Posts Tagged ‘aid and attendance’

Is a Veterans Administration Benefit Right for You?

APRIL 30, 2012 VOLUME 19 NUMBER 17
We were reminded recently of the existence of a resource for elderly veterans and their surviving spouses — one that is too often overlooked, as it happens. We had yet another client who was unaware that she might qualify to receive a Veterans Administration pension benefit. We have written about veterans benefits before, but it always surprises us to note how often potential applicants are unaware of the benefits they are entitled to receive.

To qualify, the veteran must have served 90 days or more of active duty, including a single day during a war time period. War time periods include the second World War, the Korean Conflict, the Vietnam War, and Desert Storm, Desert Shield, and really any service in Afghanistan or Iraq from August, 1990 onward. The Department of Veterans Affairs helpfully maintains a list of the actual dates of “Periods of War” online.
The veteran must also have been honorably discharged (or at least, not dishonorably discharged) from his or her military service. Unlike other VA programs, there is no “service-connected” requirement for this particular benefit.

The benefit is available to veterans and their surviving spouse. If you are the surviving spouse, you must have been married to the veteran at the time of his or her death and can not have remarried since.  There is an asset test; to qualify, you may have family net worth of no more than $60,000 to $80,000, not counting the value of your home, car, and certain other items.

In calculating the amount of your pension benefit, the VA assesses your “countable monthly income.” Under this formula, any money you receive from Social Security reduces the amount of money you will receive from the VA.  Note, however, that you can reduce your “countable monthly income” by monthly unreimbursed medical expenses. These include such things as your Medicare premium, a dental insurance premium, a long term care insurance premium, prescription drugs, hearing aid costs, vision care costs, and expenses related to transportation to your doctor’s office.

Application forms are available at the Veterans Administration website,, or by calling 1-800-827-1000. The veteran’s application is form 21-256, widows use form 21-534, and the medical expense form is 8416.

The state of Arizona has created a department of Veterans Services to assist state residents in obtaining federal veterans benefits to which they may be entitled. A counselor will assist you in making the application. The Tucson office is located at 1661 N. Swan Road, Suite 128, Tucson, AZ 85712 and their telephone number is (520) 207-4960. You can also call the Phoenix office toll-free at 1-800-852-8387.

Wondering why no one has invited you to a free lunch to hear about this exciting benefit? VA rules state that anyone who assists you in completing this application can charge you no more than $10.00 for the service. That makes it hard to make a living explaining the benefit, unless your salary is paid by the federal or state government.

Extra Income for Veterans and Spouses Can Help Pay for Care

APRIL 28, 2008  VOLUME 15, NUMBER 44

There is no doubt that in today’s economy some extra income would be welcome, especially if you are struggling to pay for long term care. Many people aren’t aware that the Veteran’s Administration (VA) has a special program, called “Aid and Attendance,” that pays additional income to Veterans and their spouses, and to the widows (and widowers) of Veterans.

In 2008 single Veterans can receive up to $1554 per month in extra income. Married Veterans may qualify for as much as $1842 per month and widow(er)s up to $998 per month. These additional funds can mean the difference between being able to stay in the home while receiving in-home care or having to be placed in a nursing home or assisted living facility.

In order to qualify, the Veteran must have served at least 90 consecutive days of active service with at least one day of that service having been during a wartime period. The Veteran does nothave to have a service connected disability. The Veteran must also meet medical criteria, which means that he or she must need supervisory care or assistance with activities of daily living. That means requiring assistance with, for instance, grooming, eating or bathing.

There is also a financial test. A Veteran, married or single, must have less than $80,000 in “countable” assets (a house, car, and some other personal items are exempt) and have limited income.

Although there are financial requirements, Veterans should know that the VA will take into account medical bills to offset income. In addition (and unlike the rules for Medicaid and most other government programs), there are no penalties for gifts or transfers. The VA programs even allocate account values based on account titling — meaning that a jointly-held account will be treated as only partially belonging to the Veteran. These rules are much more relaxed than federal/state Medicaid rules, which means that there are many more opportunities to plan for VA benefits. That can even mean securing government assistance which allows the Veteran to simultaneously stay at home while staying off of the state Medicaid system.

If a VA Aid and Attendance applicant already requires long term care it is certainly important to consider Medicaid rules at the same time, if for no other reason than the possibility that care needs might increase. Benefits received under the Medicaid system can be much more generous than those available under Aid and Attendance Income, as the Medicaid system pays for care directly. That can easily amount to $4,000 or more of care costs per month. Cautious planning is, of course, the rule when considering present Aid and Attendance applications and/or future Medicaid eligibility.

All that being said, there are planning opportunities for both programs, and many Veterans will find that they are presented with more options in receiving assistance to pay for long term care. At Fleming & Curti, PLC, we stand ready to help Arizona Veterans and their family members figure out the availability of benefits, eligibility rules and planning options.

Recent Court Cases

MARCH 13, 1995 VOLUME 2, NUMBER 36

Recent court decisions of interest to those dealing with the elderly:

Care Home Liable for Condition of Resident

Sylvia Kyro, a demented patient, was a resident at Country Home Care in the Reno, Nevada, area. After she had been at the home for about two years, she became bedridden. Four months later, in April, 1993, she was taken to an area hospital.

At the hospital, Ms. Kyro was found to be malnourished and suffering contractures of both legs. The contractures were determined to be the result of lack of movement and muscle degeneration from inadequate blood circulation.

At the time of admission hospital staff also found infected bedsores on Ms. Kyro’s hips, knees and elsewhere. The most serious sores were Stage IV–the most advanced categorization.

Ms. Kyro’s guardians sued the care home, alleging that the home should have taken steps to transfer Ms. Kyro to a higher level of care when she became bedridden. The guardians also alleged that the home failed to notify Ms. Kyro’s physician of her worsening condition, which would have been a violation of Nevada licensing regulations.

In November, 1994, Country Home Care settled the claims. The amount of the settlement: $410,704. Kyro v. Frederick d.b.a. Country Home Care, (Washoe County District Court, Nevada, November 10, 1994).

Veteran’s “Aid and Attendance” Reduces Medicaid

Roland Kreuger, a North Dakota nursing home resident, was a veteran. In 1992 the Veteran’s Administration increased his “aid and attendance” payment. Since his care was being subsidized by Medicaid, his “turnover” amount (the amount he had to contribute to his nursing home care each month) was increased by the same dollar amount, resulting in no net increase to Mr. Kreuger.

Mr. Kreuger attempted to transfer his aid and attendance increase to his wife rather than use it to pay a portion of his nursing care. His argument (which was successful in the North Dakota trial court): federal law expressly provides that aid and attendance is not “income” and therefore not available for calculation of the turnover amount.

The North Dakota Supreme Court, however, reversed the lower court holding. Since the aid and attendance allowance was intended to provide care for veterans, and since Medicaid does not provide similar care when other payors are liable to do so, aid and attendance is a third-party program legally liable for the care before Medicaid makes a contribution. Kreuger v. Richland County Social Services (North Dakota Supreme Court, December 20, 1994).

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