Government Program Pays Family Members for Taking Care of Mom and Dad

May 20, 2009 - By the NCPC

Looking for a way to help Mom and Dad pay for Home care or assisted living? Perhaps you are their caregiver. Wouldn't it be nice to receive some extra income to help you provide their care? There is financial help available for senior veterans and their spouses.

For veterans who served during a time of war or for their surviving spouses, veterans benefits such as the Veterans Aid & Attendance Pension will pay additional income to cover long term care costs. The great news about this program is that VA will allow veterans' households to include the annual cost of paying any person such as family members, friends or hired help for care when calculating the Pension benefit.

Pension can provide an additional monthly income of up to $2,085 a month for a couple, $1,759 a month for a single veteran or $1,130 a month for a single surviving spouse of a veteran. This money can be used to help pay the cost of home care, adult day services, assisted living or nursing home services.

In order to reduce income to meet the income test for pension, a rating for "aid and attendance" or "housebound" is crucial. Not only does the rating significantly increase the benefit amount but without a rating, room and board costs for assisted living are not deductible for purposes of reducing income. Only the much smaller assisted living medical costs are deductible.

For home care, non-medical costs are only deductible if the in-home attendant is licensed for healthcare in that state or if there is a rating. Since the non-medical costs for home care represent the bulk of all costs for long-term care at home, without a rating, those households with a non-licensed attendant would not qualify for the benefit. Examples of medical or nursing services at home would be help with activities of daily living such as dressing, bathing, toileting, ambulating, feeding, diapering and so on. Other services might include medication reminders or supervision necessary to provide a protective environment for the care recipient -- in the case of dementia or Alzheimer's.

A rating for aid and attendance is automatic if someone is a patient in a nursing home or that person is blind or so nearly blind as to need assistance.

It is our understanding that a non-licensed in-home attendant could be just about anyone receiving pay for providing services. This might be members of the family, friends, or someone hired to live in the home. Unfortunately, a spouse cannot be included in this list for reimbursable caregivers.

For a disabled person who has been rated, a family member will be considered an in-home attendant, but that family member has to be paid for services duly rendered. There is potential for fraud here where a family member may move into the home and ostensibly receive payment as a caregiver but not actually provide the level of care paid for. Documentation for this care must be provided to VA, and it is reasonable for VA to question whether the services being purchased from a family member living in the household are legitimate. Such arrangements should be extensively documented and completely arm's-length.

The care arrangements and payment for home care must be made prior to application and there must be evidence that this care is needed on an ongoing and regular basis. We recommend a formal care contract and monthly invoice billing for services. Money must exchange hands and there must be evidence of this. All of this documentation must be provided as proof to VA when making application for the pension benefit. Costs for these services must be unreimbursed; meaning these costs are not paid by insurance, by contributions from the family or from other sources. Even though the family member being paid for services cannot reimburse the veteran household directly,the family may pay the bills for the veteran household. This indirect form of support is allowed.

There is an application form to be submitted, along with a doctor's report form, documentation of medical expenses and payment of home care services or facility fees. Other documentation includes original discharge papers, marriage records if applicable and a death certificate where applicable. An inventory of all sources of household income and all household cash equivalent assets is also required. Providing complete documentation with the initial application will expedite a rating and approval for pension payment.

For those who want to do it themselves, the National Care Planning Council provides help in their book “How to Apply for the Veterans Aid & Attendance Pension Benefit.”https://www.longtermcarelink.net/a16veterans_books.htm

This book provides, in detail, a description of application for the Pension Benefit and what information and documentation other than the application form should be submitted. All necessary forms are included in the book such as the application form and forms for medical expenses and other costs.

ElderLawAnswers.com review of this book states; “This is the book to get if you want an in-depth understanding of how veterans' benefits work, what options are available and how to apply. https://www.elderlawanswers.com/resources/article.asp?id=6209&section=5&state 

One purchaser of the “How to Apply” book emailed his successful experience.  

 “I purchased " How to Apply for the Veterans Aid & Attendance Benefit" earlier this year, and I wanted to let you know how much of a blessing this book was. 

I followed the instructions exactly as stated in the book.  I used the forms provided (Forms 1-4).  I made copies of everything.  I submitted my dad's application on March 31, 2009.  I received a response TODAY, May 2, 2009, that approves my father's application, and he will be receiving a substantial amount in benefits monthly, beginning April 1st.  

In addition, the VA sent additional forms for me to submit stating that my dad may be eligible to receive additional benefits for medical expenses incurred from March 31, 2008 to March 31, 2009. 

In essence, I had to submit no additional documentation, just the documentation you suggested in your book.  I was approved in one month's time.  NO DELAYS!!! 

Thank you for your wonderful book!  I needed no consultants, no attorneys, no one and nothing but the advice contained within your book.  I highly recommend this book to EVERYONE who is seeking to apply for this valuable benefit.”  

To read more about the book and purchase your copy of the “How to Apply for the Veterans Aid & Attendance Pension Benefit” go to https://www.longtermcarelink.net/a16veterans_books.htm

Veterans Benefits Consultant

A veterans benefits consultant is an individual who helps veterans understand long term care benefits available through VA. This can include information on veterans health care, state veterans homes and veterans disability income benefits. Consultants place particular emphasis on Pension and Death Pension because these benefits are typically more useful for the elderly needing long term care. Pension is also known as "the aid and attendance benefit." Being a consultant is not a formal title but is merely a description of this person's function.

Consultants provide information about the aid and attendance benefit including what it is, who can qualify and what information and documentation are necessary in order to file a claim. A consultant does not participate in any way in the application process unless that consultant is an accredited attorney representing his or her client in proceedings before VA. Consultants who are accredited veterans service organization representatives can also assist claimants with the filing of a claim. For all other consultations, veteran households seeking help with filing a claim are directed to an appropriate veterans service organization or to a state or county veterans service officer or, where appropriate, they are encouraged to file a claim on their own.

Some consultants also help potential claimants realign their assets and complete important estate planning documents prior to making application.

Veterans Benefits Consultants are private practitioners or in some cases representatives of veterans service organizations and are not connected with the Department of Veterans Affairs. To find a consultant in your area go to https://www.longtermcarelink.net/ref_veterans_consultants.htm