If you are a qualified wartime veteran or the surviving spouse of a qualified wartime veteran, you may be eligible for additional pension benefits that will be paid to you, in addition to your standard VA pension. This program, referred to as the “Veterans Aid and Attendance” (V A & A) program, pays additional pension benefits to Veterans and their surviving spouses who require the daily attendance of another person to assist them with eating, bathing, dressing, undressing, administering medications, and other activities of daily living. Additional pension benefits are also paid to individuals who are blind or who are housebound. The benefits provided by the Aid and Attendance program are cash payments. With these funds, you are allowed to hire who you wish to pay for your care. The person that you hire does not have to be a licensed health care provider. You may hire a family member or friend. You are not limited to hiring someone to provide medical services. The funds can be used to pay someone for cooking, cleaning and doing the laundry. There are three basic requirements for eligibility. First, you (or your spouse) must have served during one of the military conflicts listed below, during the established time period. Second, you and your doctor must provide adequate evidence of need for benefits. Third, you must demonstrate financial need for benefits to pay for your care. The V A & A pension benefit is important because it provides cash payments for qualified Veterans and their spouses who may not qualify for benefits under the
MassHealth (medicaid) programs or who do not receive adequate services through MassHealth or their local Elder Services Agency.
Service during an Approved Military Conflict. Qualification for benefits is not based on a service related injury. Instead, you (or your spouse) must have served for at least ninety days in one of the following conflicts, during the time period listed below. Qualification based on military service in more recent conflicts is not yet approved by Congress, but may be approved in the future.
- World War I: April 6, 1917 through November 11, 1918. This period is extended to April 1, 1920 for those who served in the Soviet Union. You also qualify if you served after November 11, 1918 through July 2, 1921, if active duty was performed for any period during the basic World War I period.
- World War II: December 7, 1941, through December 31, 1946. This period is extended to July 25, 1947, for veterans with continuous active duty on or before December 31, 1946.
- Korean Conflict: June 27, 1950, through January 31, 1955.
- Vietnam: August 5, 1964, through May 7, 1975. Veterans who served in the Republic of Vietnam from February 28, 1961 through May 7, 1975 also qualify.
- Persian Gulf War: August 2, 1990, through a date to be determined by Presidential Proclamation or an act of Congress.
- Periods Not Yet Covered: Veterans who served during the Lebanon crisis in 1983 to 1984, during the invasions of Grenada or Panama or in the wars in Iraq and Afghanistan are not yet covered by this program.
Medical Need. To qualify for Aid and Attendance payments, you must be blind (your visual acuity is 5/200 or less in both eyes or you have concentric contraction of the visual field to 5 degrees or less, housebound (substantially confined to your home due to permanent disability) or need the attendance of one or more individuals with activities of daily living. As part of the application process, your doctor must fill out a form, with details about your physical and mental condition and your need for assistance, with supporting documentation, such as test results. You must also fill out a form, detailing your physical and mental condition, your disabilities, your living situation, and your need for services, as well as information about your finances. You and your doctor must establish that you are blind, housebound, or that you require the daily assistance of others to dress, undress, bathe, cook, eat, take prosthetics on and off, drive to doctors and psychical therapy visits, do shopping and errands, and other activities of daily living. You do not have to require assistance with all of these activities – you and your doctor must submit adequate evidence that you cannot function on your own and that you need the funds to hire someone to assist you with these activities. Qualification for benefits is not dependent on where you live. If you meet the requirements of the program, you will receive benefits to pay for your care in your home, in an assisted living facility, or in a nursing home.
Financial Need. In general, the financial eligibility requirements for the V A & A program are more liberal and more flexible than the financial eligibility rules for MassHealth. For those individuals living in their home or in an assisted living facility, the benefits are more generous than those provided by various MassHealth programs. In order to qualify, your income must be less than the additional pension amount. You will not qualify for benefits if your household income exceeds the pension amount. There is an exception to this rule. If you have recurring unreimbursed (out of pocket) medical expenses, your income can be adjusted by deducting your out of pocket medical expenses. In addition to the income limits, there is a limit on the assets that you own. As a general rule, your household assets (excluding your home, motor vehicles and other personal property) must be less than $80,000, although there is no specific asset test in the regulations governing the program. Veterans Service Representatives in the regional office are required to file paperwork justifying their decision to award benefits if they award benefits to someone with countable assets that exceed $80,000. For this reason, $80,000 has become the traditional asset limit. But, the service representative is encouraged to analyze the following: 1) the veteran’s or the surviving spouse’s household income; 2) the veteran’s or the surviving spouse’s financial needs for living expenses and medical care; 3) the available assets that can be easily converted to cash; and 4) whether the income from that cash will cover the difference in the household income and the cost of medical care over the care recipients remaining life span. In the end, the decision regarding allowable assets is a subjective decision made by a service representative.
The Benefits. If you are a qualified Veteran who meets the requirements listed above, you are eligible for additional pension payments of up to $1,759 per month. If you are the surviving spouse of a qualified Veteran, you are eligible for benefits of up to $1,130 per month. If you are a qualified Veteran and are married, you are eligible for benefits for up to $2,085 per month, and if you are a qualified Veteran with a sick spouse (who needs the assistance listed above), you are eligible for benefits of up to $1,373 per month. The amount that you will receive depends on a number of factors, including your marital status and whether or not you have dependent and/or disabled children or if you are the surviving spouse of a veteran. There are also different rates depending on your medical needs and classification. For more detailed information and examples of how the additional monthly pension is calculated, visit the following website:
How to Apply. If you are a Veteran, you will need to complete VA Form 21-526. If you are the surviving spouse of a veteran, you must complete Form 21-534. In addition, you must submit your Discharge/Separation papers (Form DD-214), or the Discharge/Separation papers of your deceased spouse. You must also file the following documents (if applicable) with your application:
- Copy of Marriage Certificate and all marital information
- Copy of the Death Certificate (surviving spouses only)
- Copy of current Social Security Award Letter (the letter that Social Security sends at the beginning of the year stating what your monthly amount will be for the following year)
- Net Worth information, including bank accounts, CDs, Trusts, Stocks, Bonds, Annuities, etc.
- Proof of all income from pensions, retirement, interest income from investments, annuities, etc.
- If you are a court-appointed guardian of the veteran or surviving spouse, a certified copy of the court order of the appointment is required
- Proof of insurance premiums, medications, medical bills or any other medical expenses that are not reimbursed by insurance, Medicare, or Medicaid
- Physician statement, that includes current diagnosis, medical status, prognosis, name and address, ability to care for self, ability to travel unattended, etc. If you are a veteran in a nursing home, or a family member of a veteran in a nursing home, you can use this form as a certification of that status.
- Banking information for Direct Deposit of A&A monthly payments (include a voided check)
- Employment history, if you are 65 or younger
- List of all doctors and hospitals visited in the last year
How to Get Help. The application process can be overwhelming, particularly if you are disabled. You, or an authorized family member or legal guardian can obtain help. You can ask the Veterans Administration to help you fill out the forms, or you can contact a regional office or call center. Before you contact the VA, make sure that you have the necessary information (listed above) in front of you, and have completed as much of the form as you are able. You can obtain the necessary forms and instructions online at https://iris.va.gov. You can locate the address and telephone number of the closest VA regional office at www.va.gov/directory or in your telephone book under “United States Government, Veterans”. You can also contact your local veterans’ service organization (VSO) representative to help you with your claim.