What are the Qualifications for a VA Pension?

3Ms to Veteran Pension Qualifications:

The First M is Military Service:

A veteran must have served 90 days of active duty, with one day during a war period, and have an honorable discharge to be eligible for benefits.
The periods of war include:

  • World War II: 12/07/1941 to 12/31/1946
  • Korean War: 06/27/1950 to 01/31/1955
  • Vietnam War: 08/05/1964 to 05/07/1975
    For those who actually served in the war zone, “boots on the ground” start date is 02/28/1961
  • Gulf War: 08/02/1990 to present  
    Gulf War veterans must have two years of active duty to qualify; the two years are accumulative.

VETERAN PENSION SECRET 

You don’t have to have been in the war zone to qualify. You only need to have been in the military during the war period.

For instance, someone serving in the United States or Germany during the Vietnam war would qualify.  

The Second M is Medical Need:

A claimant must need assistance from another individual with at least two activities of daily living or ADLs; these are bathing, dressing, ambulating, toileting, transferring, and eating.

The VA considers medication management as an activity of daily living or ADL for someone with cognitive impairment.

Let’s break down these ADLs and how the VA looks at them for qualification purposes.

Bathing:

With the Veterans Pension, assistance with bathing doesn’t have to be someone physically hands-on bathing you.

It can be stand-by assistance because you’re a fall risk or need reminders to take a bath because you have Dementia. Grooming is also helpful for claims approval if noted by the Doctor completing the evaluation, VA form 21-2680. 

Dressing:

Like bathing for dressing to qualify as an ADL, you don’t have to have someone putting on and taking off your clothes. Someone with Dementia may need reminders to change their clothing, which will qualify as an ADL for the benefit. Someone with arthritis may need help butting a button or tying a pair of shoes.

All of these will qualify dressing as an ADL.

Ambulating or walking:

Walking as an ADL has been on and off for Veterans Penson qualification.

I have had claims both approved and denied, with ambulating as one of the two ADL’s.

When someone at the VA denied one of my claims with just bathing (stand-by assistance only) and ambulating, as the ADLs. This came as a complete surprise to me because not a week later, I had a claim approved that was just like the one that was denied. I called the VA to find out the problem with the claim. The VSR  said it has always been that way. Ambulation is not an ADL, he told me.

So check with your claims agent at the time you are filing a claim to know if ambulating will qualify as an ADL.

Currently, it is. – see our website for an updated status on ADL’s

Toileting:

Toileting includes help getting down and up from the toilet. It’s also help personal hygiene, cleaning oneself and incontinence care.

Transferring:

Transferring is needing help getting up from a bed or chair, or wheelchair.

Help to a walker.

Eating:

Eating can also be the need to be reminded to eat for someone with Dementia.

Or they can be a choking risk and need their food cut up for them.

Cooking is not an ADL.

Your Doctor’s Role

The VA relies solely on what your doctor states on the VA form 21-2680.

If your Doctor says you are a fall risk, you are a fall risk. If they say you have early onset of Dementia and you need medication management,  then you need medication management, period.

The VA will not question your Doctor’s authority.

It is always best to have the doctor report reviewed by an Accredited Claims Agent before it is sent in to ensure it is completed properly before the VA receives it.

         

The Third M is Money:

What are the income and asset limits for 2022?

The VA calls this limit the “Bright-line limit.” For 2022 the bright-line limit is $138,489. The is a combination of all household income and assets. Many veterans have confusion about what are qualifications for a va pension.

As mentioned on page 64 the income is offset by unreimbursed medical expenses.

The limit changes on December 1 of each year. See our website for the current “Bright-Limit”, CareFundingSolutions.com/veterans/

Let’s first define countable and non-countable income and assets. 

Important to note the VA counts all marital household income and assets as jointly owned.

Income

Countable income includes:   Social Security Income(s), all pension income, earned income from employment, interest income, RMD’s from retirement accounts, short and long-term capital gains, and even gifts to you from your children to help pay for care.

Payments from any source unless specifically excluded. The following sources of income are counted for the purposes of completing the financial assessment.

Countable Income :

  • Alimony
  • Allowances
  • Benefits Subject to Garnishment
  • Complaint Settlement
  • Cooperative (Co-op) Dividends
  • Department of Labor Employment Programs
  • Dependency and Indemnity Compensation —This benefit program pays a monthly payment to a surviving spouse, child, or parents of a deceased military service member or Veteran.
  • Farm Income/Conservation Resource Program Payments
  • Foreign Currency Conversion
  • Gambling/Lottery Winnings
  • GI Bill
  • Gifts and Inheritance of Property or Cash (The fair market value of gifts or inherited property is countable in the year they are received)
  • Individual Retirement Account (IRA) Distributions
  • Interest and Dividends
  • Life Insurance Proceeds (Death Benefit paid to Veteran or spouse). Life insurance is Countable as income in the year that it is received.
  • Long-term care insurance payments.
  • Net Profits and Depredation from Business, Farm and Ranch, Real Estate
  • Partnership, and S Corporations (Depredation is added back in as income)
  • Other Income (Prizes/Awards, Inheritances)
  • Payments from Stocks and Bonds, Capital Gains
  • Pensions, Annuities, Railroad Retirement
  • Revocable Trust
  • Royalties (Books, Music, Art, etc.)
  • Settlements:
  • Alaska Native Claims Settlement Act (amounts exceeding $2,000 per individual per annum -including cash dividends on stock received from a Native Corporation)
  • American Indian Beneficiaries from trust or restricted lands (amounts exceeding $2,000 per individual per calendar year)
  • Social Security Benefits and Death Benefit Payment (including retroactive Lump Sum Payment from previous years)
  • Timber Sales
  • Unemployment Compensation
  • VA Disability Compensation – For the purposes of completing a financial assessment, the gross household income for a Service-connected Veteran who is receiving VA disability compensation and is married to a Nonservice-connected Veteran who is completing the financial assessment, VA disability compensation benefits would be countable income for the household
  • Value of Room and Board/Housing Allowances
  • Wages (Employment), Salaries, Bonuses, Severance Pay, Tips, and Other Accrued Benefits, etc.
  • Workers Compensation

Non-Countable or Exempt income includes:

  • Caregiver Payments
  • Chore Service Payments
  • Crime Victims Compensation Act Payments
  • Disaster Relief Payments or Proceeds of Casualty Insurance
  • Discharge of Indebtedness
  • Federal Emergency Management Agency (FEMA) Disaster Insurance Payments
  • Federal Government Sponsored Economic Stimulus Refunds
  • Foster Care Payments
  • Income from Domestic Volunteer Service Act Program
  • Income Tax Refunds
  • Loans (Reverse Mortgages)
  • Maintenance
  • Needs-Based Payments from Government Agency
  • Payments for participation in a program of Rehabilitative Services
  • Provisional Income
  • Relocation Expenses
  • Scholarships and Grants from school attendance
  • Settlements:
  • Agent Orange
  • Alaska Native Claims Settlement Act (income of up to $2,000 per individual per annum -including cash dividends on stock received from a Native Corporation)
  • American Indian Beneficiaries from trust or restricted lands (income of up to $2,000 per individual per calendar year)
  • VA Pension Payments
  • Welfare, Supplemental Security Income (SSI), Compensated Work Therapy (CWT), Incentive Therapy (IT) earnings
  • Withheld Social Security Overpayments

NOTE: The above list is not all Inclusive.

 

VETERAN PENSION SECRET #2

There is not a set income limit per se.

Deductible Medical Expenses: May be used to reduce other countable income for purposes of increasing pension benefits. This includes the cost of assisted living, nursing and home care and home health care cost

Income Limits:

To qualify for the full pension benefit, your income must be less than your out-go for unreimbursed medical expenses and cost of care.

Example 1: If you are a married or single veteran with a household income of $4,000 per month, and your cost of care in an assisted living community is $4,500 per month, you would have a monthly shortfall of $500. Therefore, you would qualify for the full monthly benefit.

Example 2: If your income is $4,500 per month, but your cost of care in an assisted living community is only $3,500 per month, you would have a $1,000 positive income.

Now even though you have a  $1,000 positive income, you would still qualify, but only for a partial benefit.

The benefit amount paid is determined by subtracting the $1000 from the maximum benefit to get the partial benefit amount.

I have purposely simplified and left out parts of the income and out-go. The VA uses a more detailed MAPR equation than intended for this book.

Just understand there is not a set income limit perse. You need to spend your income on care in order to qualify for benefits.  

See appendix for Commonly Allowed Medical Expenses.

See Maximum Annual Pension Rate or MAPR if you want a more detailed explanation. This can be found on our website.

The Catch 22

How do you pay for care to qualify for Veterans Pension if you don’t have the Veterans Pension benefits to pay for care?

Classic Catch 22! For some, this presents a real dilemma.

How can they use all of their income to pay for care? They have food bills,  housing, and utility bills to pay.

If they have savings, they can use the savings until the VA benefits are approved. Since it is a retroactive benefit paid back to the first of the month following the month the claim was submitted.

Meaning if you submit a claim on January 20, the benefits will accrue from February 1. So once the lump sum benefits are paid, you can put it back in your savings.

But what if you have no savings? How do you pay for needed care if you don’t have the money from the VA to pay for care?This is less of a problem if you are in an assisted living home or community. The cost of assisted living is considered a medical expense. So you could consider moving from your home.

Since an assisted living cost is all-inclusive, it includes room and board, utilities, food, and in some cases, cable.

So now you get the care and reduce your income with other expenses not otherwise included.

Another solution is apply get approved for a partial benefit, then once approved dollar for dollar up to the maximum benefit that you spend on care will be paid by the VA.

Here is what I mean, I once got a claim approved for $1.39! Woo-hoo!

And you are bragging to us about this, a $1.39 award? Why?

Here’s why the Veteran was approved. Now they can get home care in and increase the care hours over time up to the maximum benefit amount.

I hope your question of “what are qualifications for a va pension” is answered”.