|
Read Part One Here >>>
Read Part Two Here >>>
Are there any other reporting requirements?
VA requires that any change in income or assets
be reported immediately. The award is calculated for 12 months in
advance, but at the beginning of each calendar year, a formal
report called an EVR (Eligibility Verification Report) must be
filed detailing all income, assets and unreimbursed medical
expenses for the coming calendar year. For example if the award is
granted in April for 12 months in advance, an EVR must be
submitted in January of the next year that could affect the award
amount for the remaining four months of the initial 12 month
period. The EVR will be used for determining benefits for the
calendar year on which it is based.
What is a veteran’s federal fiduciary, and
does that affect the Aid & Attendance application?
|
VA can appoint a number of different types of
fiduciaries to manage the funds on behalf of an incompetent
veteran. A federal fiduciary is typically an individual such as
the spouse or a child whom the VA is most likely to appoint. If VA
is not notified with the application that the veteran may be
incompetent and that a fiduciary appointment is requested, this
could slow down the application and approval process.
Will the pension benefit pay a non-licensed
homecare provider?
|
VA does not pay providers directly but provides
extra income to make up for the cost of licensed medical care.
Medical conditions or injuries or diseases that require a need for
ongoing licensed homecare will allow the applicant to reduce
household income by the cost of homecare making it possible to
receive the additional income from a pension award. If the
beneficiary has an aid and attendance or housebound allowance, VA
will allow deductions for non-licensed providers as well.
Will the pension benefit pay a member of the
family to provide care at home?
|
As explained above, VA will not pay providers
directly but only indirectly through extra income. If the
beneficiary receiving care in the home has received a rating for
aid and attendance or housebound, VA will allow expenses paid to a
family member for care to be counted as unreimbursed medical
expenses to qualify for the benefit. The care arrangement must be
legitimate and appropriate evidence must be provided.
Does the pension benefit pay the costs of a
nursing home?
|
The application form has provision for
indicating residency in a nursing home and whether or not the
applicant is eligible for Medicaid. VA will automatically apply
the monthly cost of the nursing home in determining the pension
benefit. If the applicant is single with no dependent children at
home and is eligible for Medicaid, VA is required to stop any
payment of full benefits and only provide the veteran with $90 a
month.
Does the pension benefit pay the costs of
assisted living?
|
As explained above, VA will not pay providers
directly but only indirectly through extra income. If the
beneficiary receiving care in assisted living has received a
rating for aid and attendance or housebound, VA will allow
expenses paid to assisted living for aid and attendance or
housebound ratings -- including room and board -- to be counted as
unreimbursed medical expenses. The cost of assisted living being
used as a retirement residence is not considered a medical
expense. It does not warrant a rating and cannot be deducted.
What are the requirements to receive a death
pension benefit?
|
The applicant must be a surviving spouse or a
dependent child of an eligible veteran. VA form 21-534 is used to
apply for death pension, death compensation, accrued benefits, or
dependency and indemnity compensation (DIC). The surviving spouse
must be single. A surviving spouse of any age is eligible as long
as the deceased veteran served at least 90 days during a period of
war. They had to be married at least a year prior to death or have
a child as a result of the marriage. There is no requirement for
total disability for the surviving spouse nor for the deceased
veteran to have been totally disabled or older than age 65.
How does one prove that unreimbursed medical
expenses will recur every month?
|
VA has specific rules for proving future
recurring medical expenses. Information in our book outlines the
type of paperwork that must be submitted for each type of long
term care service. The book also contains appropriate forms for
this purpose. Neither the claims form nor information from the
regional office provides any guidance on the rules for proving
future recurring medical expenses for home care or assisted
living. One simply has to know how to do it. This one crucial step
often makes the difference between a successful claim and a
denial.
What if the veteran or spouse is currently
receiving Medicaid?
|
Our interpretation of the rules leads us to believe that VA will
not consider Medicaid payments as income. However, Medicaid will
consider the non-allowance portion of the pension to be income.
This could affect Medicaid eligibility in income test states.
There is evidence that some income test states count the entire
pension benefit including the allowance as income. According to
federal Medicaid rules this should not happen.
What happens when the veteran or spouse wants
to receive pension & Medicaid together?
|
Federal law requires that a single veteran
receiving Medicaid with no spouse or dependent children can
receive no more than $90 a month from VA. Veterans in state
veterans homes are exempt from this requirement. The veteran with
a spouse can receive the benefit to help defray the costs of a
nursing home. As a general rule, the pension benefit would
probably not work if Medicaid were paying the bill. But the
benefit does work well for non-Medicaid nursing home beds and
while the recipient is going through the Medicaid spend down.
This article is an excerpt from the book --
"VETERANS AID AND ATTENDANCE BENEFIT -- LONG TERM CARE BENEFITS
FOR VETERANS" -- published by the National Care Planning Council
and written and edited by Thomas Day, Council Director. This
first-of-its-kind book is available in two editions -- the
Standard Edition (209 pages) for the general public and the
Professional Edition (443 pages) to be used as a handbook for
advisors and care providers. Both books contain the necessary
information and forms to complete an application for the
benefit. The Professional Edition also includes citations from
rules and regulations, hypothetical planning cases, asset
reduction strategies and a software CD with benefit estimate
software, all applicable forms and planning sheets. To review
and purchase the book go to http://www.longtermcarelink.net/a16veterans_books.htm
or type in your browser window www.veteranbook.com.
Thomas Day specializes in the area of long term care planning.
As director of the National Care Planning Council and chief
spokesman for the Utah Elder Care Planning Council he maintains
a busy schedule giving advice to concerned caregiving families
and conducting radio and reporter interviews. He is also
responsible for maintaining several Internet sites one of which,
http://www.longtermcarelink.net is a frequently visited and
popular site for long term care issues. The site currently is
receiving the equivalent of 6 million hits a year. Tom is also
busy writing articles and has completed three new books on long
term care planning published by the National Care Planning
Council.
Tom graduated from the University of Utah with a BA in physics
and math and an MBA in finance. He holds a CLU designation from
the American College. Tom and his wife Susan live in
Centerville, Utah. They have seven children and 17
grandchildren.
Please contact Tom at 800-989-8137 or tomday@longtermcarelink.net
|
