Thanks for this great post. VA benefits are often underused and can be a great resource.

Best,
Bill
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I applied for the Aid and Attendace Benefit for my mom. She has both Social Security and a small pension. Unfortunately, she needs 24 hour care. She had been on Hospice Care for 18 months and we have been struggling to take turns caring for her. I could not list medical expenses as Medicare paid the entire cost of hospice. I applied hoping the benefit would allow us to hire a Caregiver, but noe the VA wants a statement from the provider as to actual costs paid. Can I provide a proposed contract from the provider. Or will they deny the claim? This is a catch 22 indeed and I am fearful my efforts will be in vain.
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Absolutely. The VA will consider prospective payments. Get a letter from the home care agency stating that you have contracted for care and the annual cost.

Make sure you have an updated physicians report indicating that care is required. If you have a good relationship with the doctor have the need made urgent. With my applications I include a personal letter from the caregiver outlining the entire situation, medically and otherwise, and include a recent picture of the applicant (not with a big smile!).

I urge you to contact your local Area Agency on Aging for support services. You may be surprised what is available. I also urge you to check into Medicaid diversion or waiver programs in your state.
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Can you please tell me how my mother who has been taking care of her ex-husband my father, would go about answering the questions for the "countable income" for care givers expense.
She has been caring for him, he cannot care for himself at all, Dr. has clarified this. She is getting to where she can no longer care for him.
How does she give an amount for "assisting home care" if he has not paid for any, but now needs it?
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Can you help me answer some of my questions please? My father is a Veteran, my ill mother is taking care of him. She cannot take care of him anymore. She has gotten worse.
She hasn't been down to the VA office because of the wait time and she cannot leave my father alone that long.
I do not live close and I have a special needs child at home that I care for.
Is there away to get an appointment, no one answers the phones at our local office. Thank you.
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How do you claim caregiver expenses as "countable income" if your mother is caring for your father and they are divorced. She is his POA also. She hasn't taken a direct amount for herself for caring for him.
She has become ill now herself and can no longer care for him like she did.
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I take care of my ex-husband who is 77 years of age. He is a veteran of the Korean war. I am 69 years of age and have had a heart attack myself. I still do ALL the work for him. I still am doing my yard work, including mowing the grass. He does absolutely nothing to help. He is still able to take a shower and eat by himself but it is getting more difficult for me to do all the work. Is there some way for me to get some monetary assistance with this. He cannot afford to go to a nursing home.
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Perhaps I can help the two posters above with this response:

Eligibility and qualification for the VA Aid and Attendance Improved Pension are predicated on the following:

1. Service. The veteran must have served at least 90 days of continuous service, one day of which must have been during a time of combat as prescribed by the VA. If a surviving spouse is applying they must, with few exceptions, have been married to the veteran at his demise.

2. Medical Evidence. The claimant must provide evidence that he or she requires regular, ongoing, daily support (the "claimant" will be the veteran in the case of single and married veteran filings and the surviving spouse for survivor filings). This can be in the form of the cost physical assistance from another person, supplies or services, or the cost of care in a facility, as examples. Keep in mind the purpose of the benefit is to assist veterans with low income/assets and high unreimbursed medical expenses. The benefit is paid to the claimant by direct deposit every month. The claimant then disperses funds as required.

3. Income and Assets. The VA does not prescribe income and asset limits as does Medicaid. The "acceptable" amount of income is arrived at formulaically. The following description of the income and asset formulas are broad for the purposes of this discussion and should not be considered "the whole story".

Broadly speaking, to receive a full award the claimant's household net Income for VA Purposes (IVAP) must be zero ($0). To receive a partial award the claimant's household income must be below the maximum monthly pension amount which for 2010 is:

a. For a single veteran $1,645
b. For a married couple $1,950
c. For a surviving spouse $1,057

So, for instance, to receive a partial award of $1,950 per month, a couple's IVAP will have to be below $1,950 per month. To receive a full award, their IVAP would have to be $0.

To determine IVAP, again broadly speaking, the claimant is permitted to deduct from gross household income the cost of qualifying, unreimbursed, medical expenses including the cost of medically related insurance premiums.

For many families, once these deductions are taken, they find their income quickly falls below the maximum pension amount and they are eligible for at least a partial award.

With respect to "deductible" expenses, there are many, many items that are potentially deductible; including Rx co-payments, incontinence supplies, etc.; the VA's "overriding" criteria is the cost of keeping the claimant and the claimant's environment "...safe from the hazards of daily living". Quite a broad requirement.

In fact, the VA will permit household member's and/or other family member's compensation for care as a deductible expense. Evidence must be shown that compensation is indeed being made and that services are indeed being provided (a contract and canceled checks, for instance).

Hint: There is no penalty for listing every expense you can think of on the application. The VA will exclude ineligible deductions for you.

With respect to assets, the formula is thus: In essence, the VA asks itself "...if the 'estate' (VA term), is divided over the life expectancy of the claimant, will the result cover the cost of reported ongoing, unreimbursed, medical expenses? This is a somewhat subjective calculation. But it does establish this: Applicant's with the same income, assets, and expenses may be treated differently due to age.

What constitutes an asset? Everything except the personal residence, automobile, and personal effects. This includes investments, savings, and cash of all types (the VA does not exclude IRA principal as some states do for Medicaid eligibility purposes).

All said, from what you have described of your circumstances, there should be a way to obtain an award for at least some of the assistance you need.

To learn more about this benefit directly from the VA, visit here http://www.vba.va.gov/bln/21/pension/

To obtain free assistance, or for local help, find a County Veteran Service Officer here:
http://nacvso.org/modules.php?name=Content&pa=showpage&pid=10

Caveat: Because of my recent witness to several instances of what I can only describe as financial elder abuse, I am compelled to warn you to be wary of the profligate "we help vets for free" firms that are actually financial service companies, typically insurance brokers, looking to sell high commission annuities. My experience has been that most of these firms are woefully inexperienced in coordinating VA benefits with other public benefit programs and as a result future access to Medicaid may be seriously compromised. If you are going to seek assistance from other than a public source, better to pay a reasonable fee than to be pressured, or worst yet, deceived into the purchase of an unsuitable financial product.
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Hi there,
I read Ralph Robbins CFP post of 10/6/10 regarding Eligibility and qualification for the VA Aid and Attendance Improved Pension. He noted that "In fact, the VA will permit household member's and/or other family member's compensation for care as a deductible expense. Evidence must be shown that compensation is indeed being made and that services are indeed being provided (a contract and canceled checks, for instance)."

I wondered, can these same kinds of unreimbursed expenses from caregivers OTHER than family be deductible and considered to lower the veteran's threshhold? My dad would qualify in every other way but he earns about $2,020 in SS and a small pension per month, but his caregiver bills (non medical assistance with cooking meals, cleaning, bathing, dressing, errands, transportation, adult diaper changes, basically all ADLs etc. as he cannot walk) total at least $500 per month, sometimes $600....

Any word on whether the household income limit might be raised in 2011?

Many thanks.
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All of the expenses you mentioned are deductible from gross income to arrive at Net Income for VA Purposes (IVAP).

Caregivers can be professional (from an agency or private hire) or non-professional (family/friend).

Your father should have no problem qualifying for an award with a properly executed application.

There are no financial benefit/requirement changes on the horizon at this time for 2011.
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Thank you!
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My father is 100% disabled vietnam vet with service connected benefits monthly. I don't receive a check per month, but he has paid my rent from his bank account for the past six months since I've been here helping him, which includes bathing, bathing, taking him to his doctor appointments, feeding, etc. Would we qualify for the additional compensation based on that? Would they consider his payment of my rent the same as paying me directly (and then I in turn would pay my rent)? Secondly, what expenses besides medical are included in the deductions from his gross amount. For example, his vehicle has a monthly payment, would that be deducted? Utilities? Cellphone? Thanks in advance for your response!
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Can you tell me::Is there a Va Benefit to help with Independent Senior Communities..So many times Veteran seniors have their own apartment but need assistance with medical needs and funds to help reduce their rent..
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In fact, the VA will permit household member's and/or other family member's compensation for care as a deductible expense. Evidence must be shown that compensation is indeed being made and that services are indeed being provided (a contract and canceled checks, for instance).
I do not have proof of compensation. Can I still apply for my father.
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nswingle:
With respect to VA Aid and Attendance Improved Pension benefits and Independent Living Facilities the following holds true:

There are two criteria to qualify for benefits: medical and financial. To meet the medical criteria, broadly speaking, the eligible veteran or surviving spouse must demonstrate that he/she requires the "....regular, ongoing, daily assistance of another person to safely navigate the hazards of their daily environment.".

To meet financial criteria, the VA will permit "unreimbursed medical expenses" to be deducted from gross income to determine Income for VA Purposes (IVAP) upon which an award may be granted.

This being the case, and since independent living facilities by definition do not provide the assistance noted above, the rent paid to such facilities is generally NOT considered a deductible expense.

That being said, however, there are circumstances where the resident of an independent living facility WILL qualify.

For example, independent living facilities generally provide transportation, housekeeping, meal preparation, and laundry services. These may be considered as necessary to assist the veteran or surviving spouse with safely navigating the hazards of their daily environment (Would the claimant be considered "housebound" and unable to make necessary physician visits without transportation? Is the claimant able to provide adequate nutrition for themselves sans the community's services? Would the apartment be safe and sanitary without housekeeping and laundry services?). Whether or not some or a portion of the rent would then be deductible will be predicated on medical evidence provided by the claimants physician. Some such claims are successful. Careful documentation and evidence must be submitted; a proper narrative accompanying the application will also be helpful.

Another situation where benefits may be awarded in an independent facility is when the claimant's other unreimbursed medical expenses bring income below the pension amount. Remember there are three levels to pension. The lowest level, "Basic" provides a relatively modest threshold for qualification (the award is also relatively modest) and the claimants existing unreimbursed medical expenses may be sufficient to provide some benefit without the inclusion of the facility's rent. "Basic" pension is awarded based solely on financial criteria and no medical evidence for care is required.

Lastly, I have had claimants who receive home health care services in independent living facilities. Home health care expenses are a deductible expense and along with other unreimbursed medical expenses may bring IVAP to a level where an award will be granted.
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vietvetla:

A distinction must be made between "Compensation" and "Pension".

Compensation is awarded based on service connected injury, disability, or death.

Pension is a non-service connected benefit based on the financial and medical needs of an eligible veteran or surviving spouse. The claimant does not have to have been injured or disabled as a result of service.

Pension and Compensation cannot be received at the same time. If one benefit is determined to be higher than the other in a specific circumstance, the veteran will receive the higher benefit of the two.

The amount of Compensation is based on a disability rating (you indicated your father is rated 100%) and he should, therefore, be currently receiving the maximum benefit he qualifies for. He is free to do with the award what he will but he is not entitled to additional funds under this scheme to pay you to help him.

Pension is awarded based on income after deductible expenses (Income for VA Purposes or "IVAP"), asset, and medical criteria. Your assistance could be considered a deductible expense if proper evidence is shown. If his IVAP is then brought to zero ($0) per month as a result, he may be awarded the full Aid and Attendance Pension of $1,644 per month (for 2011). Is this higher than his current Compensation? If so, he may want to consider making application. If your father is over 80 years of age and has assets of over $20,000, though, you may want to seek advice before making application as it may very well be denied.

There is no income or asset criteria to receive or maintain Compensation.

You may also want to check with your local VA medical center and benefit section as to other benefits your father may be entitled to given is disability rating. In some cases housing assistance is available as well as some home health aide services and respite care at a VA or contracted nursing facility.
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I have friends that have both parents who most def. qualify as far as medical and Veteran Benefit critiria are concerned. The total income is under 3,500 combined and they own a home otherwise broke at this point. The father who is in I would say... stage 6 or 7 dementia took a turn for the worst, now in and out of hospital and nursing home. He seems to have nine lives. Mother is living at home with 24/7 care at this point, she's not yet hit crisis but is going down hill. In a panic/ crisis situation they were advised by an attorney to sell home so the Dad can go into NH and eventually place Mom in the NH as well. With all these VA benefits available to them why dosen't the attorney guide them in that direction? It seems to me the attorney is either unaware or does what is most convinent. Then what happens after their homes is sold and money is depleted and they are over income level for medicaid. He advised them that would be the next step after funds are spent down from their home.
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my mom is currently receiving A&A. she receives a partial award which is not enough to pay a caregiver. i have been caring for her for many years and she has not paid me for this as she is my mom and i just do my duty as her daughter. now after the fact, i have found out that she could have received full award if i had showed proof of caregiver contract and recurring monthly expenses for me caring for her. is it too late to claim these expenses once award is granted? can i start charging her and send in the recurring caregiver expenses for her to get maximum amount of pension or do i just let it remain as is and not muddy water.
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I am a viet nam veteran, I am 100% disabled, how can I reseive benifits for my caregiver who has been with me for over year? I have been paying her out of my pocket. Is their any assistant I can receive?
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i am a veteran of the Korean War served 1954 may to 1956 may. my question is my wife needs 24 hour care, i do cooking, cleaning, washing, shopping everything. Is there an agency for personal help, help in cleaning, shopping etc
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i take care of my ret. marine dad, hes 83, while he has disab. va pension, and medicare, etc. through the va, i heard that since he lives with me and i care for him i can get paid,, does anyone know who to contact, etc? im not his dependent, just a caring daughter, who makes sure hes ok, takes meds, drives him to appts. ect. my mom passed 15 yrs ago. its just me and him now. thank you for any help.

debby
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hi
there is a pension from va called aid and attendance that can be used to pay a caregiver. i receive it for my mom. please check out this website , it has all the information u need to reply. the website is veteranaid.org

wishing u all the best in getting aid for your loved ones and being able to use these funds to get paid for being caregivers. ps..u will have to pay taxes on this income once u are being paid as caregiver.
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I have been my fathers full time caregiver for roughly 2 years. He has chronic lung disease and is barely able to walk from room to room without shortness of breath and oxygen levels dropping. I am responsible for taking him to all doctor appointments, buying his groceries, paying his bill for him (along with me paying some myself) and various other things. His only income is Social Security Income, he doesn't receive veterans benefits, disability or any other form of income. I can't work for my own health issues right now in addition to taking care of dad. I know he is eligible for so much more and that I can receive compensation for his care...problem is, I don't know where to start. If anyone could point me in the right direction, it would be appreciated. I should also mention that I have PoA but most agencies will not recognize it because my father is able to think and make decision. He just can't get anywhere to fill out applications and no one seems to want me to do it...I also need to know if my husbands income will be equated?
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I HAVE APPILED FOR AID AN ATTENDANCE LAST YEAR IN APRIL HE GETS DISABILITY AN VA PENSION HIS CONDITION IS BAD AN HAS ALZHEIMERS AN CAN NOT DO NOTHING FOR HIS SELF, AN CAN NOT BE LEFT ALONG DAY OR NITE HAS PROSTATE CANCER , DIBETIC 11 HIGH BLOOB PRESSURE, ETC. WHY IS IT TAKING THEM SO LONG I AM JIS WIFE AN HAVE BEEN TAHING CARE OF HIM ALONG TIME AN NOW WENEED SOME MORE HELP, PLEASE TELL ME WHAT CAN WE DO.
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Reesh71....
The place to start is with your local Area Agency on Aging. Every county in the US has one though they sometimes go by different names. Do a search for and see what you come up with. These agencies are usually the "lead" agency for many services and will "triage" your father's situation and help him obtain everything he is eligible for.

If you are only interested in seeking VA benefits do a search for veteran and elderly services in your area. Every state has a Department of Veteran Services as do most counties or you can find a Veteran Service Officer who can help you by going here www.nacvso.org/

As far as the POA situation is concerned what you state makes no sense unless the document has what is known as a "springing" clause which means that the Power only becomes effective if dad is declared unable to handle his own affairs. If this is the case and he would rather it not be that means he currently has capacity and you should have a new POA drawn which gives you immediate power. Institutions are required by law to recognize valid durable powers of attorney.
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VPHighlyFavor....
Did you submit the application yourself or through an office?
Have you received any correspondence about the claim at all?'
Have you called the VA on the number on correspondence?
Its a pain but if you get through you may get some help.
Keep trying and good luck.
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I attempted to contact this program and indeed I was contacted by what sounded like a sales pitch. I think this program should be for the many elders who can't afford help, but I have friends who are applying for it and they are making a good income and could help mom. Tonio
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I'm sure that the monies paid to caregivers, be it family/friends or professional, will be reported by the VA to the IRS. My question is whether they send a statement of income annually to the caregiver for income tax purposes.
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I just moved to Reno to help care for my mom and dad. Dad is a world war two combat vet...my mom has Alzheimer's...what's available to us?
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rainydaydrummer...read the above carefully and see if you then have questions.
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