Did you know that veterans or their surviving spouses may qualify for veterans benefits that will help pay for long-term care, including home care? It’s surprising how many veterans, or their family members, are unaware of these benefits.
Disability compensation may be paid to a veteran who suffered a service related injury. It is not limited by a veteran’s income or assets, and benefits may also be extended to the surviving spouse and any dependents in the form of Dependency and Indemnity Compensation (DIC).
A larger group of veterans — those who did not suffer a service- connected injury — may qualify for a low-income Veterans Administration (VA) pension. The pension is also available for the surviving spouse of the qualifying veteran. The 2012 benefit can be up to $2,019 a month for a veteran or dependent and up to $1094 a month for the widow or widower. In 2013, these amounts will increase by 1.7 percent, beginning with payments received in January.
As elder law attorney Martin Womer, with the Maine Center for Elder Law, LLC in Kennebunk explains, “Very few World War II and Korean War veterans and their surviving spouses are aware that there are any benefits for non-service-connected disabilities. VA Pension with Housebound or Aid and Attendance enhancements can make it possible to hire enough home care for seniors to remain in their homes. These benefits can also make living in an independent living facility with privately hired assistance, or in an assisted living facility, feasible. Additionally, more than 10,000 baby boomers will turn age 65 every day for the next 17 years, so the number of wartime veterans and their surviving spouses who may be eligible for these benefits is staggering.”
Service requirements for VA pension
- Served at least 90 days of active duty, at least one day of which was during a period of war
- Discharge was other than dishonorable
Age, medical and financial requirements for VA pension
- Age 65 or older, unless 100 percent disabled. (When a wartime vet turns 65, the VA automatically classifies him/her as totally disabled for this purpose.)
- Based on household income and assets. Residence, burial policies and plans, small life insurance policies, and personal property don’t count as assets.
- After deducting medical expenses, the individual’s net income must be less than the maximum pension benefit.
- Aid and Attendance
If you qualify for the basic pension and are housebound, you may be able to get additional housebound benefits to offset the cost of services provided by a home care agency.
- Cannot leave house without assistance
- Cannot drive
Veterans and their surviving spouses who need help with activities of daily living may qualify for Aid and Attendance, the highest level of pension benefits.
Activities of Daily Living (ADLs)
- Bathing or showering
- Getting in or out of bed or a chair
- Using the toilet
You do not have to need assistance with all of the activities listed, but your physician must confirm that you are not able to function completely on your own. As with housebound benefits, care can be provided in the home. If the physician documents that in order for you to receive assistance with at least two ADLs, it is necessary for you to live in a certain assisted living facility, or that you must be in a “protected environment,” the room and board costs of the facility may qualify as an Unreimbursed Medical Expense, which can offset your income in order to qualify financially.
Attorney Womer emphasizes, “VA Pension benefits are not only for wartime veterans. The surviving spouses of wartime veterans can also be claimants in their own right. The benefit amounts for surviving spouses are lower than for veterans, but they can make a huge difference in the affordability of home care nonetheless. If both spouses are veterans they can get additional benefits.”
You should expect it to take, on average, four to six months for your application to be processed and to receive a determination letter. The VA recently developed a new application form, which tends to be processed more quickly if it is entirely complete, with all supporting documentation, when filed.
If the VA determines that an incapacitated claimant needs a VA-appointed fiduciary, the process takes significantly longer. However, benefits are generally retroactive to the month after the individual initially filed an intention to apply for benefits. Womer stresses that it is important to file promptly once it appears that the claimant will be eligible.
Before applying for these benefits, it is probably a good idea to consult with a VA-accredited attorney, VA-accredited agent, or VA-accredited Veteran Service Organization to discuss whether or not you are eligible. “Certain planning techniques can also be done to enable veterans and their surviving spouses to qualify financially for these benefits,” says Womer. “It’s possible to design a plan so the steps taken for VA eligibility will not cause irreparable harm for MaineCare (Medicaid) eligibility if needed later. It is very important to consider both sets of rules when designing any plan for a client.”
And, it’s important to note that VA accreditation is required by law for anyone to assist another person with any application or claim. It is also illegal for anyone to charge a fee for assisting in the preparation or advocacy of any VA application, except for appeals of denials.