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Description of the Professional Edition

This first-of-its kind publication reveals the little-known process of applying for a veterans benefit to help with the costs of long term care. This special benefit is officially called "pension" but is more popularly known as the "veterans aid and attendance pension benefit".

The book’s publisher -- The National Care Planning Council -- estimates that as much as 30% of the US population over the age of 65 would qualify for the aid and attendance pension benefit under the right circumstances. That's how many war veterans or surviving spouses of war veterans there are. Pension is such a well-kept secret that only a fraction of eligible veteran households are actually receiving it.

Pension can provide an additional monthly income of up to $1,800 a month for a couple, $1,520 a month for a single veteran or $976 a month for a single surviving spouse of a veteran. The majority of veteran households typically only qualify for pension when these households are incurring the high costs of home care, assisted living or nursing home care. Under certain conditions, VA considers these costs to be medical expenses.

When applying for pension, the local Veterans Affairs Regional Office will calculate the benefit based on yearly income adjusted for unreimbursed medical expenses. The secret for obtaining long-term-care-related, successful pension awards is understanding what is required in the form of documentation and evidence to adjust income for future, annualized unreimbursed medical expenses. VA does not disclose this vitally important step on the application nor tell callers over the phone how to do it. One simply has to know how. The book covers this vital step in detail.

Lacking the proper knowledge, a claimant may submit an application without the necessary medical expense documentation and evidence required for a successful award. This can be a costly mistake. If the claim is denied, according to the VA rules, the claimant must wait a full year before applying again.

The publisher of this book -- The National Care Planning Council -- and the editor -- Thomas Day -- have devoted much of the content to the pension application process. However, the book also covers other long term care benefits available to veterans that may be tied to those receiving pension. In addition, a chapter is devoted to veterans health benefits and related long term care services and another chapter is devoted to state veterans homes. Finally, a chapter also covers other disability and end-of-life veterans awards such as compensation, DIC and burial benefits.

Some claims may be denied because household assets are too high. The book devotes an entire chapter in the form of numerous case studies to demonstrate legal strategies for reducing assets in order to receive a successful award. The importance of dovetailing these strategies with appropriate Medicaid planning strategies is also addressed. In addition, software is included with the purchase to help the planner estimate pension benefits before and after asset reduction strategies. All necessary forms and supportive documents are included in the book and on the software CD.

A 28 page addendum with an explanatory forward is included with the book to clarify the issue of charging fees for helping someone with an application. In general, the adviser may charge for advice but not for filling out the form. Assisted living facilities, nursing homes and home care agencies that hire a third-party to file a claim for one of their clients or residents are potentially in violation of VA rules for charging fees. The National Care Planning Council recommends using a trusted and experienced veterans service organization for the actual filing process.

This book contains 443 pages and includes six chapters, two appendices, a form support section, a software CD and an addendum. Appendix I includes contact lists of veterans service organizations, state veterans homes, VA regional offices and VA medical centers and associated clinics. Appendix II contains 133 pages of citations from VA regulations and rules to help the planner with specific issues regarding application for pension. The addendum contains 28 pages of statutes and other support material relating to the charging of fees. The form support section contains necessary forms and documents used in the application process. The software CD contains planning sheets and benefit estimate software as well as copies of all pertinent documents used in the application process.

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Charging a Fee for Filing a Claim

Federal code 38 USC sections 5901, 5902, 5903, 5904 and 5905 covers prohibitions for representatives, allowable practices for representatives and who can be a representative for a veteran in the filing of a claim.

For further details we include an addendum with all of 38 USC Chapter 59 with amendments. We also include a Federal appeals court decision concerning the challenge of payment to a third-party for filing a claim. Finally we include a letter from Tim McClain, VA General Counsel, to the Hon. Lane Evans, ranking Democratic member of the House Committee on Veterans Affairs, dated May 24, 2004. The letter addresses, directly, charging a fee for advice relating to a claim. The source of this document is:
http://veterans.house.gov/democratic/officialcorr/pdf/5-24-04attorneys.pdf

Click here for the addendum

Our purpose here is not to offer legal interpretation. You must make up your own mind what is acceptable based on current rules and regulations. Our addendum material is not all-inclusive but can give you great insight into the attitude of the Department of Veterans Affairs. Here is how the National Care Planning Council would handle a typical case regarding charging fees:

1.  From the letter from VA General Counsel, it appears to be acceptable to VA that we can charge for advice relating to the filing of a claim but not charge for filling out and filing a claim.

2.  It is our opinion that home care agencies, nursing homes and assisted living facilities that pay a specialist to file a claim on behalf of one of their residents or clients are in violation of the third-party fee provisions allowed by VA. We believe it is an obvious intent to circumvent the statute.

VA does allow disinterested third party organizations to pay someone to file an application on behalf of the veteran--based on 38 C.F.R. § 20.609(d) (1992). This regulation, addressing disinterested third-party fee payers, provides that “[a]n attorney-at-law or agent may receive a fee or salary from an organization, governmental entity, or other disinterested third party for representation of a claimant or appellant even though the conditions set forth in paragraph (c) (38 USC section 5904) [regarding fees for services after a final decision by the DVA] have not been met.”

VA amended its rules pertaining to this regulation on May 23, 2002. The following rules now apply:

• First, it prohibits an attorney or agent from charging a fee contingent, in whole or in part, upon whether the matter is resolved favorably to the claimant or appellant.
• Second, it establishes a rebuttable presumption that the spouse, child, or parent of the claimant, or a person residing with the claimant, is not a disinterested third party.
• Third, it requires that all agreements for payment by a third party be in writing, be filed with the Board, and include a certification by the attorney or agent that “no agreement, oral or otherwise, exists under which the claimant or appellant will provide anything of value to the third-party payer . . . in return for payment of [the attorney’s] fee or salary, including, but not limited to, reimbursement of any fees paid.” 38 C.F.R. § 20.609(d)(2); 67 Fed. Reg. at 36,104. (See enclosed addendum court decision for more detail.)

3.  We would refer the actual filing of claims on behalf of a veteran to a veterans service organization or to a VA appointed representative. We have included a list of these entities in Appendix 1 in our book.

We believe it is critical for the advisor or the consultant to offer advice and constructive help prior to the filing of an application or even during the claims process in order to help increase the chance of a successful award. We feel this might include educating clients on what information is required, recommending supportive forms or documents that might be effective in the claims process, providing guidance on VA's asset test, making sure the evidence for recurring medical costs and for a rating is presented in the most favorable manner and providing advice on the steps necessary to complete the application. Knowing how to submit a successful claim is 95% of the battle and filling out the form is a formality.

In our opinion, the actual process of obtaining documents and filling out forms should be done, free of charge, by the client, family members, a duly appointed power of attorney or a veterans service organization such as a state department of veteran affairs or local VFW.

The addendum letter from VA General Counsel gives an example in the third to last sentence where an attorney (VA considers any representative for the claimant an attorney) could charge for a prefiling consultation and complete the application for the veteran pro bono. For various reasons, including the fact that a veterans service organization has a better understanding of all available benefits, we recommend using a veterans service organization for the filing of claims.

We have talked to a number of advisors or consultants who have established a close relationship with a state veterans affairs department person or a competent volunteer with the local VFW or a representative from some other veterans service organization. The consultant provides the critical advice and makes sure the client gathers up the documentation necessary for a successful claim, and the veterans service organization completes the formality of filling out the forms. Both the consultant and the service representative work closely together to make sure the claim is successfully adjudicated.

We have not had positive feedback from advisors who send their clients to the regional VA office for help. Apparently, it is common procedure for VA employees to turn away potential claimants because their income and/or assets are too high. This is unfortunate, because applicants paying for long term care services can qualify with higher incomes and by adjusting their assets. VA employees who deal directly with the public also appear not to have much knowledge about the proper documentation and evidence necessary for a successful award. The experts in the back office, who know all of this information, rarely, if ever, communicate with the public.

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About the Publisher -- National Care Planning Council;
and the Editor -- Thomas Day

The National Care Planning Council is an alliance of care providers and advisors who promote and support planning for long term care. The council statement of purpose is as follows:

To promote a public awareness of the need for long term care planning.
To provide materials to educate the public on how to plan for long term care.
To provide training to members who help the public plan for long term care.
To promote the services and expertise of our members.
To provide a forum for members to share ideas and marketing strategies.

The book, "Veterans Aid and Attendance Benefit -- Long Term Care Benefits for Veterans," is an outgrowth of our statement of purpose. Over time, the council will produce or promote additional books, articles and planning guides to help the public do a better job of planning for long term care.

This book is the result of our editor, Thomas Day, spending five months, researching and presenting in a more understandable format, over 5,000 pages of government regulations and VA rules. Mr. Day also contacted organizations that are currently involved in the process of helping clients obtain pension benefits and the results of this research are also included in the book.

Thomas Day specializes in the area of long term care planning. He has 12 years of experience advising families about long term care issues. As director of the National Care Planning Council and chief spokesman for the Utah Eldercare Planning Council, Tom maintains a busy schedule writing, giving advice to concerned caregiving families and conducting radio and reporter interviews.

He is also responsible for maintaining several Internet sites one of which, http://www.longtermcarelink.net, is a frequently visited and popular site for long term care issues. The site currently is receiving the equivalent of 6 million hits a year. Tom is also busy writing articles and has completed three new books on long term care planning published by the National Care Planning Council.

Tom graduated from the University of Utah with a BA in physics and math and an MBA in finance. He holds a CLU designation from the American College. Tom and his wife Susan live in Centerville, Utah. They have seven children and 17 grandchildren.

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Table of Contents -- Professional Edition

CHAPTER 1 - Overview of Veterans Long Term Care Benefits

  About Long Term Care

  About the Department of Veterans Affairs

        Facts about the Department

        Chronological History of the Department of Veterans Affairs

  Veteran Demographics and the Need for Long Term Care

        Who Is a Veteran?

        How Many Veterans Need Long Term Care?

        Comments from the Armed Forces Veterans Homes Foundation

        Percent Distribution of Veterans by Age and Gender

        Percent Distribution of Veterans by Functional Limitation and Age

  VA Disability Programs

        Two Important Disability Programs

        More about Pension

        The VA Disability Survey

  About State Veterans Homes

  About Veterans Medical Care

CHAPTER 2 - State Veterans Homes

  About State Veterans Homes

  The Appeal of Living in a State Veterans Home

  Challenges for State Veterans Homes

  History of State Veterans Homes

  Challenges Facing the Construction of New Homes

  Nursing Home Daily Rates

  Services Available

  Eligibility and Application Requirements for State Veterans Homes

CHAPTER 3 - Veterans Health Care and Long Term Care Services

  The Best Health Care System in America

  Why the VA Health Care System Works so Well

  What is Veterans Health Care?

  Outpatient Pharmacy Services

  Veterans Health Administration Long Term Care Benefits

  Enrolling in the Veterans Health Care System

  Copayments for Medical Services -- Veterans Means Testing

CHAPTER 4 - Compensation, Pension, Death Benefits and Burial and Memorial Benefits

  About this Chapter

  Part 1

        Disability Compensation and SMC

        Dependency and Indemnity Compensation

        VA Pension

        Death Pension

        Burial and Memorial Benefits

  Part 2 Examples of How Pension Works

CHAPTER 5 - Understanding the Claims Process for Compensation, Pension, Death Benefits and HISA Grants

  About the Two Income Benefits and the HISA grant

        Compensation and Pension

        HISA Grants

  Questions about Compensation and Pension Claims

  Introduction to the Claims Process

  Chapter 6 -- Asset Transfer Strategies, Benefit Estimate Software and Case Studies

        Important Things to Know for Receiving a Pension Award

        How Pension Is Calculated

  Application forms

  The Initial Claim

  Determining Veteran Status for Pension Claims

  Verification of Facts and Relationships

  Rating for Income and Disability

        Aid and Attendance or Housebound Ratings

        Submitting Evidence for the Ratings

  Income

        Calculation of Benefits and General Statements

        Determining Income

        Exclusions and Adjustments to Income

        Deductions from Income

  Unreimbursed Medical Expenses

        Rationale for Allowing Deductions

        Recurring 12-Month Annualized Expenses

              General Information

               Insurance

              Nursing Home

              Assisted living, Residential Care, Adult Day Care or Other Similar

              Home Care

              Home Care Where Care Recipient Is Not Rated

              Home Care Where Care Recipient Is Rated

              Documentation of Home Care Expenses

        List of Deductible Medical Expenses

  Asset Tests

        VA Asset Ceiling of $80,000 Is Not Statutory

        Determining Disclosable Assets

        Determining Net Worth

        VA Life Expectancy Table for Asset Test

  Asset Transfers to Reduce Net Worth

        Authority for Asset Transfers

        Gifting Assets

        Converting Assets to Income

  EVRs -- Eligibility Verification Reports

  Accrued Benefits

  Dovetailing with Medicaid

        Retaining VA Benefits and Imputed Income

        Asset Transfers to Qualify for Pension Affecting Medicaid Eligibility

  VA Power of Attorney and Fiduciary Program

  Death Claims and Special Benefits

  Charging a Fee

  HISA grants

        About HISA Grants

        Forms to Be Submitted

CHAPTER 6 - VA Pension Planning

  Asset Reduction Strategies

  Software Program for Benefit Estimates

  Case Studies Illustrating Claims & Software Details

  Asset Reduction Strategies

        Rules Governing Asset Transfers

        The Effect of Asset Transfers on Medicaid Eligibility

        Strategies to Transfer Assets and Reduce the Estate

  Software Program for Benefit Estimates

        Using Program to Estimate Pension Benefit and Maximize Income after Transfers

        Instructions for Screen Entries

  Case Studies Illustrating Claims and Software Details

        The Ordered Process of Helping Clients Obtain Pension Benefits

        Forms List from Support Packet

        Planning Case #1

        Planning Case #1 Worksheet

        Planning Case #1 Software Screenshot

        Planning Case #2

        Planning Case #2 Worksheet

        Planning Case #2 Software Screenshot

        Planning Case #3

        Planning Case #4

  Medicaid Rules Governing Single Premium Immediate Annuities

APPENDIX I - Glossary and Lists

  Understanding the Special Language of VA

  Veterans Service Organizations

  2007 List of State Veterans Homes

  VA Medical Facilities and Regional Offices

APPENDIX II - Citations and Extracts

  Charging a Fee

  The Initial Claims Process

  Determining Veteran Status for Benefits

  Verification of Facts and Relationships

  Rating for Income and Disability

  Income, Asset Tests and Unreimbursed Medical Costs

        Calculation of Benefits and General Statements

        Income

        Income Exclusions and Deductions

        Unreimbursed Medical Costs

        Net Worth

  EVRs -- Eligibility Verification Reports

  Accrued Benefits

  Dovetailing with Medicaid

  VA Power of Attorney and Fiduciary Program

  Special Benefits

  HISA Handbook

SUPPORT PACKET

  Forms

  VA Form 21-526 -- Veteran's Application for Compensation and/or Pension, Parts A,B,C, & D

  VA Form 21-534 -- Application for Dependency and Indemnity Compensation, Death Pension and Accrued Benefits by a Surviving Spouse or Child (Including Death Compensation If Applicable)

  SF 180 -- Request Pertaining to Military Records (Used to obtain discharge record)

  VA Form 21-22a -- Appointment of Individual as Claimant's Representative (POA for claim)

  Form 1 -- Statement of Attending Physician (Used to determine rating for A&A or HB)

  Form 2 -- Care Provider Report (Used to provide evidence of recurring medical expenses)

  Form 3 -- Health Insurance Premiums (Used to provide evidence of recurring medical expenses)

  Form 4 -- Claimant's Certification (verifies out-of-pocket costs for unreimbursed medical expenses)

  VA Form 21-0779 -- Request for Nursing Home Information in Connection with Claim for Aid and Attendance

  VA Form 10-10EZ -- Application for Health Benefits (Veterans receiving pension are guaranteed health benefits without copayment)

  VA Form 10-0103 -- Veteran's Application for Assistance In Acquiring Home Improvement and Structural Alterations (HISA)

  Other Support Material

  Pension Rates for 2007

  Screenshot of Software Entry Page

  Software Installation Instructions

  Software Usage Instructions

  Worksheet for Software

  Steps in Making a Claim

  Software CD also includes an Excel version of the worksheet and copies of all of the forms

ADDENDUM

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Synopsis of the Professional Edition

READER ALERT This is a clarification of charging fees for filing claims on behalf of veterans. Readers are referred to a 28 page addendum at the end of the book that contains more details on charging fees.

FORWARD AND DISCLAIMER This book is a first of its kind publication and as such there is no body of public knowledge to support the information contained here other than information derived from thousands of pages of government regulations and rules. Mistakes and misinterpretations may have been made and readers are invited to submit clarifications. The book does not give specific instructions on filling out and filing forms but only describes the necessary ingredients of the process and offers sample documents that could be used. This is done deliberately because VA rules prohibit anyone from charging a veteran to fill out and file a claim. The National Care Planning Council and its editor Thomas Day do not purport that this book represents any individual in the filing of that person's claim and the publisher and editor will not assume any responsibility for individual claims that are not successful.

PREFACE Aid and attendance is a catchphrase for veterans pension. The benefit is usually awarded in conjunction with a medical rating where a person is declared in need of the "aid and attendance" of another person. The material in the book also addresses other veterans long term care benefits but the majority of the book is devoted to an in-depth treatment of the application process for pension.

TABLE OF CONTENTS

CHAPTER 1 (12 pages) Overview of Veterans Long Term Care Benefits

• Discussion of the definition of long term care and how long term care is provided.
• Facts and history of the Department of Veterans Affairs are presented
• The term "veteran" is defined and the demographics of veterans and those needing long term care are examined
• Two important veterans disability programs -- compensation and pension -- are discussed as an introduction for later chapters
• State veterans homes are discussed as an introduction for another chapter
• Veterans medical care is discussed as an introduction for another chapter

CHAPTER 2 (10 pages) State Veterans Homes State veterans homes are jointly funded by VA and the individual states. There are approximately 135 of these homes nationwide and the majority of them offer nursing home services. The federal government and the states jointly provide monies to build these homes and VA subsidizes each veteran in one of these facilities with $67.71 a day.

Many of these homes are located in rural areas and are not readily accessible by the majority of veterans in a state. The reason veterans will uproot and move long distances to live in one of these facilities is dictated by a desire for camaraderie with other veterans, the lower cost-of-living in a veterans home and a desire to hold on to existing assets without having to sacrifice everything to Medicaid.

There is typically great demand for veterans homes beds and many states have waiting lists. Due to a lack of federal funding at least 130 homes are waiting to be built and based on current funding it may take up to 20 years to get all of those currently on the list constructed. New construction projects are being added every year.

Each state has its own criteria for veteran status and who can reside in that state's veterans homes. All homes have a requirement for application and unlike private sector nursing homes a potential resident cannot walk in the front door and arrange for a bed on the same day.

CHAPTER 3 (16 pages) Veterans Health Care and Long Term Care Services Quotes from media sources are provided to demonstrate that the VA health care system is considered the best medical care in America . A brief analysis of why this claim is valid is provided.

Veterans health care services are outlined, an example of the veterans health system is provided and numerous long term care benefits associated with health care are listed and explained.

Enrollment for health care is now limited to veterans who have service-connected disabilities, who are low income or who are receiving pension or Medicaid. There are eight enrollment priority groups based on the criteria mentioned. All other veterans are now excluded because of lack of federal funding. A veteran qualifying for the pension benefit explained in chapters 1, 4 and 5 is automatically guaranteed enrollment in the health-care system. This can be an advantage because copayments for medical care are waived and there is a possibility, based on income, that prescriptions are free as well. Copayments for medical services and prescription drugs are outlined.

CHAPTER 4 (20 pages) Compensation, Pension, Death Benefits and Burial and Memorial Benefits Explanations and benefit amounts are provided for disability income benefits for active-duty veterans and active-duty veterans who served during a period of war. These benefits include compensation for veterans with service-connected disability and death benefits for survivors of such veterans. Pension and death pension are disability benefits for veterans and surviving spouses who do not have service-connected disabilities but who may qualify on the basis of nonservice connected disability or old-age. Burial and Memorial benefits for all veterans are also described in detail.

The bulk of the chapter is taken up by five case examples illustrating how pension Works for veterans or veterans households in various long term care settings. These examples include a veteran couple, a single veteran and the surviving single spouse of a veteran. The care settings include home care, assisted living and nursing home care. Pension Benefits for each case are presented and a discussion on how these benefits dovetail with other long term care funding is provided.

CHAPTER 5 (56 pages) Understanding the Claims Process for Compensation, Pension, Death Benefits and HISA Grants This chapter is a distillation of what we consider important issues in the claims and future reporting process. Citations from 38 CFR and excerpts from VA manual 21-1 in this section are taken from appendix II. Appendix II has additional references and citations not listed here.

This chapter provides more detail on compensation and pension and the application process for both. It also discusses another benefit for veterans receiving compensation or pension called a HISA grant.

The chapter discusses in great depth how pension is calculated, who is eligible, how income is counted and the effect of estate value on receiving an award.

Application, medical and documentation requirements are discussed in great detail. A thorough reading of this chapter leaves a potential applicant with little doubt as to what is required for a successful award for pension.

CHAPTER 6 (28 pages) VA Pension Planning

Topics

• Asset reduction strategies
• Using the software program for benefit estimates
• Detailed case studies illustrating asset reduction strategies, step-by-step claims process and the use of the software with the case study
  

APPENDIX I (55 pages) Provides contact lists for the planner

APPENDIX II (133 pages) Provides additional citations from regulations and rules to help the planner with specific issues regarding the application process.

ADDENDUM (28 pages) Support material for the interpretation of charging a fee for filing a claim.

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Contents of the Software CD

The CD contains a benefit estimate program to allow the planner to estimate the pension benefit and total household income before and after asset transfers that involve the addition or loss of income. A screenshot of the software is included below.

The CD also contains a folder called "Support Package". This folder contains copies of all the forms and documents that are used as samples in the textbook. The folder also contains a file called "Worksheet.xls". This is an Excel file that is the exact duplicate of the paper copy worksheet we have supplied in your support packet that can be used to calculate investment income from assets before and after transfers. For those of you who have Excel, the Excel version is more useful because it automatically adds up the columns for you.

Here is a listing of the files found in the "Support Package" folder. The name of the file describes what form or support material is found in the file.

01 form 21-526-Veterans Claim Form.pdf
02 form 21-534-Death Benefit Claim Form.pdf
03 formSF-180-Request for Discharge Papers.pdf
04 form 21-22a-Power of Attorney.pdf
05 form 21-0779-Veteran or Spouse in a Nursing Home.pdf
06 Form 10-10EZ- Application for Health Care.pdf
07 Form 10-0103-HISA Application.pdf
08 Form 1-Statement of Attending Physician.pdf
09 Form 2-Provider Report for Recurring Medical Expenses.pdf
010 Form 3-Medical Insurance Premium Expenses.pdf
011 Form 4-Claimant Certification of Recurring Medical Expenses.pdf
012 Pension Rates for 2007.doc
013 Screenshot.pdf
014 Software Installation Instructions.doc
015 Software Usage Instructions.doc
016 Worksheet.doc
017 Steps in Making a Claim.doc

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Previous Reviews of the Standard Edition

elderlaw\answers.com, April 25, 2007
http://www.elderlawanswers.com/resources/article.asp?id=6209&section=5&state=

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Description of the Standard Edition

This first-of-its kind publication reveals the little-known process of applying for a veterans benefit to help with the costs of long term care. This special benefit is officially called "pension" but is more popularly known as the "veterans aid and attendance pension benefit".

The book’s publisher -- The National Care Planning Council -- estimates that as much as 30% of the US population over the age of 65 would qualify for the aid and attendance pension benefit under the right circumstances. That's how many war veterans or surviving spouses of war veterans there are. Pension is such a well-kept secret that only a fraction of eligible veteran households are actually receiving it.

Pension can provide an additional monthly income of up to $1,800 a month for a couple, $1,520 a month for a single veteran or $976 a month for a single surviving spouse of a veteran. The majority of veteran households typically only qualify for pension when these households are incurring the high costs of home care, assisted living or nursing home care. Under certain conditions, VA considers these costs to be medical expenses.

When applying for pension, the local Veterans Affairs Regional Office will calculate the benefit based on yearly income adjusted for unreimbursed medical expenses. The secret for obtaining long-term-care-related, successful pension awards is understanding what is required in the form of documentation and evidence to adjust income for future, annualized unreimbursed medical expenses. VA does not disclose this vitally important step on the application nor tell callers over the phone how to do it. One simply has to know how. The book covers this vital step in detail.

Lacking the proper knowledge, a claimant may submit an application without the necessary medical expense documentation and evidence required for a successful award. This can be a costly mistake. If the claim is denied, according to the VA rules, the claimant must wait a full year before applying again.

The publisher of this book -- The National Care Planning Council -- and the editor -- Thomas Day -- have devoted much of the content to the pension application process. However, the book also covers other long term care benefits available to veterans that may be tied to those receiving pension. In addition, a chapter is devoted to veterans health benefits and related long term care services and another chapter is devoted to state veterans homes. Finally, a chapter also covers other disability and end-of-life veterans awards such as compensation, DIC and burial benefits.

Some claims may be denied because household assets are too high. Potential applicants can give away assets or convert those assets to income under certain conditions in order to qualify. There is no penalty to do this as there is with Medicaid. It is recommended that readers seek out a qualified veterans benefits specialist if assets may be a block to a successful award.

This book contains 209 pages and includes five chapters, an appendix and a form support section. The appendix includes contact lists of veterans service organizations, state veterans homes, VA regional offices and VA medical centers and associated clinics. All forms necessary for filing a claim are included in the form support section.

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About the Publisher -- National Care Planning Council
and the Editor -- Thomas Day

The National Care Planning Council is an alliance of care providers and advisors who promote and support planning for long term care. The council statement of purpose is as follows:

To promote a public awareness of the need for long term care planning.
To provide materials to educate the public on how to plan for long term care.
To provide training to members who help the public plan for long term care.
To promote the services and expertise of our members.
To provide a forum for members to share ideas and marketing strategies.

The book, "Veterans Aid and Attendance Benefit -- Long Term Care Benefits for Veterans," is an outgrowth of our statement of purpose. Over time, the council will produce or promote additional books, articles and planning guides to help the public do a better job of planning for long term care.

This book is the result of our editor, Thomas Day, spending five months, researching and presenting in a more understandable format, over 5,000 pages of government regulations and VA rules. Mr. Day also contacted organizations that are currently involved in the process of helping clients obtain pension benefits and the results of this research are also included in the book.

Thomas Day specializes in the area of long term care planning. He has 12 years of experience advising families about long term care issues. As director of the National Care Planning Council and chief spokesman for the Utah Eldercare Planning Council, Tom maintains a busy schedule writing, giving advice to concerned caregiving families and conducting radio and reporter interviews.

He is also responsible for maintaining several Internet sites one of which, http://www.longtermcarelink.net, is a frequently visited and popular site for long term care issues. The site currently is receiving the equivalent of 6 million hits a year. Tom is also busy writing articles and has completed three new books on long term care planning published by the National Care Planning Council.

Tom graduated from the University of Utah with a BA in physics and math and an MBA in finance. He holds a CLU designation from the American College. Tom and his wife Susan live in Centerville, Utah. They have seven children and 17 grandchildren.

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Table of Contents -- Standard Edition

CHAPTER 1 - Overview of Veterans Long Term Care Benefits

  About Long Term Care

  About the Department of Veterans Affairs

        Facts about the Department

        Chronological History of the Department of Veterans Affairs

  Veteran Demographics and the Need for Long Term Care

        Who Is a Veteran?

        How Many Veterans Need Long Term Care?

        Comments from the Armed Forces Veterans Homes Foundation

        Percent Distribution of Veterans by Age and Gender

        Percent Distribution of Veterans by Functional Limitation and Age

  VA Disability Programs

        Two Important Disability Programs

        More about Pension

        The VA Disability Survey

  About State Veterans Homes

  About Veterans Medical Care

CHAPTER 2 - State Veterans Homes

  About State Veterans Homes

  The Appeal of Living in a State Veterans Home

  Challenges for State Veterans Homes

  History of State Veterans Homes

  Challenges Facing the Construction of New Homes

  Nursing Home Daily Rates

  Services Available

  Eligibility and Application Requirements for State Veterans Homes

CHAPTER 3 - Veterans Health Care and Long Term Care Services

  The Best Health Care System in America

  Why the VA Health Care System Works so Well

  What is Veterans Health Care?

  Outpatient Pharmacy Services

  Veterans Health Administration Long Term Care Benefits

  Enrolling in the Veterans Health Care System

  Copayments for Medical Services -- Veterans Means Testing

CHAPTER 4 - Compensation, Pension, Death Benefits and Burial and Memorial Benefits

  About this Chapter

  Part 1

        Disability Compensation and SMC

        Dependency and Indemnity Compensation

        VA Pension

        Death Pension

        Burial and Memorial Benefits

  Part 2 Examples of How Pension Works

CHAPTER 5 - Making Application for Compensation, Pension, Death Benefits and HISA Grants

  Questions and Answers about the Claims Process

  Questions about Compensation Claims

  Questions about Pension Claims

  Application Forms for Compensation, Pension and Death Claims

  Important Things to Know for Receiving a Pension Award

  Submitting the Initial Claim

  Determining Veteran Status for Pension Claim

  Applying for a Rating

        Aid and Attendance or Housebound Ratings

        Submitting Evidence for the Ratings

  Unreimbursed Medical Expenses

        Basis for Allowing Unreimbursed Medical Expenses

        Allowable Medical Expenses Annualized for the 12 Month Future Benefit Period

              General Information and Claimant Certification

              Insurance Costs

              Nursing Home Costs

              Costs of Assisted living, Residential Care, Adult Day Care or Similar

              Home Care Costs

        Documentation of Home Care Expenses

  The Asset Test for Pension

  Death Claims and Special Benefits

        Death Benefits Available from VA Form 21-534

        Accrued benefits

        VA Burial Allowances

        Other Death Benefits Discussed in Greater Detail in Chapter 4

  HISA Grants

APPENDIX I -- Glossary and Lists

  Understanding the Special Language of VA

  Veterans Service Organizations

  2007 List of State Veterans Homes

  VA Medical Facilities and Regional Offices

SUPPORT PACKET

  VA Form 21-526 -- Veteran's Application for Compensation and/or Pension, Parts A,B,C, & D

  VA Form 21-534 -- Application for Dependency and Indemnity Compensation, Death Pension and Accrued Benefits by a Surviving Spouse or Child (Including Death Compensation If Applicable)

  SF 180 -- Request Pertaining to Military Records (Used to obtain discharge record)

  VA Form 21-22a -- Appointment of Individual as Claimant's Representative (POA for claim)

  Form 1 -- Statement of Attending Physician (Used to determine rating for A&A or HB)

  Form 2 -- Care Provider Report (Used to provide evidence of recurring medical expenses)

  Form 3 -- Health Insurance Premiums (Used to provide evidence of recurring medical expenses)

  Form 4 -- Claimant's Certification (verifies out-of-pocket costs for unreimbursed medical expenses)

  VA Form 21-0779 -- Request for Nursing Home Information in Connection with Claim for Aid and Attendance

  VA Form 10-10EZ -- Application for Health Benefits (Veterans receiving pension are guaranteed health benefits without copayment)

  VA Form 10-0103 -- Veteran's Application for Assistance In Acquiring Home Improvement and Structural Alterations (HISA)

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Synopsis of the Standard Edition  (209 Pages)

FORWARD AND DISCLAIMER This book is a first of its kind publication and as such there is no body of public knowledge to support the information contained here other than information derived from thousands of pages of government regulations and rules. Mistakes and misinterpretations may have been made and readers are invited to submit clarifications. The book does not give specific instructions on filling out and filing forms but only describes the necessary ingredients of the process and offers sample documents that could be used. This is done deliberately because VA rules prohibit anyone from charging a veteran to fill out and file a claim. The National Care Planning Council and its editor Thomas Day do not purport that this book represents any individual in the filing of that person's claim and the publisher and editor will not assume any responsibility for individual claims that are not successful.

PREFACE Aid and attendance is a catchphrase for veterans pension. The benefit is usually awarded in conjunction with a medical rating where a person is declared in need of the "aid and attendance" of another person. The material in the book also addresses other veterans long term care benefits but the majority of the book is devoted to an in-depth treatment of the application process for pension.

TABLE OF CONTENTS

CHAPTER 1 (12 pages) Overview of Veterans Long Term Care Benefits

• Discussion of the definition of long term care and how long term care is provided.
• Facts and history of the Department of Veterans Affairs are presented
• The term "veteran" is defined and the demographics of veterans and those needing long term care are examined
• Two important veterans disability programs -- compensation and pension -- are discussed as an introduction for later chapters
• State veterans homes are discussed as an introduction for another chapter
• Veterans medical care is discussed as an introduction for another chapter

CHAPTER 2 (10 pages) State Veterans Homes State veterans homes are jointly funded by VA and the individual states. There are approximately 135 of these homes nationwide and the majority of them offer nursing home services. The federal government and the states jointly provide monies to build these homes and VA subsidizes each veteran in one of these facilities with $67.71 a day.

Many of these homes are located in rural areas and are not readily accessible by the majority of veterans in a state. The reason veterans will uproot and move long distances to live in one of these facilities is dictated by a desire for camaraderie with other veterans, the lower cost-of-living in a veterans home and a desire to hold on to existing assets without having to sacrifice everything to Medicaid.

There is typically great demand for veterans homes beds and many states have waiting lists. Due to a lack of federal funding at least 130 homes are waiting to be built and based on current funding it may take up to 20 years to get all of those currently on the list constructed. New construction projects are being added every year.

Each state has its own criteria for veteran status and who can reside in that state's veterans homes. All homes have a requirement for application and unlike private sector nursing homes a potential resident cannot walk in the front door and arrange for a bed on the same day.

CHAPTER 3 (16 pages) Veterans Health Care and Long Term Care Services Quotes from media sources are provided to demonstrate that the VA health care system is considered the best medical care in America . A brief analysis of why this claim is valid is provided.

Veterans health care services are outlined, an example of the veterans health system is provided and numerous long term care benefits associated with health care are listed and explained.

Enrollment for health care is now limited to veterans who have service-connected disabilities, who are low income or who are receiving pension or Medicaid. There are eight enrollment priority groups based on the criteria mentioned. All other veterans are now excluded because of lack of federal funding. A veteran qualifying for the pension benefit explained in chapters 1, 4 and 5 is automatically guaranteed enrollment in the health-care system. This can be an advantage because copayments for medical care are waived and there is a possibility, based on income, that prescriptions are free as well. Copayments for medical services and prescription drugs are outlined.

CHAPTER 4 (20 pages) Compensation, Pension, Death Benefits and Burial and Memorial Benefits Explanations and benefit amounts are provided for disability income benefits for active-duty veterans and active-duty veterans who served during a period of war. These benefits include compensation for veterans with service-connected disability and death benefits for survivors of such veterans. Pension and death pension are disability benefits for veterans and surviving spouses who do not have service-connected disabilities but who may qualify on the basis of nonservice connected disability or old-age. Burial and Memorial benefits for all veterans are also described in detail.

The bulk of the chapter is taken up by five case examples illustrating how pension Works for veterans or veterans households in various long term care settings. These examples include a veteran couple, a single veteran and the surviving single spouse of a veteran. The care settings include home care, assisted living and nursing home care. Pension Benefits for each case are presented and a discussion on how these benefits dovetail with other long term care funding is provided.

CHAPTER 5 (56 pages) Understanding the Claims Process for Compensation, Pension, Death Benefits and HISA Grants This chapter provides more detail on compensation and pension and the application process for both. It also discusses another benefit for veterans receiving compensation or pension called a HISA grant. The chapter discusses in great depth how pension is calculated, who is eligible, how income is counted and the effect of estate value on receiving an award.

Application, medical and documentation requirements are discussed in great detail. A thorough reading of this chapter leaves a potential applicant with little doubt as to what is required for a successful award for pension.

APPENDIX (55 pages) Provides contact lists for the potential applicant

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