Clarification on VA Aid and Attendance

The RHIIP ListServ #284 has released new clarification concerning VA Aid and Attendance. This refers to how payments are to be treated with respect to annual income, and the regulations for medical expense exclusion (24 CFR 5.609(c)(4)).  According to the U.S. Department of Veterans Affairs, Aid and Attendance (A&A) is an enhanced or special monthly pension benefit paid in addition to basic VA pension.

An individual must first establish eligibility for a basic VA pension in order to be eligible for A&A.

The VA indicates that a veteran may be eligible for A&A if:

• S/he requires the help of another person for daily living activities such as bathing, feeding, dressing, toileting, adjusting prosthetic devices or protecting himself/herself from the hazards of the daily environment
• The veteran is bedridden
• S/he is a patient in a nursing home due to mental or physical incapacity
• The veteran has corrected visual acuity of 5/200 or less, in both eyes, or concentric contraction of the visual field to 5 degrees or less

Because there is no statutory or regulatory exclusion for the A&A benefit, it must be included as income.

But remember that any “amounts received by the family that are specifically for, or in reimbursement of, the cost of medical expenses for any family member” are excluded from annual income (4350.3, Exhibit 5-1, Income Exclusions, #4).  You must verify any A&A amount received that is used for medical expenses and exclude the verified amount.  Any portion of the benefit not being used for medical expenses must be included as income.