Frequently Asked Questions
There are so many misconceptions about VA disability benefits, we have added a FAQ page for your convenience. The answer to every question has a citation showing where that issue is addressed in rule, regulation or VA policy. Feel free to Google the citations for more information!
General Eligibility - "Just who can even consider applying for benefits?"
- A veteran, a financial dependent, a parent or the un-remarried surviving spouse of a Veteran may be able to receive disability benefits under the Compensation or Pension programs.
- A Veteran is someone who served at least 90 days of active duty federal service (exclusive of active duty for training) or completed the term of service for which they enlisted. A Pensioner must have served at least one day during wartime period.
- A Dependent of a Veteran is usually a child under the age of 18 or who became permanently disabled before age 18.
- Parent(s) of a veteran who are dependent upon him/her for financial support may be paid additional benefits. Dependency of a parent is based on need. Both the parental relationship and dependency of the parent must be established. Like Pension, this benefit is based on financial need.
- An un-remarried Surviving Spouse is someone of the opposite sex who was legally married to the Veteran at the time of his or her death and has not remarried.
Special Pension Eligibility - "My Dad is a Veteran and is in good health. Mom is the one who needs help. Are there any benefits available for her?"
- Not in her own right. As long as Dad is alive, all benefit rights are vested in him. However, there is a special condition that may apply in Pension cases. If you have read any of our preceding articles, you probably know that Pension is a needs based program. The VA counts the total gross household income (Mom and Dad) but you also get to deduct the total household out-of-pocket medical expenses. So, let's assume Dad has no need for medical assistance and therefore does not qualify for the special, additional aid and attendance benefit. If the household is being pauperized due to Mom's medical expenses, then we would evaluate Dad's situation as a Basic Rate Pension case. This means that because Mom's medical expenses are taking up all or most of the family's income, Dad is guaranteed a minimum monthly income as a wartime veteran. If the family's net income is less than the Basic Pension Rate for a Veteran with one dependent, the VA will pay the difference between the family net income and the amount guaranteed by law. This means Dad could be eligible for up to $1,750.00 per month in benefits. (2023 rate).
Aid & Attendance - "Just what is aid & attendance?"
- Aid and Attendance is a "special monthly benefit" that can be added to either Service Connected Disability Compensation or Non-Service Connected Disability Pension provided (1) the claimant is rated by the VA as 100% disabled (cannot hold substantially gainful employment due to their particular disabilities) and (2) meets the criteria specified in 38 C.F.R. 3.351 and 3.352. Simply put, the claimant has to have a physical or mental disability such that they require the regular assistance of a third-party care provider to safely undertake their basic activities of daily living.
Aid & Attendance - "Can I just apply for aid & attendance?"
- Well, yes and no. Aid and Attendance cannot be applied for except as a special additional benefit to Compensation or Pension. The claimant has to be eligible for each of these disability programs at the 100% level. If the physical or mental disability also exists, then Aid and Attendance can be added to either program. You cannot apply for Aid and Attendance without also being eligible for Compensation or Pension. It is not a stand-alone benefit. However, if you have been awarded Basic Compensation or Basic Pension, Aid and Attendance can be added to your benefit later through a claim for increase.
Aid & Attendance - "Are there special rules for adding Aid & Attendance to Compensation claims?"
- Yes. The need for aid and attendance (the physical or mental disabilities) must be directly related to the service-connected disabilities. For example, a Veteran has been awarded 100% disability due to a broken back suffered while on active military duty in Korea. However, the actual need for aid and attendance is due to the onset of Alzheimer's dementia. The VA will not award aid and attendance because the Alzheimer's dementia is not connected to the service-connected broken back.
Pension - "What is the Non-Service Connected Disability Pension?"
- The best way of conceptualizing Pension is that the VA is guaranteeing an eligible wartime Veteran or the un-remarried surviving spouse of a wartime Veteran a minimum monthly income. After allowable medical expenses are deducted from the total gross household income, the remainder is called Net Income for VA Purposes. The VA will pay the difference between the Net Income and the amount guaranteed by law. Theoretically, depending on the math, you could be awarded as little as one dollar or the maximum amount. Note: Historically, Pension programs began as early as 1866 and there are three "pension" programs on the books: (1) Old Law, (2) Section 306 and (3) Improved Pension. Only Improved Pension has been awarded since January 1, 1979.
Pension - "What does the VA Consider as Total Disability?"
- For VA purposes, a veteran is considered permanently and totally disabled if the veteran is a patient in a nursing home for long-term care because of disability; is disabled, as determined by the Commissioner of Social Security for purposes of any benefits administered by the Social Security Administration; is unemployable as a result of disability reasonably certain to continue throughout the life of the person; is suffering from any disability which renders it impossible for the average person to follow a substantially gainful occupation, provided it is reasonably certain that such disability will continue throughout the life of the person; or, if any disease or disorder determined by VA to be of such a nature or extent as to justify a determination that persons suffering from that disease or disorder are permanently and totally disabled. (38 C.F.R. § 3.3(3)).
Financial Issues - "The VA requires Pension applicants to prove "limited net worth." What does that really mean?"
- For VA purposes, the term "limited net worth" means the sum of net income (gross income less deductible medical expenses) plus assets contained in the claimant's estate such as checking, savings, CDs, IRAs, investments, etc. There is an asset limit, or brightline (VA term), of $150,538 which increases yearly with COLA. The principal place of residence on 2 acres or less is not considered in net worth calculations. Automobiles are also not considered countable for net worth calculations. VA's rules simply state that a decision will be made by the claim adjudicator on whether or not (in their opinion) the income and assets meet the applicable VA regulations. Therefore, you must provide supportive financial documentation of income and assets.
Assets - "How much can I have in the bank and still be eligible for Pension?"
- VA rules state the claimant needs to show limited new worth. On October 18, 2018, the VA created an asset limit, or brightline, for the first time. The brightline will increase every year with the cost of living adjustment (COLA) at the same rate as social security. The current brightline for this year is $150,538 and includes ALL financial accounts (checking, savings, CDs, money market accounts, investments, retirement funds, IRA's, annuities, trusts, etc.). The VA also created a 3 year look back period. They want to make sure there has not been a transfer of funds to create "artificial eligibility" (i.e. gifting or transferring funds to a trust or an annuity). Anything above the brightline is considered to be a covered asset and you must spend down such covered assets on goods or services at fair market value (i.e. the cost of care, home improvements, etc). One's home on 2 acres or less and any personal property does not count as an asset, unless you sell it. Then whatever you keep from the sale will become a countable asset at that time.
Assets - "Can I create artificial Pension eligibility by giving away part or all of my estate?"
- No, you cannot. On October 18, 2018, the VA added 3 new rules: 1) an asset limit/brightline; 2) a three year look back period; and 3) a penalty period of up to 5 years. The current asset limit is $150,538. Anything over this amount is considered to be a covered asset. The 3 year look back period is to make sure there has not been a transfer of funds to create artificial eligibility. The VA rule states covered assets must spend down on goods or services at fair market value (i.e. the cost of care, home improvements, etc) and cannot be given away or put into a trust or an annuity. If someone completes any "illegal transfer" and files for the VA benefit, they can be subject to a penalty of up to 5 years, meaning they will not be eligible to apply for the benefit during the penalty period. See the section below about how the three-year look-back rule and creation of a trust interact.
Assets - My attorney says I can buy an annuity or put my estate in an "irrevocable" trust. Can I do that?"
- Of course you can. And there are often good reasons to do so. However, buying an annuity or creating a so-called irrevocable trust to create artificial VA benefit eligibility is not one of them! Many irresponsible insurance agents, financial planners and elder law attorneys have preyed on elderly Veterans and their families by offering to help them obtain VA benefits by hiding assets from the VA. Their purpose in helping Veterans is often to gain a sales commission from the insurance product (annuity) or to sell expensive legal services (trusts.) The former vice chairman of the Senate Special Committee on Aging, Sen. Wyden of Oregon refers to these individual as "pension poachers" and the Governmental Accountability Office (GAO) issued a scathing report on June 6, 2012 documenting this abuse. Because of the abuse, Congress adopted a new rule of three-year prohibition on the gifting or transfer of assets before applying for Pension. Also, in light of the re-writing of VA’s net worth regulations in October, 2018, many “pension poachers” have advised their veteran clients to purchase a trust or annuity, wait out the three-year look-back period prohibiting transfers, and then apply for benefits. Unfortunately, VA considers funds placed in trust for an individual as being available for the support of that individual and therefore must be counted as assets regardless of the three-year look back!
Marriage - "My father was physically abusive to my mother and she divorced him. Is she eligible for Death pension benefits?"
- Unfortunately, no. The legal definition of a "surviving spouse" is someone who was legally married to the Veteran at the time of his or her death and has not remarried. A divorce for whatever cause or reason severs the marital relationship and the mother is not legally a "surviving spouse." This issue has been appealed numerous times before the Board of Appeals and the denial of the divorced widow's claim has always been upheld.
Marriage - "Are there any exceptions to the rule?"
- No, but there is a rule that allows a remarried widow to claim benefits from the first spouse under certain conditions. If the first spouse was a Veteran and that marriage ends due to the death of the Veteran and the widow remarries a non-veteran, if the second marriage ends due to an annulment, divorce or death between January 1, 1979 and November 1, 1991 (due to a clause in the Balanced Budget act of 1979), then the widow can claim benefits based on the service of the first Veteran even though there was a second marriage. This is the only exception to the rule. See 38 C.F.R. 3.55.
Military Service - "My dad was a sailor in the Merchant Marine during World War II. Is he considered a Veteran."
- If your dad was at sea for at least 90 days between December 7, 1941 and August 15, 1945, he is considered a Veteran by the VA and is fully entitled to benefits if he meets the other requirements of law. Note that World War II military service for merchant sailors ends on August 15, 1945 while for all other services the end date is December 31, 1946.
Military Service - "Are there any exceptions to having to have served at least 90 days of active, federal military duty for Pension eligibility?"
- There is one. If the Veteran was discharged due to a service connected injury or the aggravation of a pre-existing condition, the service performed is considered adequate for Pension eligibility consideration. However, the discharge documents must clearly state that it is a medical discharge. In World War II the unsophisticated state of military record keeping and the uncertainty of proper language may mean that the discharge papers do not fully and accurately reflect the actual medical reason behind a discharge. This is unfortunate but it is often the case.
Military Service - "My dad served in Vietnam. Is there anything I should know?"
- Potentially, Yes. If a veteran served “in-country” (including “brown-water” or "blue water"navy) from February 28, 1961 to July 7, 1975, they are considered in law to have been exposed to a family of toxic herbicides commonly called “Agent Orange” or AO. The VA, with the assistance of the National Institutes of Health, have identified several common diseases (Prostate Cancer, Parkinson’s Disease, Type II Diabetes, Ischemic Heart Disease, Respiratory Cancer, etc.) as being directly caused by AO exposure. Any veteran who served in Vietnam should contact their nearest VA Medical Center for an Agent Orange Registry Exam which will look for signs of these diseases. Importantly, if a Vietnam veteran has been diagnosed with one or more of these diseases; it is automatically considered a Service Connected disability and eligible for Compensation benefits. If, due to the severity of AO-presumed diseases, a veteran cannot “seek, gain or hold substantially gainful employment,” regardless of age, the VA is obligated under law to rate them totally disabled (100%) due to total individual un-employability. This can provide substantial financial assistance. Also see the article below about the PACT Act.
Medical Deduction - "My mom lives in a non-state licensed retirement community. Are her room and board fees deductible?"
- Perhaps. Under federal rules, only out-of-pocket medical expenses can be deducted from gross income for pension eligibility purposes. 38 C.F.R. 3.278. For many years the VA had no clear policy as to when room and board fees at any type of residential facility, licensed or not, could be allowed as medical deductions. In the mid-2000s, the VA finally determined that room and board fees as well as direct care fees at licensed assisted livings were fully deductible. However, the issue at independent / retirement / senior living facilities or communities remained unanswered. After much prodding, the VA issued a policy declaration on October 26, 2012 providing guidance to adjudicators regarding this issue. Fast Letter 12-23. The Fast Letter stated that room and board fees at non-licensed facilities would be allowed as deductions provided (1) there was a proven need for the special aid and attendance benefits, (2) the attending physician makes a certain statement in writing providing evidence of need (there is special language that must be employed in this statement), (3) the facility is staffed 24x7 with on-site personnel, and (4) there is a third-party providing "custodial care." The VA defines custodial care as assistance with two or more basic activities of daily living in the list found in 38 C.F.R. 3. 278(a)(2). Note that the third-party care provider does not have to be a professional provided by a licensed agency. It may be a non-licensed individual or indeed, a family member. The third-party does not have to be paid for the care provided. A spouse may be considered as a third-party care provider. If all four conditions mentioned above are met, the room and board fees are fully deductible on exactly the same basis as assisted living. Also see the Adjudication Procedures Manual, M21-1MR, V.iii.1.G.42.
Getting Assistance - "Who can help me with a benefit claim?"
- Federal law requires anyone assisting with a claim for VA benefits be accredited by the VA General Counsel (Title 38 USC §5901 and 38 CFR 14.626.) The VA only recognizes three types of individuals that can be accredited: attorneys, claims agents and Veteran Service Officers (38 CFR § 14.629.) Every person accredited by the VA receives credentials from the General Counsel. Ask to see credentials or search for them on the General Counsels website under the heading "accreditation search." ( http://www4.va.gov/ogc/apps/accreditation/index.asp) If the person offering to assist cannot provide their official VA credentials or you cannot find their name listed on the General Counsel’s website, then you should look for someone who is accredited. It is a violation of federal law to assist someone with filing a claim for VA benefits if you are not accredited by the VA. This also applies to individuals who state that, although they will help to prepare or give advice on a claim, the actual claim is filed by an individual who is accredited. Even to give advice or assist on a claim requires VA accreditation. This law was enacted in order to protect veterans and their families and to assure that veterans have qualified representation.
Getting Assistance - "Why do I need someone's help? Can't I do it myself?"
- Really, this isn't a very good idea! Filing a claim for VA disability benefits is a complicated process, even with so-called "simple" claims. Even though the VA makes basic claim forms available on-line and through its automated VONAPP system, the process can be daunting. Essentially, you can say anything you want on the claim application; however, federal regulations require that some (not all) of the information you provide be supported by evidence. It is also helpful for this evidence to be in a certain format expected by the VA. Not knowing what evidence is legally required or providing evidence that is not needed, can substantially delay the adjudication of the claim. Getting the proper information and evidence to the VA in the initial package (especially under the provisions of the Veterans Benefit Improvement Act of 2008) can often reduce the waiting period on Veterans claims. 38 C.F.R. 3.161.
Getting Assistance - 'Isn't it illegal to charge a fee for helping someone with a VA claim?"
- Absolutely true! Not only is it illegal to charge a fee, it is also illegal to accept a gift or a gratuity for assisting someone.
Getting Assistance - "If that's the case, why does your firm charge a fee?"
- Excellent question! First of all, let us say that we absolutely do not charge any sort or kind of fee for assisting with a claim or representing one of our clients before the VA. Period. However, in 2004, the question of when attorneys can charge for helping Veterans was posed by Rep. Joe Evans (who at that time was the Ranking member of the House Committee on Veterans Affairs) to the VA General Counsel Tim McLean. Specifically, Sen Evans asked under what conditions attorneys could accept a fee for advising about VA benefit availability and benefit eligibility. General Counsel McLean replied to this inquiry by official letter on May 24, 2004. Essentially, the VA's position is that attorneys provide good and valuable assistance and advice to individuals seeking to become benefit claimants (before becoming an actual claimant). The VA calls this advice and assistance a "Pre-Filing Consultation" and even describes what they imagine would be contained in that type of consultation. As long as this consultation occurs before an individual actually becomes a Claimant for a VA benefit, it is perfectly legal to charge a fee for these services. The term "Claimant" is defined in Title 38 in 38 C.F.R. 14.627(h) : "Claimant means a person who has filed or has expressed to a representative, agent, or attorney an intention to file a written application for determination of entitlement to benefits provided under Title 38, United States Code, and implementing directives." As long as the consultation occurs before an individual becomes a Claimant under this definition, it is perfectly legal to charge a fee for legal services as these services occur outside the jurisdiction of Title 38. We charge absolutely no fee of any kind after one of our clients becomes a Claimant.
Getting Assistance - "So why should I engage an attorney?"
- Again, a great question. We feel the answer is straightforward. With respect to services offered by our firm, the common denominator individuals contacting or being referred to us is simply that a loved one is about to experience (or perhaps already is experiencing) significant expenses for institutional or non-institutional care. These families are seeking trustworthy, accurate information about benefit availability and eligibility so they can make the best decisions regarding their loved ones care. Availability of benefits can determine the type of care received and can substantially affect the quality of life for their loved one. The information in the public domain (internet, word-of-mouth, etc.) is very often incomplete, inaccurate, or misleading. In order to make the best decisions possible, families simply want the best information available. In our case, we try to meld information about care possibilities and benefits into a useable body that provides many answers and potential option to families with these questions. Remember: VA benefit availability and eligibility is based on Federal rules and regulations, as well as certain VA policies about how VA interprets these rules and regulations. Understanding these rules and regulations and how they apply in your case is very important. Applying for benefits is a legal process. You are essentially petitioning a federal administrative law body (the VA) to grant you financial benefits. It's all about law! If you require these benefits to fund care, you want to be reasonably sure that eligibility requirements are being met before you assume the expenses associated with care. This is the basic legal service we offer. The advice and consultation is paramount; the paperwork is merely a bi-product of the legal research and consultation process.
Getting Assistance - " If I want to apply, wouldn't it be smarter to go to my local VA office for help?"
- The VA does not maintain local offices, only regional offices which are usually one per state. What you are likely referring to are County Veterans Service Offices. It is important to know that CVSO’s are county government employees who are accredited as service officers by VA. They do not work for the VA. CVSO’s do not charge a fee for their assistance and are available to everyone in the county.
Claims - "When do I start getting money after my claim is approved?"
- The effective date of VA disability awards is the first day of the month after the claim or intent to file a claim was received by the VA. It does not start when the VA actually receives the claim. Currently (June , 2023) due to the effects of the PACT Act legislation, the national average for completion of VA claims appears to be about 4.5 months, although some claims go through much faster and some are slower. However, even if it takes the VA 4-5 months to adjudicate your claim, your first award check will be for all of the months retroactively from the effective date. This is called the retroactive payment. Subsequently, the VA will pay benefits on the first of every month for the preceding month. It is important to note that if the VA proposes to find the claimant incompetent to handle their own financial affairs, this retroactive payment will be held by the VA until a fiduciary is appointed.