Following questions and answers are provided by Jerome Sebesta - Omega's National VA Accredited Claims Agent. These are FAQ's based on current law. If you are thinking of filing for a pension, CALL OMEGA TODAY FOR ADVICE!!
1. How long does it take to start receiving the Aid & Attendance Benefit?
From the time of filing the application with the Regional Office of the Department of Veterans Affairs it typically takes approximately two to three months to receive a response from the VA. Assuming that the application packet is complete, then one can receive the award within that time duration. However, since each VA adjudicator looks at the application somewhat differently and may want something additional or even the same information on a different form, we are averaging 4-6 months to receive the award.
2. Is the benefit retroactive?
Typically, the benefit is awarded retroactive to the first of the month following the date the application or the Intent to File Pre-Application was filed. For example, if the application or Intent to File Application was filed March 26, then the “award date” would be April 1 even though approval might not occur until many months later.
3. Does the veteran/spouse have to be a resident of an Assisted Living Facility (ALF) or Skilled Nursing Facility (SNF) before making application for the benefit?
The benefit is not necessarily tied to where the applicant is residing. So if one were living at home, that person could still file. However, the benefit is tied to the applicant’s “income for veterans affairs purposes” (IVAP) which is basically a calculation of gross income minus various “medical expenses” (as defined by the VA). Medical expenses usually include the cost of the ALF or SNF. Therefore, as a practical matter, unless the applicant is already residing in an ALF or SNF, his medical expenses will be very low resulting in IVAP that exceeds the limit for the benefit to be approved. Here you will need our help in identifying other strategies to reduce the income to qualify. There are answers to 99% of our cases.
4. Is room and board at a facility considered a medical expense in
calculating income for veterans affairs purposes?
All unreimbursed fees paid to the facility for custodial care (including room and board) and medical/nursing care are typically considered medical expenses. Basically, if there is a need to live in a protected environment, the entire amount paid to the facility is a medical expense.
5. Is my home an exempt asset for the rest of my life?
If you consider your home your primary residence (even if you live in a facility),then it is not counted in calculating your net worth for VA purposes (i.e. exempt). However, if the home is sold or there is not intent to return, the home and proceeds are not considered exempt and eligibility for the benefit is typically lost. However, again, this is a situation that Omega can resolve with some legal assistance.
6. My parent already has a Family Trust/Revocable Living Trust (RLT). Why would she need a different kind of trust now?
An RLT is neutral in its effect on eligibility for the VA benefit. Therefore, any assetsheld by the RLT are counted as if owned directly by the creator of the trust (the parent). If one's net worth is too high to qualify for the benefit, one can transfer assets to a different kind of trust, a Irrevocable Trust or often called a QVAP trust. Because of the manner in which the QVap trust is drafted, assets held by it are not counted as owned by the creator of the trust (the parent). The QVap trust can also retain for the family the ability to claim the $250,000 exclusion from capital gain and obtain a step up in income tax basis on the death of the parent.
7. Why is it so important that we use an Accredited Individual?
VA accreditation is the only way that a consumer can be sure that the individual knows the laws and regulations that apply to the VA benefit programs. To be accredited,we must pass a very extensive exam and must periodically take a certain amount of continuing education courses on VA benefits. There are not many of these however. Today, for example, there are only 16 National VA Accredited Claims Agents in North Carolina. I (Jerome Sebesta - Omega Care Planning Council) am one of these and you can verify that by going to the official VA Website at www.va.gov.
8. Can I, my family, or the facility (I plan to live in) pay a fee to an
individual offering to do the VA application for me?
It is unlawful for anyone to charge an applicant a fee for processing the application. Further, it is unlawful to charge the facility, or ask for a donation.
9. This sounds to good to be true…what’s the catch?
There really is no catch. However, please understand that in approximately 95% of the cases that we handle, the applicant, when we first meet, is not qualified based either on income or net worth, or both. Therefore, either some legal or financial work has to be done to get the applicant eligible prior to filing. This is what is called Medicaid Planning or what we call LTC Planning. There are charges for this legal and financial work. You will be informed of what needs to be done and what those charges will be prior to becoming obligated!
10. How much in net worth am I allowed to have?
You may hear that there is a limit of $80,000 to qualify (not counting exempt assets). This is merely a VA guideline and depends on your age and other factors. One such factor is in practice, the VA regulation has no limit but then again the VA only allows 12 months of cash reserves based on medical needs. Wow, if you understand that then all the other factors, then please file on your own.
11. How much income am I allowed to have?
That depends on whether you are a veteran or a surviving spouse and your rating (i.e. category). The allowable income is expressed as IVAP. (IVAP is income for “veterans affairs purposes” which is basically a calculation of gross income minus various “medical expenses, “ as defined by the VA. Medical expenses usually include the cost of the ALF or SNF and excluded Independent Living or Home unless a Legal Care Agreement is in place.) Your IVAP must be less than the maximum amount of pension you could obtain for your rating. A married veteran in need of aid and assistance (i.e. rated for aid and assistance) would be entitled to a maximum pension of approximately $2169 per month (2018 Rate). The actual pension is computed by subtracting the IVAP from the maximum pension. So the IVAP must be less than the maximum pension to be entitled to anything. Here about 9 out of 10 applicates are denied without some assistance. I encourage you to work with Omega if this is an issue.
12. Can I use the benefit to pay an individual for Home Health Care?
Yes, you can.
13. Can I use my current financial planner to help me file for the benefit?
First, unless the financial planner is accredited by the VA it would typically be unlawful for him to do so, even if he were acting for free. Second, if he is not accredited, how can you know if he really knows the rules that apply to this program and is giving you the best possible advice. If you file and 6 months later get denied simply because this person did not understand the law, then you lost 6 months of benefits as well. Use your head and make the right financial decision is my advice.
14. What is a VA fiduciary and how can that delay the benefit?
If the VA believes that the applicant is unable to handle his own financial affairs (usually based on information contained in the applicant’s physician's report) then the VA will award the benefit but defer any retro payment until someone is appointed to take care of the money for the applicant. This person is called a VA fiduciary and is usually, but not always) a family member. The process of determining if a fiduciary is necessary and whom to appoint can add another 4-6 months to the process before VA retro money is actually received. However, the award is retroactive so we eventually get to you the entire amount of the retro payment.
15. What is the VA application process?
It is the process of the preparation, presentation and prosecution of the claim.
16. How much does it cost to have Omega Care Plannig Council help me.
First, Omega Care Planning Council acts as a community service with a mission to inform and educate veteran families. Everyone receives this service for free. If you decide you want to investigate the VA Pension to see if you qualify you will fall into one of two groups. The first group are the people who have assets and income that qualify without any need for legal, accounting or financial advice. Therefore, everything is Pro Bono...Free.
The second group is a different story. This group has income and/or assets that disqualify them. Typically they will have to pay for legal, accounting and financial advice. The typical cost for preplanning will be somewhere between $500.00 to $3,000.00. The Preparation, Presentation, and Prosecution by the Volunteer VA Accredited Agent for filing the claim is Free.
Call Omega Care Planning Council today to inquire about the Aid and Attendance Benefit which is really called "Improved Pension"