Changes in VA Qualification & Deductions

senior_veteran_editorial_only_2There’s good news and bad news these days for folks seeking or already receiving VA Aid & Attendance benefits. For veterans who are already on A&A, the news is all good: annual Eligibility Verification Reports (EVRs) have finally been eliminated! For new applicants, the elimination of EVRs is indeed good news, but there is also some bad: no longer will the cost of room and board count as an unreimbursed medical expense (UME) for the purpose of qualifying for Aid & Attendance benefits.

Like all public benefits matters, these changes are a veritable alphabet soup of acronyms and complicated rules. I’ll try to unpack the details and explain it all in layman’s terms.

The EVR change is the simpler of the two. According to this December 20, 2012 press release, the Department of Veterans Affairs has eliminated the need for veterans receiving Aid & Attendance benefits to re-qualify for their pension benefits every year. That means that beneficiaries and their families no longer have to fear benefits will be suspended if the EVR isn’t received on time. It also means less paperwork all around, both for beneficiaries and VA staff, which the VA hopes will help to streamline its entire claims system. We can all universally celebrate the elimination of stressful and cumbersome red tape!

The not-so-good news for new Aid & Attendance applicants was announced in an October 26, 2012 letter from the Department of Veterans Affairs. In this letter the VA clarified its position on unreimbursed medical expenses (UMEs) for the purpose of Aid & Attendance qualification. To qualify for A&A benefits, the applicant’s total UME dollar value must exceed his or her total income. Previously some A&A applicants were able to count room and board at care facilities, including Independent Living Communities, as UMEs, but now the VA has significantly narrowed the conditions in which this is allowable.

Now room and board at a facility only counts as a UME if the facility provides custodial care, defined by the VA as assistance with at least two activities of daily living (ADLs). ADLs include “bathing or showering, dressing, eating, getting in or out of bed or a chair, and using the toilet.” So room and board at a facility are only countable as UMEs if the facility assists the individual with two or more of these ADLs.

There are a couple of other conditions in which room and board might be countable as UMEs. If the veteran’s physician certifies in writing that “the claimant must reside in that facility and separately contract for custodial care with a third-party provider,” then room and board can be counted as a UME. Less commonly, if a facility assists with instrumental activities of daily living (IADLs), meaning “activities other than self-care that are needed for independent living,” such as meal preparation and managing medications, VA may count room and board as a UME – but only if two conditions exist: first, the individual qualifies for a pension at the A&A or household rate, or the veteran’s physician has certified the need for the individual to live in a protected environment; and second, that the facility provides medical services or help with ADLs to the applicant.

These new guidelines for counting room and board as UMEs only apply to veterans who qualify for A&A benefits after the date of the letter (October 26, 2012). Individuals who qualified prior to that date need not worry about their benefits being retroactively denied.

It seems that all the major public benefits programs have recently been rethinking their rules and guidelines. Applying for benefits can be a complicated process, especially if you are unfamiliar with all the new rules. If you have questions about qualifying for VA or other public benefits programs, let me know what’s on your mind. I will be happy to give you the resources you need and point you in the right direction.