Veterans Benefits

San Diego is a military town.  Yet even here Veterans Benefits are perhaps the most misunderstood and underutilized resources.  Resources that are available to millions of veterans and their families.  While it is commonly known that certain benefits are available for the brave men and women who served in our armed forces, many veterans (and their families) are unaware that they could be eligible for a wide range of benefits through the United States Department of Veterans Affairs even if they did not directly retire from the military or suffer injuries in the line of duty.

We regularly work with each of the following Veterans Benefits which are offered to eligible beneficiaries in San Diego include:

Veteran’s In Home Care Eligibility  For most Americans being able to stay in their own homes, while receiving help with the necessities of life is much preferable to nursing home care.  In home care can be expensive, but for many Veterans there is help available.  Veterans and their surviving widows who need help in their homes may qualify for a special pension to reimburse them for part or all of these expenses.  Most Veterans who served in wartime do not know that their affairs can be arranged to qualify for this entitlement.  Attorney Weissler is VA Certified to represent veterans.

Burial and Memorial:  In exchange for the service that Veterans have selflessly given to the United States, the Department of Veterans Affairs and the Department of Defense provide several memorial and burial services for eligible active-duty, Reserve, Guard, retired and veteran members.  All Veterans and military family members should be aware of the memorial benefits offered by the Department of Veterans Affairs before they are actually needed.

Death Pension: The VA Death Pension is a benefit paid to eligible dependents of deceased wartime veterans.

Veterans Health Care:  The Veterans' Health Care Eligibility Reform Act was passed by Congress in October of 1996, paving the way for the Medical Benefits Package plan to be made available to all enrolled veterans. The Medical Benefits Package emphasizes preventive and primary care and offers a full range of inpatient and outpatient services.  During the past ten years a complicated system of priorities for care has developed.  For many Veterans benefits are only available if they rearrange their affairs in order to qualify for a better benefits priority ranking.

In addition, combat veterans returning from active military service may be eligible to receive free health care services and nursing home care for up to two years, beginning on the date of separation from active military service. This benefit covers all illnesses and injuries except those clearly unrelated to military service.  Dental services are not included in this health care package.

Unfortunately, the complicated rules and difficult paperwork required to apply for Veteran's benefits results in many eligible beneficiaries being initially denied these benefits when a claim is filed.  Applicants should be aware that the decisions for these claims can be appealed by veterans and their eligible family members.  The process for appeals generally begins with the Board of Veterans Appeals (BVA) in Washington, D.C.  Once a claim has been filed and consequently denied, the veteran or other potentially eligible beneficiary has sixty days to file for an appeal with their regional office. 

Federal law allows veterans to retain an attorney to represent them in front of the Department of Veterans Affairs to challenge any denial of benefits by filing a “Notice of Disagreement” (NOD) on their behalf.  The Department of Veterans Affairs benefits claims and appeals process can be complicated.  If a veteran or a veteran’s family members have received a denial of benefits to which they believe they are entitled, it is in their best interest to contact an attorney who is familiar with veterans benefits to assist them with the application and appeals process.

Three Different Cash Benefits Available to Living Veterans

Not Requiring Service Related Injury

There are three types of benefits available that provide a monthly cash payment to veterans who have long term health care needs. Below is an overview of the three benefits, and more detail will be provided on each benefit in the following paragraphs.

Service Pension. The VA provides a monthly cash payment to wartime veterans who meet active duty and discharge requirements, who are either 65 or older or disabled, and who have limited income and assets. Service pension is also available to a surviving spouse of a wartime veteran. An unmarried veteran can receive up to $1054 per month, a married veteran can receive up to $1381 per month, and a surviving spouse can receive up to $707 per month (with additional payments available if dependent children are present in the home).

Pension with Housebound Allowance. A slightly higher monthly payment is available to wartime veterans (who meet the same service requirements as Service Pension) but who are confined to their home for medical reasons. An unmarried veteran can receive up to $1204 per month, a married veteran can receive up to $1510 per month, and a surviving spouse can receive up to $808 per month (with additional payments available if dependent children are present in the home).

Pension with Aid and Attendance. The highest monthly benefit is available when a wartime veteran or surviving spouse requires the assistance of another person to perform activities of daily living, is blind or nearly so, or is a patient in a nursing home. This benefit, often referred to simply as "Aid and Attendance" is the most widely known and talked-about benefit as it offers the highest possible monthly payment. An unmarried veteran can receive up to $1758 per month, a married veteran can receive up to $2085 per month, and a surviving spouse can receive up to $1130 per month (with additional payments available if dependent children are present in the home).

While Aid and Attendance is the most popular VA benefit, it is important to remember that Service Pension is available to wartime veterans or surviving spouses who do not require assistance with activities of daily living but are either disabled or 65 or older.

Prerequisite for Benefits

Wartime Service. As noted above, a veteran must first meet certain service and discharge requirements before being considered for any type of pension benefit. A veteran must have served 90 days of active duty with at least one day beginning or ending during a period of war. After September 1, 1980, the active duty requirement increases to 180 days. In addition, the veteran must have been discharged under circumstances other than dishonorable.

Disability. To qualify for any type of pension benefit, a claimant must also be 65 or older or be permanently and totally disabled. A claimant is the individual filing for benefits - either a veteran or surviving spouse.

Permanent and total disability includes a claimant who is:

• In a nursing home;
• Determined disabled by the Social Security Administration;
• Unemployable and reasonably certain to continue so throughout life; or
• Suffering from a disability that makes it impossible for the average person to stay gainfully employed.

Asset and Income Requirements
The financial eligibility requirements of any pension benefit address a claimant's net worth and income. A married veteran and spouse should have no more than $80,000 in countable assets (less for a single veteran or surviving spouse), which includes retirement assets but excludes a home and vehicle. However, the $80,000 limit is a guideline only - it is not a rule set by the VA. The VA looks at a claimant's total net worth, life expectancy, income and medical expenses to determine whether the veteran or surviving spouse is entitled to special monthly pension benefits.

\The Key to Accessing this Entitlement:Many times the most difficult task in this area is to reduce a claimant's assets down to the applicable level (or what one hopes will be acceptable to the VA). Unfortunately the VA cannot coach a Veteran on how to do this.  Only any attorney with training and experience in this area can ensure that the right strategies are used while preserving a Veteran's rights to receive benefits as needed under Medi-cal.

A veteran or surviving spouse must have Income for VA Purposes ("IVAP") that is less than the benefit for which he or she is applying. IVAP is calculated by taking a claimant's gross income from all sources less countable medical expenses. Countable medical expenses are recurring out-of-pocket medical expenses that can be expected to continue throughout a claimant's lifetime. If a claimant's IVAP is equal to or greater than the annual benefit amount, the veteran or surviving spouse is not eligible for benefits. The Table below shows the applicable income and pension amounts for both veterans and surviving spouses.

Is the Claimant Housebound?

If a claimant qualifies for regular pension and is housebound, the claimant's maximum allowable income increases (as does the annual benefit amount) to the special monthly pension. The VA defines housebound as being substantially confined to the home or immediate premises due to a disability that will likely remain throughout the claimant's lifetime. A veteran with no dependents who is housebound is eligible for benefits of up to $15,462 in annual income.

Unreimbursed medical expenses will reduce a claimant's income dollar for dollar after a small co-pay (5% of the annual pension amount) is met. But remember, to be eligible for a special monthly pension for being housebound, the claimant's IVAP must be less than the annual income threshold.

To illustrate, a veteran with exactly $15,462 in annual income would not be eligible for a special monthly pension for being housebound. However, if that veteran was able to show annual income of $20,000 and unreimbursed medical expenses of $25,000, the veteran would be eligible for $15,462 in special annual pension (paid on a monthly basis) because the veteran has negative IVAP. A surviving spouse with no dependents who is housebound must have annual IVAP of less than $10,371.

Does the Claimant Require the Aid and Attendance of Another?

If a claimant can show, through medical evidence provided by a primary care physician or facility, that the claimant requires the aid and attendance of another person to perform activities of daily living, that veteran or surviving spouse may qualify for an additional special monthly pension commonly referred to as aid and attendance pension benefits.

The VA defines the need for aid and attendance as:

• Requiring the aid of another person to perform at least two activities of daily living, such as eating, bathing, dressing or undressing;
• Being blind or nearly blind; or
• Being a patient in a nursing home.

The Table below shows the applicable pension amounts for each type of VA pension.

National Program Benefits:The maximum pension for a married veteran is $2,085 per month ($25,022 per year), while the maximum pension for a veteran's widow is $1,130 per month ($13,563 per year). The VA pays this pension directly to the claimant regardless of where the claimant is living.

Qualification

As stated above, the VA looks at a claimant's total net worth, life expectancy, and income and expenses to determine whether the claimant should qualify for special monthly pension benefits. Unlike Medicaid, there is no look-back period and no penalty for giving assets away. However, one must use caution when considering a gifting strategy to qualify a veteran or surviving spouse for special monthly pension benefits as this will cause a period of ineligibility for Medicaid which could be as long as five years. Other Medicaid planning strategies may apply when trying to qualify a veteran or surviving spouse for special pension with aid and attendance.

Coordinated Action: The client's advisors must work together to determine the best combination of strategies and financial products that will gain eligibility for special monthly pension but not disqualify the client from Medi-Cal.

The Application Process

While the application process for special monthly pension can be agonizingly slow - some applications take over a year before the VA makes a decision - the benefit is retroactive to the month after application submission. Having the proper documentation in place at the time of application (for example, discharge papers, medical evidence, proof of medical expenses, death certificate, marriage certificate and a properly completed application) can cut the processing time in half.

Retroactive Benefits:Benefits are retroactive to the month after application submission. Therefore, it is imperative for potential claimants to seek legal help immediately to become eligible and to apply as quickly as possible.  Benefits are not retroactive if the applicant dies before benefits are awarded.

Conclusion

Time is of the essence for veterans or surviving spouses who have earned these benefits and need to access these entitlements.  The VA's slow process makes it imperative that Veterans and their families appropriately arrange their affairs and apply for these VA benefits as early as possible.