VA Benefits in General

1. NJ INSTITUTE FOR CONTINUING LEGAL EDUCATIONA Lawyer’s Guide to the Law Affecting Veterans and the Military APRIL 25, 2017VA PENSION BENEFITSPresented by Donald D. Vanarelli, Esq.Accredited VA Attorney Certified Elder Law Attorney Founding Member, Assn. of Special Needs PlannersNamed to the NJ “Super Lawyer” list, 2007 - Present

2. VA Benefits in General Benefits provided by the Department of Veterans Affairs (VA) range from healthcare, compensation and adaptive housing grants for service-connected disabilities, needs-based pensions, education, vocational training, home loan guarantees, life insurance, and burial and memorial benefits.

3. VA Benefits in General (cont’d) Certain VA benefits are also provided to eligible dependents and survivors of veterans.

4. Veterans Health Administration (VHA) Purpose: To provide health care primarily for the benefit of veterans with service-connected disabilities, combat veterans, and low-income veterans.

5. Veterans Health Administration (VHA) (cont’d) Programs include: -- VA Hospitals (163 hospitals) -- VA Nursing Homes (137 nursing homes) -- Information Resource Centers -- Inpatient and Outpatient Clinics (850 Outpatient Clinics) -- Domiciliary, Home Health, Adult Day Care, Residential/Respite Care Programs

6. Veterans Benefits Administration (VBA) The VBA provides an integrated program of veterans’ benefits. The major benefits include: -- Compensation (for service - connected disabilities) -- Compensation for surviving spouses and dependents of deceased veterans -- Burial Benefits

7. Veterans Benefits Administration (VBA) (cont’d) -- Rehabilitation assistance -- Home Loans -- Specially-adapted housing -- Pension (for non-service connected disabilities)

8. Overview of Major Disability Benefits Programs • Service-Connected Compensation Disability compensation is a monetary benefit for veterans who are disabled by an injury or disease that was incurred or aggravated during active service.

9. Overview of Major Disability Benefits Programs (cont’d) • Needs-Based Pension Pension is a monetary benefit for veterans who (1) are disabled (2) have low income and resources, and (3) served during a period of wartime.

10. Non-Service Connected Benefits: VA Improved Pension Program • Not dependent upon service–connected disability to qualify. • Assists families who need additional monies to help care for ailing veterans who have low income and resources. • VA’s version of SSI benefits. • Spouse is not eligible if veteran is living.

11. VA Improved Pension Program:Three Tiers of Benefits • 1. Low Income Pension • 2. Housebound Benefits • Aid and Attendance Benefits

12. VA Improved Pension Program:Three Tiers of Benefits (cont’d) Housebound benefits and Aid and Attendance benefits are supplements paid in addition to the basic Low Income Pension to certain veterans to cover the additional costs of care for their added disabilities.

13. Basic Eligibility Criteria for VA Improved Pension Program All of the following criteria must be met before a veteran or widow(er) of a veteran can receive Improved Pension benefits: a. The veteran must have served at least 90 days of active duty service, one day of which must have been during a wartime period;

14. Basic Eligibility Criteria for VA Improved Pension Program (cont’d.) In general, wartime is: World War I World War II–Dec. 7, 1941 – Dec. 31, 1946 Korean War–June 27, 1950 – Jan. 31, 1955 Vietnam War – Aug. 5, 1964 – May 7, 1975 Gulf War – August 2, 1990 through date to be set by law by Presidential Proclamation

15. Basic Eligibility Criteria for VA Improved Pension Program (cont’d.) b. The veteran must have received a discharge other than dishonorable; c. The claimant must have limited income and assets; and, d. The claimant must be permanently and totally disabled, or be over age 65.

16. COUNTABLE INCOME “Countable” income for VA purposes (“IVAP”) includes income from most sources, including earnings, disability and retirement payments, interest and dividend payments from annuities, net income from farming or business, waived income and income from joint accounts (in proportion to ownership interest).

17. excluded from “countable” income Public assistance such as SSI, IRA interest, income tax refunds, loans (including reverse mortgages), insurance dividends, life insurance proceeds representing a return of premiums, and profit from the sale of property (other than from a regular business).

18. EXAMPLE As of December 1, 2016, the income eligibility limit ( “Maximum Annual Pension Rate” or “MAPR”) for a single veteran w/o children is less than $12,907. Medical expenses may be deducted from countable income if they exceed 5% of the income limit ($645, for the single veteran w/o children).

19. Excess Income Although most veterans have income that exceeds the permissible family income limits, unreimbursed medical expenses paid by the claimant may be used to reduce the claimant’s countable income. Unreimbursed medical expenses that may reduce income include: doctor’s fees, dentist’s fees, prescription glasses, Medicare premium deductions and co-payments, prescription medications, health insurance premiums, transportation to physician offices, therapy, and funeral expenses.

20. Excess Income (cont’d) The most beneficial unreimbursed expenses that may reduce countable income are the costs of home health care, assisted living facilities, or nursing homes.

21. Net Worth: Standard The VA considers the net worth of the individual seeking benefits, excluding the value of the person’s home, furnishings, and car. The standard as to whether a person will be eligible for benefits is whether the person has “sufficient means” to pay for his or her care.

22. Net Worth: Standard (cont’d) Assets that are counted toward the “sufficient means” analysis include bank accounts, certificates of deposit, money market accounts, investment accounts, annuities, retirement accounts, life insurance cash surrender values, etc.

23. How Much Does VA Pay? VA pays the difference between the maximum annual pension rate (MAPR), a yearly limit set by Congress, and the veteran’s countable family income. This difference is generally paid in 12 equal monthly payments rounded down to the nearest dollar.

24. Planning For VA Pension Eligibility • Retitle assets to joint names (joint owner not in veteran’s household) • Gift assets (donee not in veteran’s household) • Transfers with retained life estate not recognized • Assets in SNT are countable • Personal Services Contract • Caveat: Medicaid transfer rules are different!

25. Look-Back Period For VA Pension Eligibility • Currently, there is no look-back period. • GAO recently recommended that Congress establish asset transfer look-back period, with associated penalties, for non-service connected pension applicants.

26. VA Improved Pension Program: Housebound Benefits Pension benefits with a Housebound supplement are available to a veteran or widow(er) of a veteran who is disabled (or over age 65), confined to the home and financially eligible.

27. VA Improved Pension Program:Aid and Attendance • Available to eligible veterans and surviving spouses who require the regular attendance of a person to assist them in eating, dressing, undressing or taking care of the needs of nature. • Also includes individuals who are blind, in a nursing home because of mental or physical incapacity.

28. VA Improved Pension Program:Aid and Attendance To qualify medically, a veteran or surviving spouse must meet one of the following conditions: 1. Is bedridden, or 2. Requires the aid of another person to perform activities of daily living

29. VA Improved Pension Program:Aid and Attendance (cont’d) 3. Is a nursing home resident, as a result of a mental or physical incapacity, or 4. Is blind or nearly blind in both eyes.

30. The Medicaid Effect Since both Housebound and A&A Benefits are supplements to the basic Low Income Pension, the supplemental benefits are exempt when determining the veteran’s eligibility for ALF Medicaid. Low Income pension may be exempt in determining Medicaid eligibility when UMEs exceed the Low Income Pension benefit amount.

31. The Medicaid Effect (cont.) If a claimant is in a NH or ALF receiving Medicaid, the VA pension benefits payable is reduced to $90 per month.

32. Accreditation by the VA As of June 23, 2008, the VA began REQUIRING that ANYONE who assists a veteran or family member with the preparation, presentation and prosecution of a claim for benefits be accredited by and through the VA BEFORE they can legally provide assistance.

33. Who Can Charge Fees, and When? Veterans may obtain free assistance with completing an application for benefits from accredited veteran services organizations and others who are accredited. No organization nor individual, including lawyers, can charge for the preparation, presentation, and prosecution of an initial claim.

34. Who Can Charge Fees, and When? (cont’d) But, if a claim is denied or approved for fewer benefits than are expected, a claimant may hire and pay an accredited attorney or other accredited representative to assist with an appeal after a Notice of Disagreement has been filed.

35. Who Can Charge Fees, and When? (cont’d) Only accredited agents and attorneys may receive fees from claimants for services provided in connection with representation.

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