June 24, 2015 by brmmlaw
Veterans, as well as spouses and dependents, may be eligible for a variety of medical and pension benefits. If you or a loved one is a veteran, it is important to be aware of these benefits and know if you are eligible.
Medical Care Benefits
The VA provides medical care benefits to veterans. The standard medical benefit package includes preventative care services, outpatient and outpatient diagnostic and treatment services (including mental health and substance abuse treatment), prescriptions, and long-term care, which can include nursing home care for eligible veterans.
To be eligible for medical benefits, most veterans must be enrolled in the VA health system. Those veterans who need not be enrolled in the VA health system to qualify for medical care benefits are:
- 50 percent or more disabled due to a service-connected disability
- seeking care for a VA rated, service-connected disability
- discharged for a disability less than a year ago that the military determined was caused or worsened by your service, but the disability is not yet rated by the VA.
The VA considers a number of factors to determine whether or not a veteran is eligible. To qualify, the veteran must not have been dishonorably discharged. Length of service is also one factor. In general, you must have served a continuous 24-month period of active duty military service. There are many exceptions to this, including for reservists, national guard members, service-related disabilities, and hardship discharges. Other factors include whether or not the veteran has service-related disability, what the veteran’s income level is, and what VA resources are available.
The VA offers two major disability-related benefit programs: disability compensation and disability pension.
Disability compensation benefits are available for veterans suffering from service-connected disabilities. This means that you are 10% or more disabled from an injury or disease was incurred or aggravated while on active duty, active duty training, or inactive duty training. Amount of compensation depends on the degree of disability. Veterans may also receive benefits for diseases or conditions that are secondary to service-connected conditions or for diseases or conditions that may be presumed to be from service even if they occur after service is complete.
The compensation you receive is based on compensation rates set out by the VA. Compensation is between 10% and 100% depending on severity. If you are 30% or more disabled and you have dependents, then you may qualify for an additional allowance.
The VA pension is available to low-income veterans. It is available to the veteran, veteran’s spouse, and children. For this pension, your injury or disease need not be service-connected.
In order to be eligible, the veteran must meet certain requirements. The veteran must have served 90 days of active duty service, with at least one day of wartime service. If you entered active duty after September 7, 1980, you must have served 24 months or the full period you were called into active duty, with at least one day of wartime service.
In addition, to be eligible, you must meet one of the following — you must be either at least 65 years old, permanently and totally disabled, a patient in a nursing home requiring skilled nursing care, receiving Social Security Disability Insurance, or receiving Supplemental Security Income.
Your annual family income must be less than the limit Congress set. Countable income includes earnings, disability / retirement payments, annuity interest and dividend payments, and net income from farming or business. Net worth includes bank
accounts, stocks, bonds, mutual funds, annuities, and property other than residence and reasonable lot area. If you qualify for the disability pension, then you would receive the difference between countable income and the annually set pension limit.
Aid and Attendance
This is a veteran’s pension benefit program available to veterans and their families. The program is available to help with unreimbursed home health and medical costs and the unreimbursed cost of assisted living.
There are four requirement prongs that must be met to qualify for Aid and Attendance. This benefit can be the difference for a Veteran or the widow of a Veteran from having to go to a nursing home or staying at home or in assisted living. The yearly benefit for a Veteran can be as much as $21,000 and a widow of a Veteran almost $14,000. All benefits are income tax free.
Service Prong — The Veteran must have served in the active military, navy or air service: (1) for 90 consecutive days or more during a period of wartime, (2) during a period of war was discharged under conditions other than dishonorable or released from such service for a service-connected disability, (3) for a period of 90 consecutive days or more and such a period began or ended during a period of war; or (4) for an aggregate of 90 days or more in two separate periods of service during more than one period of war.
Disability Prong — The applicant need not have a service-connected condition, but must be “permanently and totally disabled”, meaning the veteran needs “care or assistance” on a “regular basis” from another person which protects him or her from “dangers of a daily living environment”. There are many ways to sufficiently show this including being blind, living in an assisted living facility, needing adjustment or attendance to prosthetics or orthopedic appliances, being unable to dress or clean oneself, or has a serious mental or physical incapacity that requires regular assistance. However, the VA presumes “disability” for individuals over the age of 65. Furthermore, the veteran or a widow of a veteran must need assistance with at least two activities of daily living, such as eating, bathing, dressing, transferring and toileting or being cognitively impaired.
Asset Prong — The VA pension benefit is a needs based benefit, and while there is no hard and fast rule, we recommend the surviving spouse should not have more than $40,000.00 plus a home and a car. Before you or loved ones think about transferring assets or doing any other planning, you should consult with one of our estate planning and elder law attorneys. Improper transfers can affect Medicaid eligibility.
Income Prong — The basic rule is one’s unreimbursed medical expenses have to exceed or equal their income to qualify for the full benefit amount. If not, then the veteran could receive a partial benefit. If one does not have actual medical expenses payable to a third party there can be a way to establish a care contract between family members that will qualify as a medical expense.
Determining what benefits you qualify for can get overwhelming, but remember that it can be relieving as well. If you qualify for VA benefits, you should find out as soon as possible so that you can properly undertake veterans planning. At BRMM, attorney Don Rosenberg is a VA accredited attorney; the VA requires that only accredited attorneys advise veterans on pension eligibility. If you have questions or would like more information, contact us for a free consultation at (248) 641-7070 or fill out our online form.