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Aid and Attendance and Housebound benefits

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Posted on: Wednesday, June 20, 2012

Jim,

I have a question in regards to the difference between aid and attendance, housebound, and special compensation. I have been rated by the VA as 100% service connected. I have TBI. PTSD, plus a multitude of other (sc) injuries. My wife helps me with my medication some of which I take three times a day. She drive me to my doctors appointments, cleans my CPAP machine, makes my meals, and dispenses my pain medications. Without her I don’t know how I would function daily. Without knowing my case in depth my question is do you think we would qualify for any of the special allowances for the extra care my wife gives me. If we do how can we insure the VA will approve the claim?

Reply:

I'll begin by answering the last question first.

There is no way that you can ensure that any claim will be successful. Even the best prepared and most deserving claims are routinely denied by the VA. There are many reasons thought to exist for this.

We know that somewhere between 40% and 70% of all initial claims are denied. On appeal, we know that 70% of those are approved. There's a message in there somewhere.

The housebound and AA benefits are confusing. One comes with disability compensation, the other with disability pension. The Special Monthly Compensation is an add-on benefit for those who are so severely injured that they more or less require 24 hour care or devices like special wheelchairs.

Veterans Attorney Drew Early has written an excellent article to help us understand these important benefits. You'll find that on this page http://www.vawatchdog.org/Benefits_Guide.html

What are Aid and Attendance and Housebound benefits?

Aid and Attendance (A&A) is an enhanced or special monthly pension benefit paid in addition to basic pension. You may not receive enhanced or special monthly pension without first establishing eligibility for basic VA pension. However, because enhanced pension is based upon a higher income limit, a claimant ineligible for basic pension due to excessive income may be eligible for enhanced pension benefits. A Veteran may be eligible for A&A when: The Veteran requires the aid of another person in order to perform his or her activities of daily living, such as bathing, feeding, dressing, attending to the wants of nature, adjusting prosthetic devices, or protecting himself/herself from the hazards of his/her daily environment, OR, The Veteran is bedridden, in that his/her disability or disabilities requires that he/she remain in bed apart from any prescribed course of convalescence or treatment, OR, The Veteran is a patient in a nursing home due to mental or physical incapacity, OR, 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. Housebound is an enhanced or special monthly pension benefit paid in addition to basic pension. You may not receive enhanced or special monthly pension without first establishing eligibility for basic VA pension. However, because enhanced pension is based upon a higher income limit, a claimant ineligible for basic pension due to excessive income may be eligible for enhanced pension benefits. A Veteran may be eligible for Housebound benefits when: The Veteran has a single permanent disability evaluated as 100-percent disabling AND, due to such disability, he/she is permanently and substantially confined to his/her immediate premises, OR, The Veteran has a single permanent disability evaluated as 100-percent disabling AND, another disability, or disabilities, evaluated as 60 percent or more disabling.

A Veteran cannot receive both Aid and Attendance and Housebound benefits at the same time.

How to Apply for Aid and Attendance and Housebound:

You may apply for Aid and Attendance or Housebound benefits by writing to the VA regional office having jurisdiction of the claim. That would be the office where you filed a claim for pension benefits. If the regional office of jurisdiction is not known, you may file the request with any VA regional office. You should include copies of any evidence, preferably a report from an attending physician validating the need for Aid and Attendance or Housebound type care. The report should be in sufficient detail to determine whether there is disease or injury producing physical or mental impairment, loss of coordination, or conditions affecting the ability to dress and undress, to feed oneself, to attend to sanitary needs, and to keep oneself ordinarily clean and presentable. In addition, it is necessary to determine whether the claimant is confined to the home or immediate premises. Whether the claim is for Aid and Attendance or Housebound, the report should indicate how well the individual gets around, where the individual goes, and what he or she is able to do during a typical day.

Special Monthly Compensation Rates are here http://www.vba.va.gov/bln/21/rates/comp0299.htm

The regulatory path to SMC is very complex. I suggest that you spend plenty of time reviewing this as it may not come easy. Patience is an asset. Click http://www.benefits.va.gov/WARMS/docs/admin21/m21_1/mr/part4/subptii/ch0...

As you study and learn about the benefits that may be available to you now and in the future, I believe that you should first look to the Caregivers benefits that have become available. It sounds to me as if this may be just the benefit you need today.

Please click here to learn more https://www.vawatchdog.org/Benefits_Guide.html

I urge veterans to file for claims and to communicate with the VA benefits office ONLY in writing. Phone calls and emails are often ignored or lost. Please read https://www.vawatchdog.org/Letter_Templates.html

Most claims are quickly denied. Most claims denied are won on appeal. Please click https://www.vawatchdog.org/how-to-appeal.html

I suggest that you and your wife spend a lot of time reading my web site. It's updated daily and I've done my best to provide you with timely, accurate information that is organized in such a way that veterans can make sense of it. I'm usually around to answer questions.

With your injuries you and the VA will be tied together for your lifetime. Many of us have a similar relationship with VA. Currently, the VA is badly broken. This has occurred due to politics and mismanagement over the last 10 years. It won't get any better in the neat future so you need to begin to learn how to effectively use the system for yourself.

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Comments

Submitted by Rptp1211 on Sun, 2014-08-10 11:59

I'm a 90% plus 10% unemployability and I'm currently receiving SMC in the amount of $3,715 - $300 for mortgage insurance. I have been told that I am also eligible for aid and attendance as well. Right now I'm entitled to 6 hours per week for a person to assist me with bathing and dressing and medicating and preparing my meals. The question that I have is how much is aid and attendance and is that in addition to what I'm already receiving?
Thank you so much for your assistance!
Bob

Submitted by Jim Strickland on Tue, 2014-08-12 13:34

The A & A program may have variables for each individual veteran.

Please click this link to learn more http://www.benefits.va.gov/PENSION/aid_attendance_housebound.asp