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Which Comes First, the Pension to Buy the Services, or the Services to Qualify for the Pension?

By Tracey Ingle

Which came first, the chicken or the egg?  This is the quintessential issue in VA nonservice connected disability pensions.  We talked last month about the VA calculating a veteran’s income for determining qualification for Aid and Attendance benefits by subtracting unreimbursed medical expenses from the total household income.  If there are insufficient expenses to decrease the income below the benefit level, then the veteran receives no pension benefit. Huh? What?

The example we used last month was Sally, our single veteran with total monthly income of $1,900.  Sally also pays $98.40 for Medicare, $175 for health insurance, $48.60 for Medicare Part D.  If that were the end of the story, Sally would only qualify for $66.67 a month of the Aid and Attendance pension benefit.  But in our example, at the recommendation of her doctor, Sally was also paying $1,500 a month for a home health aide to help her with some of her daily, personal chores like getting washed up and dressed in the morning, and meals.  This meant that Sally actually received $1,566.67 a month as an Aid and Attendance pension.

The question becomes then, did Sally NEED to hire the home health aide in order to qualify for the pension, or could she have applied, gotten the benefit and then hired the home health aide?  In other words, which comes first, receiving the pension benefit to be able to afford the home health aide, or hiring the home health aide in order to qualify for the pension benefit?

For many social service benefits, we apply, find out if we qualify, and then once the benefit is approved, receive the services.  The VA’s nonservice connected disability pensions (a/k/a Aid and Attendance) works the other way around though.  The veteran needs to already be paying for the services before the VA will approve and pay the benefit.  This means that there is a certain amount of financial risk to the veteran. The veteran could purchase the services only to find later that for some other unrelated reason, they do not qualify.

The moral to this story is that you have two choices: you can purchase the services and risk losing the cost of them if you are later denied the benefit for other reasons, or you can not purchase the services and not apply for the benefit.  With the first, you can always cancel the services later, and only have lost the cost of them while the application was pending.  With the second, you are guaranteed to receive neither services nor benefits.

The good news is that there are attorneys accredited by the VA to guide veterans in determining their eligibility for the Aid and Attendance benefit.  Unfortunately, the VA does not make it easy to find a local accredited attorney.  Go to the VA website:  In their search window (upper, right corner of the screen), select “Search all VA web pages”, type in “accredited attorneys” and click search.  Scroll through the search results looking for “OGC – Accreditation Search”.  (It was the ninth listing in my search.)  From that window, you will be able to search for attorneys, claims agents, and veterans service organization representatives.

Tracey Ingle is the Probate Puzzle Person and Principal of Ingle Law.  She can be reached at 508-281-7900 or or go online at

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