VA Aid and Attendance Requirements: Who Qualifies and How Hawaiʻi Veterans Apply
VA Aid and Attendance is a monthly payment added to a VA pension. It goes to wartime veterans and surviving spouses who need another person's help with daily life, and families can put it toward care at home. Many Oʻahu households with a qualifying parent or spouse have never heard of it. The VA Aid and Attendance requirements come in layers. The pension comes first, with its rules about service, age or disability, income and net worth. The care need sits on top, and a medical examiner records it on a VA form. Each layer has its own checklist, and the application moves faster when you know the order. This post covers who qualifies, how VA figures the payment, and how to apply, including the free help available on Oʻahu. It also shows how families use the payment for in-home care. What Is VA Aid and Attendance? VA Aid and Attendance is an extra amount that VA adds to a monthly pension payment. It attaches to the Veterans Pension for wartime veterans and to the Survivors Pension for their surviving spouses. Because the add-on rides on the pension, a person qualifies for the pension first, and the care need then moves the payment to a higher rate. The money arrives each month, and the family decides how to spend it. Some use it for help at home, some for an assisted living community, and some for a nursing home. VA describes its pension benefits as tax-free. Hawaiʻi has 87,697 veterans, so many Oʻahu families have a wartime veteran or a surviving spouse in the household or close by. A veteran who never filed for a pension, or a widow who assumed the benefit ended with her husband, may hold a claim worth checking. Two other benefits have similar names. The Housebound allowance is a smaller add-on for people who spend most of their time at home because of a permanent disability. VA pays Housebound or Aid and Attendance, one at a time. The Aid and Attendance level of Special Monthly Compensation is a separate benefit for veterans with service-connected disabilities, and VA pays it through disability compensation. This post covers the pension add-on. The Pension Requirements Come First Aid and Attendance rides on the pension, so the pension rules apply first. They make up most of VA Aid and Attendance eligibility, and they are the best place for a family to begin. Service comes first. A veteran who started active duty before September 8, 1980 needs at least 90 days of active duty, with at least 1 day during a wartime period. A veteran who enlisted after September 7, 1980 needs at least 24 months, or the full period the person was ordered to serve, with at least 1 day during wartime. VA lists a few exceptions, including some for officers. The discharge must be something other than dishonorable. A veteran with an other than honorable or bad conduct discharge can ask for a discharge upgrade or a VA Character of Discharge review. The veteran also needs at least one of these: age 65 or older, a permanent and total disability, long-term nursing home care because of a disability, or receipt of Social Security Disability Insurance or Supplemental Security Income. VA recognizes these wartime periods: Mexican Border period: May 9, 1916 to April 5, 1917, for veterans who served in Mexico, on its borders or in adjacent waters World War I: April 6, 1917 to November 11, 1918 World War II: December 7, 1941 to December 31, 1946 Korean conflict: June 27, 1950 to January 31, 1955 Vietnam War era, served in the Republic of Vietnam: November 1, 1955 to May 7, 1975 Vietnam War era, served outside the Republic of Vietnam: August 5, 1964 to May 7, 1975 Gulf War: August 2, 1990 through a date yet to be set by law or presidential proclamation Wartime service of any kind counts, from a desk in Honolulu to a combat zone. Any health condition can create the care need, including conditions that began long after service. The Care Needs That Qualify Once the pension rules are met, VA looks at the care need. At least one of these must be true: The person needs another person's help with daily activities such as bathing, eating and dressing. Illness keeps the person in bed, or in bed for a large part of the day. The person is a nursing home patient because of a loss of mental or physical abilities. The person's eyesight meets the limits VA sets: 5/200 or less in both eyes, even with glasses or contact lenses, or a visual field of 5 degrees or less. A medical examiner fills out the examination section of VA Form 21-2680, the Examination for Housebound Status or Permanent Need for Regular Aid and Attendance. That form records a detailed picture of a typical day and the help it takes. Specifics help the examiner. A note such as "needs a person beside him for every shower and to stand up from the bed each morning" paints a clear picture. Before the exam visit, families can jot down a normal day: who helps with meals, who stands by during bathing, how often someone helps with trips to the bathroom, and what the night looks like. Income and Net Worth Limits VA applies two money tests. The first is income for VA purposes, which adds up Social Security, retirement and investment income, and any income a spouse receives. Medical expenses lower that number. Costs that insurance does not reimburse can be deducted, and what a family pays for care counts among them. VA lets a household deduct only the amount above 5% of the maximum pension rate, which works out to $872 for a veteran with no spouse or child and $1,141 for a veteran with one dependent. The second test is net worth, which combines the applicant's and dependents' assets with income for VA purposes. The limit is $163,699 for the period that
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