August 29, 2017
Steps for a Successful VA Benefits Claim
Every VA Claim our firm submits is different. With that said, we’ve been helping Michigan families submit VA Claims for Aid and Attendance since 2008. There are some common attributes of a successful VA Benefits claim.
Michigan VA Benefit Basics
If a veteran or surviving spouse meets certain requirements, they can receive up to $2,120 (in 2017) per month, tax free. The amount of maximum benefit depends on their scenario.
- Married Veteran- $2,120/mo
- Single Veteran-$1,794/mo
- Sick spouse of a healthy Veteran $1,404
- Surviving Spouse $1,153
To receive these benefits, there are five requirements. Those requirements are as follows:
1. 90 Days Active Duty
The veteran must have at least 90 days of active duty time with the military. Those 90 days do not need to be consecutive.
2. One Day During a Period of Conflict
One of those 90 days of active duty needs to be during a period of conflict, such as WWII, Korea, Vietnam, etc. The best way to figure out if there is one day of active duty is to look for a DD214 or the veteran’s separation papers from the military. The periods of conflict are as follows:
- World War I (April 6, 1917 – November 11, 1918)
- World War II (December 7, 1941 – December 31, 1946)
- Korean conflict (June 27, 1950 – January 31, 1955)
- Vietnam era (February 28, 1961 – May 7, 1975 for Veterans who served in the Republic of Vietnam during that period; otherwise August 5, 1964 – May 7, 1975)
- Gulf War (August 2, 1990 – through a future date to be set by law or Presidential Proclamation)
3. Cannot Be Dishonorably Discharged
This is straight forward, the veteran cannot be dishonorably discharged.
4. More LTC Costs than Income
The veteran (or surviving spouse) needs to have more long-term care costs going out, than income coming in from social security and pensions. The amount of long-term care costs going out needs to exceed the income coming in by 5% to receive the full maximum benefit. To qualify as a long-term care cost a doctor needs to sign off on the claimant needing assistance with daily living activities (at least 3) and someone else or a facility must be providing that assistance with ADL’s.
5. Asset Test
The VA currently has an asset test where if a married veteran has more than 80k in assets or a single/widow with more than 40k has more in assets, they will not qualify. That said, we like to get both veterans and married veterans below 30k to be safe. Plus, if we have a married veteran who passes away, then we try to qualify the surviving spouse, it is important to be below that 30k-40k range.
Currently, there is no look-back period, but that may be changing as soon as fall of 2017. The VA has proposed a 3 year look-back period to the benefits.
A VA application cannot be submitted until a veteran is below the asset test.
The Process for a Successful VA Benefits Claim
The process for submitting a VA Benefits claim for Aid and Attendance is almost always the same.
Step 1: Update the Estate Plan
It starts with reviewing and updating a client’s estate planning documents, typically. The reason for this is that most veterans and their surviving spouses need to have well drafted powers of attorney in place, need to set up a Veterans Asset Protection Trust and sometimes need to have a personal care contract in place. Having these estate planning documents in order sets the foundation for a successful VA Benefits claim.
Step 2: Fund the Veterans Asset Protection Trust
The next step, once the Veterans Asset Protection Trust is created, is to fund the trust. This means change ownership and beneficiary designations of the assets to name the new Veterans Asset Protection Trust either as an owner or a beneficiary of the asset to get under the VA Benefits asset test.
This process can typically take a couple weeks due to the different financial institutions involved. More often than not, we need assistance from clients to help find and organize the different assets. We give our clients homework, entitled “Funding Checklist” to create an accurate list of assets and accounts.
This step is vital, because an application cannot be submitted until the Veterans Asset Protection Trust is funded (if a VAPT is part of the plan).
Step 3: File the Intent to File
Once the VAPT is funded and the assets are below the required amount, we can lock in a retroactive date by filing a Notice of Intent to File. The VA often will sit on applications for months at a time. By filing the Notice as soon as possible, you lock in a retroactive date, so if there is a delay on the VA side, you’ll get a lump sum payout based on the number of months the VA sits on the claim.
This also allows time to gather any missing information, such as doctor’s forms establishing the long-term care need or forms from the care provider.
Step 4: File the Formal Application
Once all the documents are gathered and the application is finalized, it can be submitted to the VA. Typically, once the VA gets the full application, it takes about 3-5 months before they approve the application and they release the pension amount.
Things To Watch for with a VA Benefit Application
There are some common hangups that families need to watch for when preparing a VA application.
There Needs to be At Least 3 ADLs
Activities of daily living (ADLs) can be thought of as the first things you do in a morning, including getting out of bed, going the bathroom, bathing, taking medications, getting dressed and preparing a meal. For a successful VA Benefit claim it is important to have 3 ADLs.
Doctor forms and caregiver forms need to be completed thoroughly.
Often it seems the Doctor’s form, outlining that the claimant needs assistance of another has to be re-done because the Doctor or their staff do not complete the VA form sufficiently. The Doctor’s form needs to show that the claimant needs help.
LTC Expenses need to exceed income by 5%.
To receive the maximum VA Benefit, a veteran or surviving spouse needs to have their income exceeded by their long-term care expenses by at least 5%. If the veteran does not have their income exceeded by their long-term care expenses, then their benefit will be reduced.
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VA Benefits Planning GuideIf you would like assistance with your VA Claim from a VA Accredited Certified Elder Law Attorney then your next step should be to download our free VA Benefits Planning Guide to learn more about planning for VA Benefits.