CAUTION: Obtaining a VA Improved Pension with Aid & Attendance award can be very tricky (technical term!). Application missteps, however inadvertent, can cause long delays in an already lengthy process (issuance of awards may normally take anywhere from as little as 30 days to up to 12 months).
Overall, eligibility requirements for this benefit are more fluid than other public benefits. This can be better or worse for the applicant depending on the circumstances.
If, after reviewing the information below, you suspect that you or your loved one may not qualify due to health, income, or assets call me for a free initial consultation before applying.
If an application is denied you may have to wait a full year before re-application is possible!
VA IMPROVED PENSION WITH AID AND ATTENDANCE
On December 16, 2006, then Secretary of Veterans Affairs Jim Nicholson issued a press release which read, in part, as follows:
VA Secretary Nicholson: VA Reaches Out to Veterans and Spouses
“Aid and Attendance” an Under-Used Benefit
WASHINGTON – The Department of Veterans Affairs (VA) is reaching out to inform wartime veterans and surviving spouses of deceased wartime veterans about an under-used, special monthly pension benefit called Aid and Attendance.
“Veterans have earned this benefit by their service to our nation,” said Secretary of Veterans Affairs Jim Nicholson. “We want to ensure that every veteran or surviving spouse who qualifies has the chance to apply.”
The Aid and Attendance Pension can provide up to $1,519 per month to a veteran, $976 per month to a surviving spouse, or $1,801 per month to a couple.*
Although this is not a new program, not everyone is aware of his or her potential eligibility. The Aid and Attendance pension benefit may be available to wartime veterans and surviving spouses who have in-home care or who live in nursing-homes or assisted-living facilities.
Many elderly veterans and surviving spouses whose incomes are above the congressionally mandated legal limit for a VA pension may still be eligible for the special monthly Aid and Attendance benefit if they have large medical expenses, including nursing home expenses, for which they do not receive reimbursement.
To qualify, claimants must be incapable of self support and in need of regular personal assistance.
*2006 benefit numbers; see below for current benefit rates.
Despite the publicity, the Aid and Attendance pension is still not as well known as it should be, particularly among those who need it the most.
WHAT ARE AID AND ATTENDANCE BENEFITS?
“Aid and Attendance” is technically known as “Improved Pension with Aid and Attendance”. It is awarded to eligible and qualifying claimants who’s assets and incomes fall below specified levels and/or those who need financial help paying for Unreimbursed Medical Expenses; typically long-term care expenses incurred in the home, an assisted living facility, or a nursing home.
It is paid by The Department of Veteran Affairs (VA) Veterans Benefit Administration (VBA) directly to eligible veterans or surviving spouses who then, in turn, pay providers.
This is a non-service connected disability benefit in that the claimant’s incapacity or disability does not have to be a result of service. Non-service connected benefits such as this and service-connected compensation (disability) benefits cannot be received at the same time (the veteran may choose the higher award). VA Pension with Aid and Attendance benefits are paid to those applicants who:
- Meet service requirements
- Are eligible for Basic Improved Pension
- Meet certain age and/or disability requirements
- Meet income and asset limitations
WHO IS ELIGIBLE FOR VA BASIC IMPROVED PENSION?
A VA Improved Basic Pension benefit is awarded 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 is also a Survivors Pension available to the surviving spouse of a deceased wartime veteran who was married to the veteran at the time of his/her death and has not remarried. A disabled child of a deceased veteran may also be eligible.
WHAT ARE THE SERVICE REQUIREMENTS VA IMPROVED PENSION?
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
- Had 90 days of continuous recognized military service and served at least one day during one of the following wartime periods (actual service in combat not required):
World War I – April 6, 1917 through November 11, 1918
World War II – December 7, 1941 through December 31 1946
Korean War – June 27, 1950 through January 31, 1955
Vietnam War – August 5, 1964 (February 28, 1961 for veterans who served “in country” before August 5, 1964) through May 7, 1975
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 he or she must generally 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 VA IMPROVED PENSION WITH AID AND ATTENDANCE?
Veterans, spouses of veterans, or surviving spouses can be eligible for the Aid and Attendance level of 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 (also know as Activities of Daily Living or “ADL’s”) 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.
Claimants will be required to submit VA Form 21-2680 “EXAMINATION FOR HOUSEBOUND STATUS OR PERMANENT NEED FOR REGULAR AID AND ATTENDANCE”. This form must be signed by a physician though it need not be a VA physician.
WHAT ARE THE INCOME REQUIREMENTS FOR IMPROVED PENSION WITH AID AND ATTENDANCE?
The claimant’s countable “Net Income for VA Purposes” (IVAP) must be below a yearly limit set by law.
Countable Income for this purpose means income received by the claimant, his or her spouse, and dependents living in the household. 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 (but Social Security is).
The following chart includes the yearly income rate/annual pension Aid and Attendance limit set by Congress on December 1, 2022 for 2023; it also includes the maximum monthly award:
| Aid and Attendance Maximum Annual Pension Rate (MAPR) Category If you are a… | MAPR Amount Your annual countable income must be less than… | Maximum Monthly Pension Rates |
| Single Veteran | $26,752 | $2,229 |
| Veteran with Spouse/Dependent | $31,714 | $2,642 |
| Surviving Spouse | $17,888 | $1,490 |
NET INCOME FOR VA PURPOSES AND UNREIMBURSED MEDICAL EXPENSES
As the above chart illustrates, the maximum monthly Aid and Attendance award that can be paid to a single veteran in 2023 is $2,229. To receive this award, however, the veteran must have countable Net Income for VA Purposes (IVAP) of $0.
To arrive at IVAP the VA uses the following calculation:
- Add all annual gross household income from all sources.
- Deduct all annual non-countable income.
- Deduct annual allowable Unreimbursed Medical Expenses*.
- Add 5% of MAPR (Deductible)
- Result = IVAP
Unreimbursed medical expenses* may include:
- The cost of a nursing home.
- The cost of an assisted living facility.
- Personal home care.
- Medicare Part A, B and D premiums.
- Health related insurance premiums such as Medicare supplement insurance.
- diabetic supplies, incontinence supplies, prescriptions or prescription drug co-pays, medically related transportation expenses.
- Emergency alert systems.
- Dental care.
- Other medically related services, supplies, and durable medical equipment.
*Only that portion of unreimbursed medical expenses that exceed 5% of the MAPR (see above) may be deducted. Therefore, referencing the chart above, a single veteran could only deduct from annual income those expenses that annually exceed $687.
HOW IS THE VA IMPROVED PENSION WITH AID AND ATTENDANCE AWARD CALCULATED?
An important concept to understand regarding VA Pension awards is that they are calculated on PROSPECTIVE as opposed to a PERSPECTIVE basis.
Although current income and expenses are used to evidence and determine the award, the award being granted is actually based on an annual PROJECTION of income the claimant EXPECTS to receive and unreimbursed medical expenses the claimant EXPECTS to incur during the upcoming 12 months.
This is very important information to have for if income or expenses change during the course of the ensuing 12 months it may be possible to receive additional benefit at the end of the year.
Conversely, money could be OWED to the VA as a result of over payment to the claimant!
Once IVAP has been established, determining the monthly award is relatively simple:
- Subtract IVAP from MAPR.
- If the result is $0 or less than $0 a full award will be granted.
- If the result is between $0 and MAPR, a partial award will be granted.
- Divide the result by 12.
- The result is the monthly Improved Pension with Aid and Attendance award.
Example 1:
- A single veteran has projected Net Income for VA Purposes (IVAP) of $0.
- The MAPR for a single veteran from the chart above is $26,752.
- Subtracting IVAP ($0) from MAPR ($26,752) = $26,752.
- Divide $26,752 by 12.
- The result is the maximum monthly award of $2,229.
Example 2:
- A single veteran has projected Net Income for VA Purposes (IVAP) of $12,000.
- The MAPR for a single veteran from the chart above is $26,752.
- Subtract IVAP ($12,000) from MAPR ($26,752) = $14,752.
- $14,752 is greater than $0 and less than $26,752. The veteran qualifies for a partial award.
- Subtract $12,000 from $26,752 = $14,752.
- Divide $14,752 by 12 months.
- The result is a monthly award of $1,229.
ASSET LIMIT
As of October 18, 2019 the VA changed asset limit policy and has initiated a “bright line” approach.
In 2023 the countable household countable asset limit is $150,438.
HOW DO YOU APPLY FOR VETERANS AFFAIRS BENEFITS?
Applying for the VA Improved Pension with Aid & Attendance is often complicated and it may take longer than six months to receive an award even with a “clean” application. Benefits, however, are retroactive to the month after the application was filed.
If you feel that no planning is required with regard to income or assets, you can apply on-line, download forms at the VA website, or you may consider using resources provided at no cost by County Veteran Service Officers.
Keep in mind, however, that neither the VA nor Veteran Service Officers are required to, and most likely will NOT, offer advice with respect to meeting income and assets limits.
Furthermore, it is not infrequent that misinformation is received from VA toll free numbers and from many veteran service offices (as has been reported to me over and over again throughout the years).