Long Term Care Benefits Available to Surviving Spouses of Wartime Veterans

There are millions of surviving spouses of veterans currently living in the United States.   Many of these surviving spouses are receiving long term care or will need some type of long term care in the near future, and there are funds available from the Veterans Administration (“VA”) to help pay for that care.  Unfortunately, many of those who are eligible have no idea that any benefits exist for them or that an attorney can help them become eligible.

Benefits Available
There are three types of pension benefits available that provide monthly cash payments to surviving spouses who either have low income, long term health care needs, or both.  The pension benefit is referred to as “Death Pension.”  Below is an overview of the three benefits, and more detail will be provided on each benefit in the following paragraphs.

Death Pension.  The VA provides a monthly cash payment to surviving spouses of veterans who meet active duty and discharge requirements, who are either 65 or older or disabled, and who have limited income and assets. A surviving spouse can receive up to $736 per month (with additional payments available if dependent children are present in the home).

Death Pension with Housebound Allowance.   A slightly higher monthly payment is available to surviving spouses of wartime veterans (who meet the same service requirements as Service Pension) but who are confined to their home for medical reasons.  A surviving spouse can receive up to $899 per month (with additional payments available if dependent children are present in the home).

Death Pension with Aid and Attendance.  The highest monthly benefit is available when a surviving spouse requires the assistance of another person to perform activities of daily living, or is blind or nearly so, or is a patient in a nursing home.  This benefit, often referred to simply as “Aid and Attendance” is the most widely-known and talked-about benefit as it offers the highest possible monthly payment.  A surviving spouse can receive up to $1,176 per month (with additional payments available for dependent children).

While Aid and Attendance is the most popular VA benefit, it is important to remember that Death Pension (with no additional allowances) is available to surviving spouses who do not require assistance with activities of daily living but are either disabled or 65 or older and have low income.

Eligibility Requirements (generally):

Valid Marriage.  The surviving spouse and the veteran must have been married for at least one year prior to the veteran’s death. Next, the surviving spouse must not have remarried. Additionally, the surviving spouse must have been living with the veteran at the time of the veteran’s death.  If the couple was living apart, it must have been for medical, business, or other reasons besides marital discord, unless the marital discord was not the fault of the surviving spouse.

 Wartime service and discharge.  The deceased veteran must have met certain service and discharge requirements before the surviving spouse can be considered for any type of pension benefit.   The deceased veteran must have served 90 days of active duty with at least one day beginning or ending during a period of war.  After September 1, 1980, the active duty requirement increases to 180 days.  In addition, the veteran must have been discharged under circumstances other than dishonorable.

Disability.  To qualify for any type of pension benefit, a surviving spouse must also be 65 or older or be permanent and totally disabled.

Permanent and total disability includes a claimant who is:

  • In a nursing home;
  • Determined disabled by the Social Security Administration;
  • Unemployable and reasonably certain to continue so throughout life; or
  • Suffering from a disability that makes it impossible for the average person to stay gainfully employed.

Asset and Income Requirements

The financial eligibility requirements of any pension benefit address a claimant’s net worth and income.  A claimant is the individual filing for benefits.  A surviving spouse should have no more than $50,000 in countable assets.  Retirement assets are counted, but a claimant’s home and vehicle are not. However, the $50,000 limit is a guideline only – it is not a rule set by the VA. The VA looks at a claimant’s total net worth, life expectancy, income and medical expenses to determine whether the surviving spouse is entitled to any monthly death pension benefits.

Many times the most difficult task in this area is to reduce a claimant’s assets down to the applicable level (or what one hopes will be acceptable to the VA).  The assistance of legal counsel is important to insure the right strategies are used with minimal impact on possible Medicaid in the future.

A surviving spouse must have Income for VA Purposes (“IVAP”) that is less than the benefit for which he or she is applying.  IVAP is calculated by taking a claimant’s gross income from all sources less countable medical expenses.  Countable medical expenses are recurring out-of-pocket medical expenses that can be expected to continue throughout a claimant’s lifetime.  If a claimant’s IVAP is equal to or greater than the annual benefit amount, the veteran or surviving spouse is not eligible for benefits.

Qualification

As stated above, the VA looks at a surviving spouse’s total net worth, life expectancy, and income and expenses to determine whether the spouse should qualify for special monthly pension. Unlike Medicaid, there is no look-back period and no penalty for giving assets away. However, one must use caution when considering a gifting strategy to qualify a surviving spouse for death pension benefits as this will cause a period of ineligibility for Medicaid which could be as long as five years.  Other Medicaid planning strategies may apply when trying to qualify a surviving spouse for death pension with aid and attendance. 

The client’s trusted advisors must work together to determine the best combination of strategies and financial products that will gain eligibility for monthly death pension but not disqualify the client from Medicaid. 

The Application Process

While the application process for the monthly pension can be agonizingly slow – some applications take over a year before the VA makes a decision – the benefit is retroactive to the month after application submission. Having the proper documentation in place at the time of application (for example, discharge papers, medical evidence, proof of medical expenses, death certificate, marriage certificate and a properly completed application) can cut the processing time in half.

Benefits are retroactive to the month after application submission.  Therefore, it is imperative for potential claimants to seek legal help immediately to become eligible and to apply as quickly as possible. If a claimant dies prior to a decision being made by the VA on the application, the potential benefits are totally lost.