GUIDE & TOOL KIT. Veterans Affairs Aid & Attendance and Housebound Benefit Programs

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1 GUIDE & TOOL KIT Veterans Affairs Aid & Attendance and Housebound Benefit Programs

2 OVERVIEW The U.S. Office of Veterans Affairs (VA) offers a variety of programs and services for veterans and their surviving spouses. Information on all of these benefits is available at While the range of benefits includes everything from home loans to life insurance, this ALFA Toolkit provides information on the Aid & Attendance (A&A) and Housebound Benefit programs. Veterans and spouses may be eligible for these needsbased benefits when a beneficiary requires assistance with activities of daily living, such as help with dressing, bathing, eating, preparing meals, etc. These benefits may not be paid with or without a beneficiary s eligibility for pension. Eligibility for A&A or Housebound benefits can be established using VA Form In 2010, the Office of Veterans Affairs simplified Form to ease the burden of applying for benefits. The form was cut from 23 pages to 10. ELIGIBILITY REQUIREMENTS Pension is a benefit paid to wartime veterans or surviving spouses who meet certain income requirements, who are age 65 or older or, if under 65, are permanently and totally disabled. Un-remarried surviving spouses or un-married children of deceased wartime veteran are also eligible. Veterans or surviving spouses who are more seriously disabled may qualify for A&A or Housebound benefits, monetary benefits that are paid with or without pension benefits. Beneficiaries may use payments toward the cost of senior living expenses. The dollar amount of the benefit is the difference between the beneficiary s net income and the Aid & Attendance threshold, which is adjusted annually. The A&A benefit is available for eligible veterans and their spouses who require the aid of another person to perform personal functions required in everyday living, such as bathing, feeding, dressing, attending to the wants of nature, adjusting prosthetic devices, or protecting themselves from the hazards of their daily environment. It is also available to veterans (or spouses) who are bedridden, who are patients in nursing homes, or are blind or nearly blind. The Housebound benefit is available for eligible veterans and their spouses. The benefit amount is less than the A&A benefit, but is available for qualifying veterans and spouses who reside in assisted living or their own home. The Housebound Quick Reference U.S. Department of Veterans Affairs 810 Vermont Ave. NW Washington, DC / General information about VA benefits: Frequently asked questions: All VA Forms: VONAPP (Veterans On Line Application) for completing forms online and checking claims status: 2 ALFA GUIDE AND TOOL KIT: VETERANS AFFAIRS A & A BENEFIT

3 benefit is granted when a beneficiary has a single permanent disability rated 100 percent disabling and has other disabilities independently rated at 60 percent or more, or is permanently housebound because of his/her disabilities. Medical evidence is required for the benefit. Note that a veteran/spouse cannot receive both A&A and Housebound benefits at the same time. There is no set limit on how much net worth a veteran, a surviving spouse, and his or her children can have in order to qualify for benefits, but net worth cannot be excessive. The decision as to whether a claimant s net worth is excessive depends on the facts of each individual case. All net worth should be reported, and VA will determine if a claimant s assets are sufficiently large that the claimant could live off these assets for a reasonable period of time. VA s needs-based programs are not intended to protect substantial assets or build up an estate for the benefit of heirs. Note that net worth refers to the value of the assets of the veteran or the surviving spouse and his or her children. It includes such assets as bank accounts, stocks, bonds, mutual funds, and any property other than the surviving spouse s residence and a reasonable lot area. Clearly, a number of criteria may affect a person s eligibility for benefits. The VA encourages individuals who are unsure whether they qualify to file an application, particularly if their countable income (includes earnings, disability and retirement payments, interest and dividends, and net income from farming or business) appears to be near the maximum. If the VA determines a potential beneficiary does not quality, he or she may reapply if he/she has un-reimbursed medical expenses during the 12-month period after VA receives the claim that bring the countable income below the yearly income limit. (These are expenses the potential beneficiary has paid for medical services or products for which he or she will not be reimbursed by Medicare or private medical insurance.) The A&A benefit is available for eligible veterans and their spouses who require the aid of another person to perform personal functions required in everyday living. HOW TO APPLY FOR AID AND ATTENDANCE AND HOUSEBOUND BENEFITS To apply for benefits, individuals must complete VA Form and include copies of evidence validating the need for A&A or Housebound-type care. (Note that VA Form b should be completed by veterans seeking increased benefits for conditions already determined by VA to be related to the veteran s military service. The new form more clearly describes the information needed to support claims for increased benefits.) For current senior living residents seeking benefits, ALFA advises the resident and/or family members to sit down with a qualified staff member at the senior living residence to complete the form and gather documentation. You can ask VA for help completing the form by contacting a regional office or call center. Complete the form online: The VONAPP (Veterans On Line Application) website at enables service members, veterans and their beneficiaries, and other designated individuals to apply for benefits online. When you use this site to complete and send an application to the VA, the application will be sent directly to the VA office with jurisdiction over the application. Processing will begin and you will receive an automated response from the VA office letting you know that your application has been received. Or, mail the completed form: If you prefer to send the form through the mail, ALFA GUIDE AND TOOL KIT: VETERANS AFFAIRS A & A BENEFIT 3

4 completed forms should be sent to the VA regional office with jurisdiction over the applicant s claim, which is the same office where the applicant filed for pension benefits. If the regional office of jurisdiction is not known or if the applicant has not applied for pension benefits, file the request with any VA regional office. To complete the form, have the following documents on hand: n Driver s license n Emergency contact information n Voided blank check from the resident s checking account for direct deposit of benefits n Documents indicating dates of and types of service The following documents, where relevant, should be included with the claim: n DD 214 or its equivalent (certificate of release or discharge from active duty) n Prior divorce decree or death certificate if applying for benefits and the veteran has a new spouse n Senior living and physician assessments, including details on what the individual is able to do during a typical day. The report should be in sufficient detail to determine whether there is disease or injury producing physical or mental impairment, loss of coordination, or conditions affecting the ability to dress and undress, to feed oneself, to attend to sanitary needs, and to keep oneself ordinarily clean and presentable. VA Form AT-A-GLANCE Part I: General Information Q1 What are you applying for? Check the box next to pension. Q2 Have you previously applied for any VA benefits? Check only if you have pension, compensation, or other VA benefit Q3-9 Includes basic information about veteran s and spouse s names, mailing address, phone numbers, place and date of birth, and gender Q10A Have you ever filed a claim from the Office of Workers Compensation Programs? If the answer is yes, answer Q10B-C regarding the claim. Part II: Nature and History of Service-Related Disability Q11-18 These questions cover service-related disability. You only complete this information if the veteran is applying for service-connected disabilities. Part III: Active Duty Service Information Q19A-E Date and place the veteran entered the service, service number, date and place last served, branch of service, and rank. 4 ALFA GUIDE AND TOOL KIT: VETERANS AFFAIRS A & A BENEFIT

5 OTHER BENEFITS Other benefits are available to veterans and/or surviving spouses and their dependents, including the following: Medications: Free medications are available for Housebound and A&A beneficiaries. VA will furnish each beneficiary with an allowance for drugs and medicines prescribed by a physician. Respite Care: For A&A beneficiaries, the VA can provide limited institutional respite care to aid family caregivers. A cost may be assessed, depending on the situation. Home- and Community-based Primary Care: This is primary health-care delivered by an interdisciplinary team of VA Staff to homebound veterans. Services may include medical and nursing care, patient education, rehabilitation, nutritional counseling, medication review, social work intervention, and spiritual counseling. Hearing and Eyeglasses: Both hearing aids and eyeglasses are available free of charge to A&A and Housebound beneficiaries. Part IV: Reserve and National Guard Service Information Q20-22 Like the active duty information, this section asks for details on Reserve and National Guard service if applicable to the applicant. Part V: Military Retired/Severance Pay Q23A-26 Check yes only if the applicant is currently receiving military retired pay. Unless the applicant checks Q25 ( No, I do not want VA compensation in lieu of military retired pay ), the applicant is indicating he/she is choosing to receive VA compensation instead of the military retired pay. Most likely, the senior living resident is not currently receiving military retired pay and would check no in Q23A. Part VI: Marital and Dependency Information Q27-29 Report current and past marital status here Q30-31 Report details on dependent children, including names, ages, and disabilities Other benefits are available to veterans and/ or their surviving spouses and dependents, including medications, respite care, and more. Part VII: Non-Service Connected Pension Q32-33 Medical evidence of disabilities is needed for individuals who are housebound or require the regular assistance of another person if applying for Aid & Attendance or Housebound benefits. Check yes to Q33 if applying for Aid & Attendance benefit. Provide additional Q34A-E information in Q45-Remarks. These questions are only for individuals residing in skilled nursing homes. ALFA GUIDE AND TOOL KIT: VETERANS AFFAIRS A & A BENEFIT 5

6 Part VIII: Income Information Q35-36 Provide information on income expected to be received for the veteran, spouse, and dependent children. Report the total income before taxes, insurance, etc. Part IX: Net Worth Q37A-F This section must be completed with the net worth of the applicant and his/her dependents (such as spouse). Net worth includes all assets except the house you live in and personal items such car, clothing, and furniture. Be sure to have details available on bank account, IRAs, stocks, bonds, mutual funds, etc., of the veteran, spouse, and dependent children. A number of criteria may affect a person s eligibility for benefits. The VA encourages individuals who are unsure whether they qualify to file an application. Part X: Medical, Legal, or Other Expenses Q38A-E Describe all medical and legal expenses here. Do not include expenses for which you were reimbursed. If more space is needed, use Q45. Part XI: Direct Deposit Q39-41 Provide information for benefits to be deposited directly to applicant s financial institution. Attach a voided personal check from the applicant. Part XII: Certification, Authorization, and Signature Q42-44 Certify and authorize the release of the information in the application. Part XIII: Remarks Q45 Use this space to provide any additional information/statements related to the claim, such as additional details on applicant s need for assistance with activities of daily living. 6 ALFA GUIDE AND TOOL KIT: VETERANS AFFAIRS A & A BENEFIT