Aid & Attendance Handbook for Professionals & Consultants

I am passionate about long term care issues. This passion, in particular, spills over to my helping veterans deal with long term care because I am a veteran and because I am disabled myself and most importantly, thanks to the VA healthcare system, I am able to help other veterans become aware of their benefits.

My health was going downhill. Vital nerves in my body were gradually deteriorating which would have eventually resulted in an early death. The treatments I received from VA health care saved my life from this rare, wasting disorder. Private-sector doctors couldn't figure it out, but VA doctors did figure it out and stopped the disease process. Unfortunately they could do nothing about the residual nerve damage which has left me mostly disabled. Despite the physical limitations, this great gift from VA has allowed me to become actively involved in helping veterans and other folks in the community obtain needed government benefits.

Improved pension and death pension benefits -- more commonly known as the aid and attendance benefit -- are generally only available to veteran households or to surviving spouses of veterans who are incurring the high cost of long term care. Even though about a third of all seniors could qualify for this benefit; very few can actually receive it unless they can apply the provision to allow a reduction in income for the cost of long term care services. As a result, the pension benefit is generally linked with veterans receiving expensive home care, adult day services, assisted living services or nursing home services. With our assistance, and with the information from our new handbook, you can help more veterans qualify for this benefit.

I believe this 686-page aid and attendance reference and guide book which I have compiled and updated this year (2012) is the most complete publication of its kind available anywhere. This resource is intended for use by financial consultants, attorneys, care managers, home care companies and other professionals helping their veteran clients with long term care issues.

Table of Contents | Learn More | Purchase

Here are just a few of dozens of important issues discussed in this new book:

• important Medicaid planning strategies to dovetail with the veterans benefit
• step-by-step guide for handling claims
• extensive excerpts from M21-1MR in order to understand how VA processes claims
• accreditation for practitioners who are not attorneys

The following link provides more information on how this new reference and guide book will help your practice: veteranbook.com

Tom's Educational Background, Credentials and Certifications

• Accredited Claim's Agent with the Dept. of Veterans Affairs
• BA in physics and math, University of Utah, 1969
• USAF pilot training, Webb AFB, Texas, June 1969 to June 1970
• USAF Survival School, Fairchild AFB, Washington, July 1970
• USAF Pilot Instructor School, Tyndall AFB, Florida, August 1970 to November 1970
• MBA, University of Utah, 1983
• Series 6 Exam, 1985
• Series 7 Exam, 1990
• CLU, American College, 1992
• Series 65 Exam, Registered Investment Advisor, 1996
• Author of over 105 web published articles
• Author of 4 print published books
• Author of 6 print published training manuals and marketing booklets
• Editor - Study guide and manual for the VA accredited agent's exam.

A Brief History

After graduating from high school in 1962, I pursued a year of study at the University of Utah. The next 2 1/2 years were spent in the European country of Austria for my church where I learned to speak German and serve the Austrian people. I reenrolled at the University of Utah in studies with the Department of Physics in the spring of 1966. I graduated with a BA in physics and math in the winter of 1969. My sweetheart, Susan and I met and married in the spring of 1967.

During my college years, the Vietnam War was in full swing and knowing I would be called up, I decided to enlist in the Air Force ROTC program. I subsequently received a commission as a second lieutenant when I graduated from college. I spent the next year -- from June 1969 through June 1970 -- completing basic pilot training at Webb Air Force Base in west Texas. Additional advanced flight training was completed by November of 1970 and I was then assigned as an instructor pilot for T-38 advanced jet training at Moody Air Force Base in Georgia. I left the service as a captain with an honorable discharge in the winter of 1973 having completed a little over 4 1/2 years as a pilot in the Air Force.

The years from 1973 through 1985 were spent in a variety of business pursuits. In 1985, I joined a large insurance company as a registered representative and agent. One aspect or another of financial services has been my profession ever since. In 1997, I struck out on my own as an independent registered investment advisor and fee-based financial planner. Because I no longer had group health insurance for my family, I obtained individual insurance for them and I enrolled in the VA healthcare system. At that time VA was still taking priority 8 veterans into the health care system. As it turned out, enrolling in VA health care was one of the most important events in my life because it prolonged my life and allowed me to pursue the goal of helping other people with long term care issues.

During the intervening years I have not only been grateful for veterans health care, but I was able to use the VA loan guarantee for purchasing a home and the veterans educational benefit for completing an MBA at the University of Utah School of Business.

Tom's Experience with Long Term Care Planning

I started working with seniors and their children in 1994, primarily as a result of my and Susan's experience dealing with long term care for all four of our parents. I had an eager desire to help people prepare for the financial risks associated with retirement and in addition help those who were older plan for their final years. This message and mission often fell on deaf ears as most people refuse to deal with this type of risk planning.

I was able to find my targeted clientele by conducting planning seminars at local colleges. These were educational courses sponsored by the schools that resulted in a number of attendees requesting my help as well as the help of my teaching team which included me, an elder law attorney, a non-medical home care provider, a care manager and a reverse mortgage specialist.

As an RIA, I would typically charge a planning fee to help my clients with their retirement planning issues, but I focused the planning primarily on preparing for the final years of life which sometimes involved the purchase of long term care insurance. If there was an interest in long term care insurance, I would change hats and act as an agent -- selling one or more policies.

My increasing disability forced me to recognize that I needed to find another pursuit in life. One which did not involve seminars, driving or using my hands for typing or writing as these activities were becoming increasingly difficult.

A 30-year fascination with computers -- I bought my first of many personal computers in 1980 -- led to my launching a website in 2002 to help the public with long term care/eldercare issues. I devoted the next 4 years solely to researching and writing articles and books about long term care issues. More than 100 of these articles eventually found their way to my website. Over the years I have also been kept busy doing radio interviews and webinars. And I talk to many people every day all over the country -- both professionals in the eldercare field and individuals looking for help.

The website endeavor has evolved into a major business for me and Susan -- my wife and partner. The National Care Planning Council was launched in February of 2006 and currently has 7 full-time and part-time employees. To professionals in the community, we offer our books, our marketing package for veterans consultants and our state council marketing system. We also offer internet listing services to our 1,500 plus members on over 30 different websites. In addition, we manage and host over 95 websites for our veterans benefits consultants. We drive traffic to consultants' websites which results in about 6,000 visitors a month clicking through to these unique sites. This in turn generates approximately 40 to 60 lead requests a day that go directly to our veterans consultants.

Here are the current books I have written or co-written with the help of Dragon NaturallySpeaking voice recognition software. In addition, I have researched and written over 100 articles on all facets of long term care.

The 4 Steps of Long Term Care Planning	How to Apply for the Veterans Aid and Attendance Pension Benefit	Aid & Attendance Handbook for Professionals	How to Become a Veterans Benefits Consultant

Tom and Susan's Personal Experience with Long Term Care

I am passionate about long term care issues. I and my wife, Susan, (she took the brunt of it) went through it with all four of our parents--hers and mine. And at the tender age of 66, I'm confronting the reality of long term care for me. Because of our experience, the launch of the National Care Planning Council is our attempt to help other caregivers find information and help.

From 1989 to 1992, my mother attended to my father at home. He was flat on his back with Parkinson's Disease. He was as stiff as a board, couldn't move a muscle, could only whisper, had lost his vision and hearing and had dementia. Because his swallowing muscles barely worked, it took us 2 hours to feed him and because of dementia he called out day and night in a terrified whisper.

My mother chose to care for him at home because she hated nursing homes. She was in excellent health and planned to use their savings on herself when he was gone instead of spending the money on paid care. Besides this was back when Medicare offered forever home care as long as there was a medical need, so she had some help. His need was a catheter.

Despite the home care aides, the strain of caring for my father destroyed my mother's physical and emotional health. Against her wishes, I put him in a nursing home where he eventually died. After his death, I had her in and out of a mental institution and hospitals for over a year before she was stable enough to go to an independent retirement community where she could get supervision and meals. She suffered from some form of dementia or psychosis, which eventually got to a point where the facility couldn't care for her. We took her into our home in September of 1994.

Shortly after arriving, she fell and broke her hip and although she recovered, she made up her mind she couldn't walk. That made it easier to care for her with her abnormal mental state. We also received aides, therapists and nurses from Medicare because she had a bizarre fluctuating blood pressure that had to be monitored every day. She also came home with a pressure sore from her original hip surgery recovery in the hospital. They didn't take very good care of her during the two week stay in the hospital rehab wing. The sore eventually developed into an nasty ulcer that went so deep, it exposed her spine. We also received home health care for that.

In the Fall of 1997, Medicare changed the rules and cut off home care for chronic patients. We were contemplating a nursing home for Mom but she contracted pneumonia and died at home in December of 1997.

Susan's father suffered a stroke in March of 1998 which deprived him the use of his left arm and leg. He was taking care of Susan's mother at home but Medicare had changed its rules and would no longer provide home care help for chronic conditions, so he went to a nursing home on Medicaid. He died there in January of 2000. We took care of Susan's mother in our home for 2 1/2 years and she died in August of 2001.

I suffer from an immune demylinating neuropathy--called an anti-MAG neuropathy--which makes it difficult to walk and affects the use of my hands. What minute amount of illegible writing I do is executed very slowly with extreme difficulty, and what I do on the computer is with my unsteady left index finger and a specially modified mouse. None of my other fingers are steady enough to type. I use Dragon NaturallySpeaking voice recognition software which allows me to produce articles and books about eldercare and to communicate via email.

At the tender age of 66, I am already needing limited help with activities of daily living such as filling out forms, signing my name, feeding myself and dressing. I also experience an essential tremor in my hands and legs which causes my hands to flap around when I try to use them and makes my already weak legs very wobbly. Many people with neuropathy experience unbearable pain. I am so fortunate to have only mild, chronic, burning discomfort and limited peripheral numbness.

After treatment eight years ago, the condition stabilized and I actually improved a little, but I eventually relapsed. Even though I don't have cancer (it's more like a blood tumor), I started a new treatment four years ago, under VA doctors, using a lymphoma therapy called Rituxan. This eliminated most of the numbness in my hands and legs but worsened my ability to walk and use my hands. I had to stop the treatment but I still remain in remission.

I recently qualified for Medicare, but I have been with the Veterans Administration health care system since 1997 and far prefer that to the private sector. In fact I would like to make an aside and sound praise for the excellent care I receive at the local Salt Lake Veteran's Administration Medical Center. No one else was ever able to diagnose my condition. Not only did the VA diagnose it but they came up with a treatment--chemotherapy--that kicked the disorder in the pants, even resulting in some improvement. I cannot praise the doctors and staff enough. I have learned recently that the VA health care system is considered the best health care in America. I would certainly vouch for that.

I want you all to know that because of our experience, Susan and I are strong advocates of long term care insurance. We each bought a policy 15 years ago when I was still insurable. The cost was only $113 per month for both policies, but because I didn't know much about the insurance then, I made a poor choice and bought inadequate benefits. For only $30 more per month we could have bought an unlimited benefit at $100 per day instead of the $200,000 at $100 per day we signed up for. At least we were smart enough to buy the compound automatic yearly benefit increase so the original benefit has grown after 15 years to about $200 per day and about $420,000 total. We had a premium rate increase four years ago to $149 a month. This is still very affordable for the benefit and we would continue to buy the insurance even if it went to $400 a month.

Unfortunately, insurance is only a part of the long term care puzzle. Besides, not everyone can qualify for or afford insurance. A comprehensive care plan should be in place during retirement. It is foolish for people to ignore the possibility of needing long term care and not structure a plan for it.

Now a little about my background. First, as you can tell from the stuff I have written for this site, I am not a literary star. My strengths are research, analysis and organization. I have a BA in Physics and an MBA. I also have a professional CLU designation from the American College.

My interests are not mainstream and some of you might find unusual those things I find interesting. I spend countless enjoyable hours researching topics on the internet or in a library when someone can take me. I could spend a great deal of time reviewing financial statements or studying thousands of pages of regulations, not for assignment, but purely for an interest in learning more or picking up tidbits no one else knows about. I love museums, history, geography, statistics, foreign languages, music and technical studies.

We live in Centerville, Utah. We have a mormon-sized family of 7 children and 21 grandchildren. Six of our kids are married and five of them live close to us. The 7th is our youngest and she's currently working as a school psychologist in a school district about 50 miles away. Susan and I don't know the meaning of "empty nest" syndrome. With our family so close, at least one of our kids or grandkids comes by every day.

Because of Susan's and my experience with long term care, I started marketing long term care insurance 16 years ago. In conjunction with insurance sales, I taught retirement planning seminars at two local colleges and did fee-based financial planning. About 4 1/2 years ago I had to retire completely from any activities outside of my home office since it is so hard for me to get out and walk, use my hands or stand. Three years ago Susan took the car keys away from me because she didn't trust me driving anymore.

Currently I oversee our continually-growing list of 35 plus websites, talk to people about our marketing packages, write articles and books and entertain phone calls from people requesting help from all over the country and sometimes even from overseas. I also supervise promotional strategies for the National Care Planning Council and for the Utah Eldercare Planning Council. In addition, I help train those individuals or companies who buy our marketing systems. I also do interviews for radio programs and for journalists writing articles about the eldercare issues.