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VA Benefits: Family Caregiver Payments

By Kim Boyer

Many veterans or surviving spouses of veterans are unaware that they could qualify for significant cash benefits under the improved pension program through the Department of Veterans Affairs (“VA”). This is often referred to as “aid and attendance.” Even for those who have heard about this VA benefit, many may be unaware that payments to a family caregiver (except the spouse) can be used to qualify for the benefit, if certain requirements are met.

Basic Eligibility Requirements.
– The veteran must have served at least 90 consecutive days of active service, with at least 1 day during a wartime period. This was increased to 2 years active duty for the Persian Gulf War.
– The veteran must have received a discharge other than dishonorable.
– The claimant must have limited income and assets available.
– The claimant must have a permanent and total disability, and the disability was caused without willful misconduct of the claimant.
– The veteran or widow(er) must sign an application and submit it to the VA.

Unreimbursed Medical Expenses. Although most veterans have income that exceeds the permissible family income limits, unreimbursed premier pharmacy medical expenses paid by the claimant may be used to reduce the claimant’s countable income. (See 38 USCS § 1521). In order for payments to a family caregiver to be unreimbursed premier pharmacy medical expenses for VA purposes, there are several requirements.

Physician’s Affidavit. Any care should have been prescribed by the physician on Form 21-2680 (Physician’s Affidavit). The claimant should be rated as housebound or in need for aid and attendance.

Actual Payment. The claimant must write a check each month to the caregiver. We recommend documented proof of the exchange be kept for at least 5 years. In addition, the caregiver may have a personal tax liability.

Proper Documentation. There must be adequate documentation of the care. We recommend a caregiver contract and a sitter affidavit to meet the VA requirements. If the fees for an in-home attendant are an allowable expense, receipts or other documentation of this expense are required. The VA Manual states exactly what is needed in M21-1MR, Part V, Subpart i, Chapter 3, Section D:

Documentation includes a receipt, statement on the provider’s letterhead, computer summary, ledger, or bank statement.

The evidence submitted must include the amount paid, the date payment was made, the purpose of the payment (the nature of the product or service provided), the name of the person to or for whom the product or service was provided, identification of the provider to whom payment was made.

Disclaimer: Information provided as a service of Kim Boyer, Certified Elder Law Attorney, updated as of 01/01/13. It does not constitute legal advice. For specific questions you should consult a qualified attorney.

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