 (February 28, 1961, for veterans who served "in country" before August 5, 1964), through May 7, 1975
o Persian Gulf War: August 2, 1990, through a date to be set by Presidential Proclamation or Law. If the veteran entered active duty after September 7, 1980, generally he/she must have served at least 24 months of the full period for which called or ordered to active duty (there are no exceptions to this rule).
What are the Disability Requirements for Aid and Attendance?
Veterans, spouses of veterans or surviving spouses can be eligible for Aid and Attendance benefits if they meet the following disability requirements:
• The aid of another person is needed in order to perform personal functions required in everyday living, such as bathing, feeding, dressing, toileting, adjusting prosthetic devices, or protecting himself/herself from the hazards of his/her daily environment; or
• The claimant is bedridden, in that his/her disability or disabilities require that he/she remain in bed apart from any prescribed course of convalescence or treatment; or
• The claimant is in a nursing home due to mental or physical incapacity; or
• The claimant is blind, or so nearly blind as to have corrected visual acuity of 5/200 or less, in both eyes, or concentric contraction of the visual field to 5 degrees or less.
What are the Income Requirements for Aid and Attendance?
 The claimant's countable family income must be below a yearly limit set by law. Countable Income means income received by the claimant and his or her dependents. It includes earnings, disability and retirement payments, interest and dividends, and net income from farming or business. A claimant must report all income, but the VA will exclude any income that the law allows. Public assistance, like SSI, is not counted as part of countable income. The annual income limits for the Aid and Attendance program are higher than those set for the basic pension. The maximum Aid and Attendance benefit that can be paid monthly to a single veteran is $1,645, but the veteran must have countable income of $0 to receive the maximum benefit.
The following chart includes the set yearly income rate/annual pension Aid and Attendance limit set by Congress on December 1, 2008 for 2009; it also includes the maximum monthly benefit:
Unreimbursed Medical Expenses
Most veterans have some countable income, but there are exclusions that may reduce countable income, including a portion of unreimbursed medical expenses paid by claimants.
Unreimbursed medical expenses include: cost of a long term care institution or assisted living, health related insurance premiums (including Medicare premiums), diabetic supplies, private caregivers, incontinence supplies, prescriptions and dialysis not covered by any other health plan. Only the portion of the unreimbursed medical expenses that exceed 5% of the MAPR may be deducted (see above chart for MAPR amounts). It is important to note that VA Aid and Attendance benefits are also exempt as income for Medi–Cal purposes.
Example A: Single Veteran/No Spouse or Dependents — Income Less Than MAPR
• Jim's yearly income is $10,736, and he has no unreimbursed medical expenses this year. His VA pension will be $9,000 ($19,736 MAPR – $10,736 = $9,000) paid in monthly installments of $750 per month.
Example B: Single Veteran/No Spouse or Dependents — Income Over MAPR — No Med Deduction
• Frank's countable income is more than $19,736/yearly or $1,645/monthly, and he does not have any medical expenses. He is not eligible for VA Veterans Pension with Aid and Attendance. He may reapply again when his countable income falls below the limit or when he has unreimbursed medical expenses that would reduce his income.
Example C: Single Veteran/No Spouse or Dependents — Income Over MAPR — Med Deduction
• Anne's annual income is $30,000. Anne's medical expenses are $45,000/year and her medical insurance pays $25,000/year of that amount, so Anne has $20,000 in unreimbursed medical expenses, which will reduce her countable income.
o That portion of Anne's unreimbursed medical expenses ($20,000), which is more than 5% of the MAPR for a single veteran, will be deducted from her total income, which then increases the amount the VA will pay Anne.
o $19,736 MAPR x 0.05 = $986.80
o $20,000 med expenses – $986.80 = $19,013.20 medical deduction
o $30,000 Anne's income – $19,013.20 = $10,986.80 Countable Income
o Anne's VA Pension would then be $8,749.20 ($19,736– $10,986.80) for that year, or $729.10/monthly
Example D: Married Veterans — Income Below MAPR — Need Aid and Attendance
• Both Carlos and Patricia live in a senior apartment and need a caregiver 24 hours a day to remain safely in their house. SSI is their only monthly income, so their countable income for VA purposes is $0. They are eligible for $2,582, the maximum benefit to help pay for their care.
Example E: Surviving Spouse of Veteran — Income Above MAPR — In Assisted Living
• June is an assisted living facility. Her income is $13,260 per year in Social Security. Her children help pay for the assisted living cost of about $4,000 monthly. Thus, June's unreimbursed medical expenses are $4,000/monthly or $48,000 per year.
o $12,681 MAPR x 0.05 = $634.05
o $48,000 in unreimbursed medical expenses is $47,366.95 more than 5% of the MAPR and more than her income. Thus, June would be eligible for the maximum benefit of $1,057 to help her children pay for the assisted living facility.
What are the Asset Requirements for Aid and Attendance?
 Net Worth (the value of your assets) also affects eligibility. VA pensions are a need–based benefit, and a large net worth might affect your eligibility. All personal goods are exempt from the net worth. These goods include the home you live in, a vehicle used for the care of the claimant, and household goods and personal effects such as clothes, jewelry and furniture. Unfortunately, there is no asset limit set by law, and the determination of eligibility can be made at the discretion of a VA caseworker.
How do You Apply for Veterans Affairs Benefits?
Applying for VA pension is often complicated and may take some time. It is a good idea to keep copies of all unreimbursed medical bills for at least twelve months. The average wait for approval is six months. However, the benefits are retroactive to the date of application.
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