“It’s Complicated,” is the title to a movie starring Meryl Streep and that guy that imitates Donald Trump. It is also an apt description of VA benefits. There are two main types of VA benefits to look at, when considering income for purposes of paying for assisted living: Service Connected Disability and Improved Pension Plan aka Aid and Attendance.
Service Connected Disability applies to service persons who were injured during the course of their service in the United States military and certain survivors. To be eligible for this benefit, the service person must have been injured while on active duty, or exposed to something like Agent Orange that affected them adversely in ways that may not show up until long aft er discharge.
Service connected disability is calculated in percentages of disability. The higher the percentage, the greater the income. Income is also set by the rank the veteran had while in service. Income is not affected by the assets of the veteran or family survivor.
The other type of VA benefit is through the Improved Pension Plan, commonly known as Aid and Attendance Benefits. Actually, Aid and Attendance is the highest level of benefits paid through the Improved Pension Plan. Basic pension benefits apply to qualifying veterans and some survivors, who can still get in and out of the home themselves. Homebound benefits apply to qualified veterans and some survivors who, obviously enough, are homebound. Aid and Attendance benefits apply to qualified veterans and some survivors who need help to get through their daily lives. Typically, this applies at assisted living facilities, although it can apply at independent living centers and even at home under certain circumstances.
Pension plan benefits require several factors to be met. First, the veteran must have had at least 90 days of active duty, at least one of which was during a time of war, at least up until the Gulf wars. Gulf War veterans must have at least two years of active duty to qualify for the benefit.
Second, the veteran has to have limited income. The maximum benefit amount for one veteran is $25,525, as of Dec. 1, 2016. Every dollar the veteran and household family earn, counts against that amount and reduces the benefit dollar for dollar. However, if the expenses are qualified expenses, like the cost of assisted living, the qualified expenses reduce the income that is counted against the benefit dollar for dollar. Because this is remarkably unclear; if a veteran had income of $25,525 a year and no qualified expenses, the veteran might qualify in terms of service and resources, but get no benefit because the veteran’s income matched the benefit. If the same veteran had $30,000 in assisted living expenses, the veteran would get the entire benefit of $25,525.
Resources are the final category of eligibility. The current limit on resources is unknown. The VA regulation states that resources should be reasonable under the circumstances. There is a proposed regulation, that would limit resources to $119,220. That regulation has been in circulation for a while, and rumor is it will go into effect sometime early in 2017. President- elect Trump has proposed rather sweeping changes to VA benefits. It may well be that if the proposed regulation goes into effect, it will be effective for only a limited period of time.
Should you, the attorney, decide to assist a client in obtaining VA benefits, you should be aware of several other important things. First, you should be accredited by the VA to practice before the VA. That requires specific education in several areas and an update of your education every two years. Second, you may not be paid to help with the application for benefits, unless it is already been denied at the first level. Lawyers typically provide other legal services and throw in assistance with the application “for free” to get around this requirement.
Finally, many attorneys put in an informal application to achieve an early start point for benefits if they are approved. Given that the review process for these informal applications averages seven to nine months, I believe an informal application is a bad idea. I prefer to put in the effort to get all information necessary and put in a formal application, where processing times are much shorter. Be careful. If an application is rejected, there is a one-year waiting period for a new application. Karl Warden