There is a tremendous amount of misinformation circulated about this program both from uninformed Veterans Groups, Financial Planners, Insurance Agents and Attorneys; as well as the employees at the Veterans Administration itself. This is intended to help dispel some of the more common myths.The VA is comprised of two divisions. They are: Medical and Benefits. Both fall under “The Law”; Title 38 § U.S.C. and the regulations Title 38 CFR’s. Title 38 USC in Part II, Chapter 15; pertain to the Non-Service Connected Disability Pension Program. The Adjudication Procedures Manual and VA Fast Letters provide guidelines and procedures on how to handle the law. We will use all of these to dispel a few of the more common myths that surround the Veterans Pension
If you here something from someone that is putting themselves out as an expert. Ask that person to show you the law, if they can't support what they are saying then it is probably not true. Ask your questions here our VA Accredited Claims Agent will give you an accurate answer.
Myth 3: The need for medication management is a trigger for benefits.
Myth Dispelled: The VA uses Fast Letters to clarify VA policy, on October 26, 2012 a fast letter was released, it stated that medication management is not an Unreimbursed Medical Expense (UME). This same fast letter further clarified that the VA does not consider emergency pull cords, 24-hour staffing, and locked exterior doors as a medical or nursing service. see 38 C.F.R. § 4.124a note 3.Myth 4: To receive benefits, the veteran must be living in a nursing home or assisted living.Myth Dispelled: False, home health care, as in a paid family member caregiver, other than a spouse qualifies as an UME. Note: The cost of care must exceed the income to qualify for the full A&A benefit.Myth 5: If the veteran is receiving VA compensation (disability benefits) they cannot receive A&A.Myth Dispelled: False, on several levels. The claimant can receive the greater of the two benefits either compensation or pension, not both. Example: A married veteran with a 30% compensation rating is receiving a little over $400 per month, if qualified for A&A would receive over $2,000 per month. So they would lose the $400 and gain the $2,000 benefit amount. Veterans with a full 100% rating can receive an additional benefit called Special Monthly Compensation, which is triggered like A&A.Myth 6: If the veteran dies before the claim for the A&A claim is approved the claim ends with no benefit payments.Myth Dispelled: False, the claim does end however the surviving spouse can apply for accrued benefits. Others can also request reimbursement for certain final expenses, ie, burial, hospital medical expenses.Myth 7: It is illegal to transfer assets in order to qualify.Myth Dispelled: False, under current law, a veteran or surviving spouse can transfer assets by gifting or transferring to a properly written trust or other legal instruments. The gift must be a complete gift and it cannot be someone in their own household (exceptions apply). Please beware that gifting comes with its own unique problems and should not be done without careful planning, consult a competent advisor.
Myth 2:The home of a claimant is an exempt asset.
Myth Dispelled: Yes, the home is exempt. However, this is much more complex than it would seem on the surface, a simple yes would be less than accurate. It requires further investigation like;
Did the claimant reside in the home at the time of claim? What happens to the home exemption if the home is later sold, are the proceeds considered a countable asset at that time?Supposedly, The Veterans Administration Office of General Counsel has indicated that the home remains exempt even after the claimants move from their home, and have asked to be notified when not handled in this manner. Yet, under the Code of Federal Regulations; 38 CFR § 36.4501 Definitions. Home means a “place of residence”. If the claimant moves from the home to an assisted living community, making the ALC the primary resident, is the home still exempt? The VA is consistently inconsistent in this area leaving questions in its wake on how to proceed without problems.Solution: Transfer the home ownership prior to applying for benefits. This can be done in one of three methods. These should be discussed with your attorney.
Improved Pension with Aid and Attendance
Myth 1: A single veteran can have $50,000 and married couple can have $80,000 in total net worth.
Myth Dispelled: There is NO mention in the law that a single veteran can have $50,000 nor is there any mention of a married couple having $80,000. The law doesn't’ distinguish between married and single. The law, under Title 38 § U.S.C. Part II Chapter 15 Section 1522, statute (a); states, “The Secretary shall deny or discontinue the payment of Pension... it is reasonable that some part of the corpus of such estates be consumed for the veteran's maintenance.” This is vague at best. The CFR’s, the Code of Federal Regulations are regulations written to clarify the law. Under 38 CFR § 3.272 -§ 3.275 only states that “in determining net worth amount, consideration will be given to the amount of the claimant’s income together with the following: Whether the property can be readily converted into cash at no substantial sacrifice; life expectancy.” Again, not one reference to the $50,000 or $80,000.Then, there is the M21-1MR Compensation and Pension Manual, this is the Adjudication Procedures for both Compensation and Pension, this is the manual used by the VA when reviewing a claim.
M21-1MR, Part V, Subpart (i) Chapter 3, Section A (b-c): Developing for Net Worth.
(b) Review of Net Worth Information: Review the net worth information provided on the application to determine if it is reasonable for the claimant to consume some of his/her estate for maintenance. A net worth administrative decision should be made if it is determined that the claimant’s net worth should be used for maintenance.
(c) Requirement of Net Worth Administrative Decision: A formal net worth administrative decision must be completed if the claimant has an estate of at least $80,000, and it has been determined that net worth is not a bar to entitlement.
Note: Always consider a claimant’s net worth even though it might be below $80,000.
The only mention of $80,000 is if the net worth exceeds $80,000 then an Administrative Decision is required. The manual makes note to always consider net worth even if the claimant’s net worth is below $80,000. The problem is that this is a subjective process that is supposed to take into consideration a number of factors. This is why it is important you are working with an experienced VA Accredited Claims Agent or an attorney. Submitting a claim with too high of a net worth can cause delays or even denial of a claim.