August 28, 2023 • 28 mins
Want to understand the intricacies of the Aid and Attendance benefit program? Our host Attorney Bob Mannor, walks us through the ins and outs of this potentially life-altering benefit for elder veterans. Nested under VA's improved pension program, this benefit could be the answer to your worries about independent living, assisted living and nursing home expenses, or even in-home care. Bob, an accredited expert by the Veterans Administration and a nationally board certified elder law attorney, also elaborates on the special criteria that could unlock these benefits.
Now, here's a teaser - did you know that changes in asset rules and gifting can significantly impact your Aid and Attendance benefit? Bob explains these changes, giving you an in-depth understanding of grandfathering assets gifted before October 18th, 2018, the exemption rules for a house and two acres, and the new modifications to the income annuity rule. He also offers valuable insights on the types of assets allowed, how to stay qualified, and the potential consequences of transferring assets. Don't miss out on this opportunity to arm yourself with knowledge on maximizing veterans' benefits.
Host: Attorney Bob Mannor
Producer: Savannah Meksto
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Mannor Law Group helps clients in all matters of estate planning and elder law including special needs planning, veterans’ benefits, Medicaid planning, estate administration, and more. We offer guidance through all stages of life.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Savannah Meksto (00:01):
You're listening to Advice from your
Advocates, a show where weprovide elder law advice to
professionals who work with theelderly and their families.
Today's webinar will discuss apotentially life-changing but
not well-known Veterans benefitcalled Aid and Attendance.
Before I pass the mic to Bob,I'd like to first cover a few
(00:24):
details.
Now, why should you listen towhat the folks at Mannor Law
Group have to say?
We are a nationally recognizedand respected elder law and
estate planning firm.
All three of our attorneys areaccredited by the Veterans
Administration to assistveterans with claims and appeals
.
Attorney Bob Mannor isnationally board certified as an
(00:46):
elder law attorney by theNational Elder Law Foundation.
He's one of only 19 attorneysin Michigan to achieve this
designation.
Bob is also a leader amongelder law attorneys in Michigan.
He was chair of the State Barof Michigan Elder Law and
Disability Rights Section andpast president of the National
Academy of Elder Law AttorneysMichigan Chapter, and Mannor Law
(01:11):
Group has been honored byreaders of our local paper as
the best or favorite law firmfor the last eight years in a
row.
Now, without further ado, I'dlike to welcome Attorney Bob
Manor.
Bob Mannor (01:23):
Hi folks.
So this is a really goodbenefit for folks that qualify,
and it's a benefit that is forveterans.
But a lot of veterans don'trealize that they might be
eligible for it, because it'snot just for veterans that were
injured during service oranything like that.
It's also not just for veterans, it's also for potentially
(01:46):
spouses or widows or widowers ofveterans, in other words, the
surviving spouse of a veteran.
So we're going to go throughthe terms here and talk about it
, but before we do that, let'skind of clarify this from the
standpoint of the veterans'benefits as a whole, because
there are probably threedifferent areas that the VA can
(02:08):
provide some long-term carebenefits, because we're looking
at this in the standpoint of along-term care context, and so
the one that we're going to betalking about today is the aid
and attendance.
But let me just quickly gothrough the other two.
So the other two are certainlyany veteran that has a
service-connected issue, andthis is particularly true for
(02:32):
Vietnam veterans or some of thethat served in Korea that
actually served in Vietnam or inKorea and during the time
periods that the Agent Orangewas used, and so there are so
many diseases that we're seeingin the elderly population that
are tied to this Agent Orangeand they can get some really
(02:55):
substantial benefits as part ofthat.
I have a whole otherpresentation on that If you want
to go back and look at that onour website.
We're not going to be talkingabout that today, but anybody
that has a service-connected andwe got to look towards that
because it's not always obvious.
So Parkinson's or Parkinsonismnow is even considered a
service-connected disability foranybody that served in an area
(03:18):
that was exposed to Agent Orange, even diabetes and things like
that.
The other one, which is oftenoverlooked, is if you're
eligible for discounted or freemedical services, and not every
veteran is.
A lot of veterans assume thatthey can get free or discounted
medical services through the VAmedical, and it's not everybody
(03:42):
is.
But if you are eligible forfree veterans medical with
health services, the VA has moreflexibility in offering some
home care help, whereas underMedicare and your insurance
generally that's just going tobe short-term skilled care.
With the VA they can actuallyauthorize a home care person
(04:05):
that is paid through the VA.
So really great opportunitiesto think about.
Not the topic for today.
Today we're going to be talkingspecifically about this aid and
attendance benefit.
So I always like to talk aboutwell, what does it pay for?
Well, it doesn't really pay foranything, and that's what I
mean by that is it's actually areimbursement program.
They actually call it a pensionof all things.
(04:27):
Most people call it aid andattendance, but the VA calls it
a pension, or sometimes theycall it improved pension.
And why is it a pension?
Well, it was designed after theCivil War and they were worried
because there was a lot ofveterans that didn't have any
income.
And so they said, well, ourveterans of a wartime period are
going to get a minimal incomeif they don't have any other
source of income, and that's thekey.
(04:48):
And so then it kind of fell outof favor because once health
security came in, most elderlyfolks would have some form of
income because they had socialsecurity and that was going to
kind of offset this veteransimproved pension.
And then in the 90s theyactually changed it to say, well
, for veterans of a wartimeperiod, we're going to look at
their income as income minusmedical expenses, and that's how
(05:12):
this all came about and whyit's considered a pension
program.
Is it's actually areimbursement?
It's an income because you'respending all your money on
long-term care services.
You're spending all your moneyon medical services, home health
aid, assisted living, nursinghome, whatever it is you're
spending all your income.
So your income for VA purposesis zero.
So it can help pay forindependent living.
(05:34):
There's a couple of specialrules with regard to that I'll
come back to.
You can certainly pay forassisted living, nursing home,
in-home care and if you do itright, you can even pay a family
member.
There's two things that are youneed more information about
regarding you know who, you who,what the money can be used.
To consider a medical expense,first of its independent living,
(05:54):
you have to have the doctor'sstatement specifically identify
the independent living as aProtected environment.
So we really want the doctor'sstatement to specifically say
hey, they're in this independentliving, they need to be there
because it's a protectiveenvironment.
The second thing is you have tobe paying for two ADL.
(06:15):
So, especially if you're anindependent living, you have to
be paying in addition to justyour rent.
Can't just be rent.
If you're just paying rent,you're not gonna.
It's not gonna be counted as amedical expense.
But if you're paying rent andyou're paying for assistance
with two activities of dailyliving dressing, bathing,
toileting, eating, gettingaround, you know those types of
(06:37):
things, then you know showering,then you can the the rent will
count as a medical expense.
Also, with regard to paying afamily member or any kind of
in-home care, I highly, highly,highly recommend that you have a
lawyer like us draft what'scalled a care contract,
specifically and mostimportantly, if it's a family
(06:59):
member, because, well, the VAdoes not require that Medicaid
currently does.
Now I'm hoping that Medicaidrule changes someday, but
currently Medicaid requires thatif you're gonna pay a caregiver
at home, we need to havenotarized contract.
There's a bunch of rules wehave to follow, so just be aware
of those couple of things.
(07:20):
Okay, so basic rules about thisprogram.
One of the basic rules is youhave to have 90 days of active
duty.
What's interesting about thatis only one day has to have been
during a more time period.
So this is for wartime vets andI'm gonna get to those dates in
just a second here.
But there has to have been 90days of active duty and that's
important because a lot of timesI've actually seen a few cases
(07:45):
where somebody just had exactly90 days of active duty and then
they got a medical discharge orsomething like that, or they had
a family you know Discharge orwhatever.
It is general discharge, but ifyou got to that 90-day mark
then you're qualified.
It can even be where it was 45days here, and then another
(08:07):
situation is 45 days here.
An example of that might be ifyou were in the Army reserves or
if you were in the NationalGuard and the National Guard get
called up for federal activeduty.
So if it is active, if it isNational Guard or if it is
reserves, you have to have beenactivated for 90 days and it has
to be federal activation.
(08:27):
So if it was, you know, back inthe 70s and 60s, national Guard
usually didn't get activated bythe federal government.
In fact people used to say,well, they went into National
Guard to avoid having to getdrafted.
That's them, you know.
Sometimes that was maybe true,sometimes it wasn't.
But the idea is that NationalGuard doesn't count unless it's
(08:49):
federally activated.
Nowadays, if you're in theNational Guard, it's pretty good
chance you're gonna getactivated by the federal
government and you're gonna getactive duty for federal, federal
duty.
I've also had Situationsactually this has come up a lot
when somebody served more than90 days of active duty and they
don't think that they servedduring a wartime period at all.
(09:09):
They served maybe between Koreaand Vietnam or you know.
Just the dates of service don'tcomply, you know, don't line up
with the dates of service ofwhat they consider active duty
or wartime.
I'm sorry, and one of thethings we look at is well, if
you did, were you in thereserves where you're in the
National Guard afterwards andwhere you ever called up?
(09:30):
So there is a A lot of folksaround here that were in the
reserves or National Guard in1968 or 1969 and they were not
active duty at the time but thenthey were called up because of
riots.
So there were riots in 68-69and the federal of the you know
(09:52):
National Guard reserves were alot of them were called up for
10 days and that counts becauseyou only have to have one day
during a wartime period.
68-69 was wearing the Vietnamera and so if, because they were
activated for 10 days, eventhough they otherwise didn't
serve during wartime period, itcounts because they served for
10 days in 1968 or whatever,have to have a discharge other
(10:14):
than dishonorable.
So any discharge other thandishonorable it's dishonorable.
We'd have to get that changedbefore we could apply for this
benefit, and sometimes there'sways to change that and there's
attorneys that can help withthat.
A medical discharge, a generaldischarge, anything like that.
This is generally for folksover age 65 and so in theory you
(10:36):
could get it if you're not 65,but then you'd probably qualify
under the disability rules.
So if you're over age 65, youdon't have to prove disability
or anything like that.
All right, so here's the datesthat we were talking about.
We don't really see I'm notsure that there's any World War
I veterans left.
(10:56):
Maybe there are some widows,possibly over World War I that
could still qualify, or widowers, in theory, world War II.
We have the dates listed thereand you'll notice those are not
the dates that line up with thehistory, but they always have
some cleanup afterwards, likesome time, that they count as
part of the wartime period, evenafter the war was officially
(11:18):
over.
The Korean conflict we see fromJune of 1950 through January
1955.
And then Vietnam has a specialrule that if you served during
this time period you qualify.
If you served between August of64 and May of 75.
However, there's someadditional dates for those
people that actually served inVietnam.
(11:40):
So we had our advisors,advisors that carried guns and
shotguns, presumably starting inFebruary of 1961.
Technically, we weren't part ofthe Vietnam conflict at that
time because they, for whateverreason.
So if you served in Vietnam, orif you're a client or the
person you're looking at, yourpatient, your resident were to
(12:07):
have served in Vietnam betweenFebruary 61 and August of 64,
they would also qualify, even ifthey didn't serve after August
5th of 64.
Everybody else that did notserve in Vietnam but they served
in Germany or they were inKorea or they were wherever else
, then they have to have servedat least a single day between
August 5th 1964 and May 7th 1975.
(12:30):
This does not relate to thatother thing where at service,
connected disability, age andorange exposure, anything like
that.
This is specifically for thisaid and attendance benefit.
Okay, so what is the VAeligibility measure?
Well, we have to have a medicalneed as determined by your
doctor, not by the VA's doctor.
So, unlike some of the otherprograms through the VA where
(12:53):
you have to go to a VA doctor,this does not require you to go
to a VA doctor.
You can use your personaldoctor.
Your doctor certifies that youhave a medical need, that you
name the regular aid andattendance of another person.
We are gonna you have to look atincome.
Now.
Income's usually easy to dealwith.
A lot of times I'll haveveterans say, oh, I can't
qualify because they make toomuch income.
Well, that's not true.
(13:13):
You just don't spend enoughBecause remember, the way that
the VA calculates income isincome minus spending.
So if you're spending $6,000 onassisted living or memory care
or someplace like that a monthand your income's less than
$6,000 a month, you may havereally good income.
You may have $5,000 in income.
You'd still qualify for thisprogram.
In fact, if you had $6,000 inincome and you're spending
(13:37):
$6,000, you'd still qualify forthis program.
In other words, we're justbasically saying that in order
to get the maximum benefit, yourmedical expenses or your
long-term care expenses have tobe more than what you bring in
from your pension and socialsecurity.
And then assets.
We're gonna talk about assetshere.
Before we talk about assets,let's talk about the numbers.
So these are the numbers.
(13:59):
If you're a veteran and youhave a dependent, usually a
spouse, you can qualify fortax-free, $2,295 every month.
And if you're a single veteran,you can qualify for $1,936
every month, tax-free, survivingspouse $1,244.
(14:20):
And then we have this unusualcategory Well, the veteran's
healthy, the veteran's stillalive.
So my spouse number is theveteran has passed away,
veteran's still alive andhealthy, doesn't need care, but
their spouse needs care.
So let's say a veteran'shealthy and the spouse has
dementia or something like that,well then the veteran can
qualify for $1,520 asreimbursement of the money that
(14:43):
they're spending on their spouse.
If it's the veteran that neededthe care, they'd get $1,936,
I'm sorry, if the veteran neededthe care, they get the $2,295
because the veteran and thespouse.
But if it's the spouse thatneeds the care and the veteran's
healthy, it's $1,520.
These are all tax-free.
I just heard, I just read anarticle earlier today that it's
(15:05):
expected that these are gonna goup by about 6%.
So people always love it whenthey seems like they're getting
a raise in their social securityor their veteran's benefits and
that's great.
It also generally means thatinflation, that the value of
your dollar, is going down, andthat's why you're getting a
raise is because the inflation,and so what's gonna?
(15:26):
They're trying to keep up withcost of living, and so I have
heard.
Obviously, this isn't official,we won't know until about
November 1st, but the article Iread said it's very likely that
it's gonna be in the 6% range ofthe increase that will occur
for next year.
All right, so then I promisedyou we'd talk about assets here,
(15:49):
right?
So here's what you can keep.
These rules changed dramaticallyas of October 18th of 2018.
So almost three years ago andthat three years is important,
we'll talk about that.
So almost three years ago, theydrastically changed these rules
.
Before this, they were not veryclear on how much money you
(16:11):
could still have and qualify forthis.
In fact, they basically saidwell, we're going to look at all
these factors.
There's your age and what youractual health is and what your
diagnosis is and what your lifeexpect, all of this stuff.
And I used to say, well, intheory, what they would tell you
is they're going to put allthat in a can, stir it up and
(16:31):
then pull out a number and Iknow that sounds kind of funny,
but I mean that's the way theydescribed it.
The VA described it.
So we kind of knew, generally,if you're married, that
somewhere between $60,000 and$80,000.
If you were single somewherebetween $30,000 and $40,000.
(16:51):
So those were the rules ofthumb, but the VA would never
say those numbers.
They would just say well, ifyou have too much, you can apply
and we'll deny you.
So this is better in thatregard, and that not only did
they increase the numbersubstantially, they defined it.
So, just like the other stuff,this will be adjusted for
(17:14):
inflation.
You can have a house with up totwo acres.
Well, what if you have a housewith three acres?
Well, the house and two acresare going to be exempt, and then
the other acre is going to haveto be counted into the other
assets.
So you can have a house and twoacres.
That's exempt.
You can have cars.
(17:35):
You can have multiple cars.
Unlike Medicaid, they don't sayhow many cars.
In fact, they even say familycars.
So in theory the thought is atleast the way the VA wrote this
rule you could have cars foryour kids.
I'm not saying that's a goodidea or that I would recommend
that, but it seems to be what isimplied by the wording of the
(17:58):
rule with regard to this.
So you can have cars, multiplecars, you can have a house in
two acres and you can have$130,733 in other assets, and
that would include bank accountsor investments, other things.
Big change is they do not allowgifting.
So prior to October 18, theydidn't have a look back like
(18:22):
Medicaid does.
So they didn't have a giftingrule.
You could gift and then applyfor benefits.
So now what they said was thatthey were going to grandfather
anybody in that had made a giftprior to October 18, 2018.
So they say the look back isthree years, but technically the
look backs only three years, upuntil October of 18, 2021.
(18:45):
And then we'll say it's threeyears.
In other words, we still haveit's actually two years and 11
months, and how many ever daysit is that you're watching this
video but as of October 18, 2021, it'll be a three year look
back because anything happenedbefore that was grandfathered in
.
So when I say no transfers, nogifting.
(19:06):
If you put your kids in thehouse, they're going to penalize
you.
If you took money out and gaveit to your granddaughter,
they're going to penalize you.
There is not an exemption Intheory, and under Medicaid,
there's an exemption if youdidn't do it for Medicaid
purposes.
In other words, you neverexpected to go to a nursing home
.
They happened to give a nicegift to your granddaughter was
(19:27):
getting married and gave a fewthousand dollars.
The Medicaid has a rule thatsays well, if you can prove that
it wasn't for Medicaid purposes, then VA does not have that
rule.
They basically it's a strictliability.
You gave it away, you addedyour kids names to the deed, to
the house.
You got a problem.
You're going to have a penalty.
Now the house deed.
(19:48):
Hopefully the kid would givethe house back and we can fix
that and still have it exempt.
So this is a big deal.
With regard to the house, though, we do have some planning
opportunities because, if youthink about it a lot of times,
somebody needs to qualify forthis benefit.
They have the house.
They might be eligible, butthey move into an assisted
(20:11):
living or independent living Nowthey have an empty house.
Would make sense maybe to sellthe house, but now if we sell
the house, it's gonna put themover assets.
If you have something like that, send them our way, send them
to us, and we can help them withthat and help them stay
qualified and not bedisqualified from the proceeds
from the sale of the house.
So the other big one is noincome annuities after October
(20:34):
18th 2018.
An income.
Annuity is where you take money$100,000, whatever it is and
you put it into this investmentthat pays you back a monthly
income stream, okay.
And they said, if you do that,we're going to penalize you.
You took $100,000 and you putit into a monthly income stream
that's gonna pay you $1,000 amonth.
They're gonna treat that as ifit was a $100,000 gift.
(20:58):
Doesn't really make a whole lotof sense.
They have their rationalebehind it.
There was a bunch of peopleselling these annuities that
were selling annuities toveterans that didn't need
annuities and it was probably apoor product, a poor financial
product for veterans, and theywere kind of trying to combat
that.
There was a bunch of people outthere selling annuities to
(21:20):
veterans tell them they need toget this annuity in order to get
veterans benefits, which wasnot true, but there was a whole
bunch of people doing it, and sothe VA.
One of the reasons why theychanged the rule was because
they wanted to stop these peoplefrom selling inappropriate
investments to veterans and thentelling them that's what they
needed to do to get theseveterans benefits.
Why annuities?
(21:42):
I can't say for sure, but Ihave a suspicion and that's
because they get a bigcommission on annuities.
The salesperson got a bigcommission on annuities and they
get their entire commission upfront.
Most financial products theyget an ongoing commission and so
they have a reason to continueto be your financial advisor.
With annuities like this, thesalesperson would often get a
(22:07):
big commission up front and thenhave nothing after that, so
they have no incentive toactually help you out in the
future.
They sold the thing, they gottheir money, they abandoned you
basically, or at least that wasthe problem or the concern that
was had.
Okay, so that's the two bigthings.
First of all, they've increasedthe dollar amount.
They've clarified you know youcan't have 100 acres.
(22:29):
Before it wasn't 100% clear asto how much acreage you could
have, so now they said a houseof two acres.
What's weird about that, ofcourse, is you could have a $2
million house on two acres andit's exempt.
Seems a little odd.
That's the rule.
That doesn't work for Medicaidpurposes.
That does work for VA purposes.
And then so the two otherthings is no gifting, there's
(22:51):
three year, look back, and notalways income annuities.
All right, a couple of myths.
A lot of times I've heard thesethings.
I'm a veteran, but I can't getthis benefit, this pension
because I didn't get hurt duringservice.
Nope, that's not required.
That's a different program.
That's what the VA callscompensation.
You'll hear people say I've got20% from the VA or I get 100%
(23:15):
from the VA.
That's compensation.
Service-connecteddisability-service-connected
illness, agent-orange, hearingloss, PTSD, whatever it is.
They tie that to your serviceand that's a different program
altogether.
I did not serve in combat notrequired.
(23:35):
A lot of the folks that we getthe aid and attendance benefit
for never served in combat andsome of them never left the
United States.
They served in a non-combatarea.
They never really had to carrya gun.
It doesn't require you to servein combat for this program.
You just have to serve during awartime period, those dates
that we talked about earlier.
(23:56):
Income is too high?
Nope, can't be, you're just notspending enough.
The VA defines income for thisprogram as income minus medical
expenses or income minuslong-term care expenses.
So if your home health aidcosts more than your social
security check, if your assistedliving or home health aid plus
(24:16):
independent living costs morethan your social security and
pension check, then your incomefor VA purposes is zero.
So I do hear people say all thetime oh, I have too high of
income.
Sometimes people mix up thosewords income and assets, and for
this program, for Medicaid,there's a clear distinction
between income meaning what youhave coming in every month, your
pension and social security andassets, which is a whole
(24:38):
different set of rules, and Ihave too many assets.
We just went through thoseasset issues there, all right.
So last thing to think about iscan you protect assets?
Is there anything that we cando as lawyers to protect assets?
And there are a few things alot less things than I could do
back before October of 2018, butthere's still a number of
(25:01):
things.
Now.
If you have $1 million unlessyou buy a $1 million house,
there's not a heck of a lot I'mgoing to do.
I could do, except if we do theplanning three years in advance
.
So legal planning can still bedone, but I say up to three
years in advance, because if youonly have $300,000 and you're
spending $5,000 a month and yourincome is $2,000, we're going
(25:24):
to do the math.
We're going to figure out, ok,what things can we do to not
have to wait the three years toqualify for veterans benefits,
and there are options.
It gets a little bit morecomplicated, but that's why you
have lawyers because it getscomplicated and we figure out
all the math and we figure outwhether we can protect assets
and if we protect assets, willwe get qualified faster than the
(25:44):
three years?
And the answer is yes.
If you're in that example that Ijust gave you, so if you're
under $500,000 of accountableassets meaning the house doesn't
count, the cars don't count,things like that it's probably
worth a review.
You're up to $1 million inassets.
If you want to apply for thisprogram, we can protect assets,
(26:05):
wait three years and then apply.
But if your low asset already,if you have a less than $130,000
in assets, then this is aprogram that you just have to
look at.
You have the medical need, areyou spending money on care and
assets aren't going to be aproblem.
So let's see if we have anyquestions.
(26:25):
And if we don't have any typedin questions, then Savannah is
going to tell us how you can getyour questions answered in the
future here.
So she's going to give you acouple of different options for
getting questions answered.
I know I think we maybe have afew social workers on the call
and we're watching this video.
(26:46):
We always want to be able to behelpful if it's something that
a social worker has a questionabout this.
Please follow up with us.
Savannah is going to give yousome details about how to do
that.
Savannah Meksto (26:59):
Thanks, Bob.
As Bob mentioned, we do have acouple of easy ways for you to
contact our team.
Whether you're a social worker,as he mentioned, or you just
want some help, we're here.
I have our phone number and alink.
Our 1-800 number is1-800-990-6030.
You can call that number andtalk to our team.
(27:23):
We'll ask you a few questions,get some more information, and
then you can ask us questionstoo.
We are here to help.
You can also email info atmannorlaw.
com, and that's justI-N-F-O-@-M-A-N-N-O-R-L-A-W dot
com.
Thanks again, everyone, forjoining us today and we look
(27:46):
forward to seeing you next time.
Thanks for listening.
To learn more, visitmannorlawgroup.
com and we'll see you next time.
You're listening to Advice from your
Advocates, a show where weprovide elder law advice to
professionals who work with theelderly and their families.
Today's webinar will discuss apotentially life-changing but
not well-known Veterans benefitcalled Aid and Attendance.
Before I pass the mic to Bob,I'd like to first cover a few
(00:24):
details.
Now, why should you listen towhat the folks at Mannor Law
Group have to say?
We are a nationally recognizedand respected elder law and
estate planning firm.
All three of our attorneys areaccredited by the Veterans
Administration to assistveterans with claims and appeals
.
Attorney Bob Mannor isnationally board certified as an
(00:46):
elder law attorney by theNational Elder Law Foundation.
He's one of only 19 attorneysin Michigan to achieve this
designation.
Bob is also a leader amongelder law attorneys in Michigan.
He was chair of the State Barof Michigan Elder Law and
Disability Rights Section andpast president of the National
Academy of Elder Law AttorneysMichigan Chapter, and Mannor Law
(01:11):
Group has been honored byreaders of our local paper as
the best or favorite law firmfor the last eight years in a
row.
Now, without further ado, I'dlike to welcome Attorney Bob
Manor.
Bob Mannor (01:23):
Hi folks.
So this is a really goodbenefit for folks that qualify,
and it's a benefit that is forveterans.
But a lot of veterans don'trealize that they might be
eligible for it, because it'snot just for veterans that were
injured during service oranything like that.
It's also not just for veterans, it's also for potentially
(01:46):
spouses or widows or widowers ofveterans, in other words, the
surviving spouse of a veteran.
So we're going to go throughthe terms here and talk about it
, but before we do that, let'skind of clarify this from the
standpoint of the veterans'benefits as a whole, because
there are probably threedifferent areas that the VA can
(02:08):
provide some long-term carebenefits, because we're looking
at this in the standpoint of along-term care context, and so
the one that we're going to betalking about today is the aid
and attendance.
But let me just quickly gothrough the other two.
So the other two are certainlyany veteran that has a
service-connected issue, andthis is particularly true for
(02:32):
Vietnam veterans or some of thethat served in Korea that
actually served in Vietnam or inKorea and during the time
periods that the Agent Orangewas used, and so there are so
many diseases that we're seeingin the elderly population that
are tied to this Agent Orangeand they can get some really
(02:55):
substantial benefits as part ofthat.
I have a whole otherpresentation on that If you want
to go back and look at that onour website.
We're not going to be talkingabout that today, but anybody
that has a service-connected andwe got to look towards that
because it's not always obvious.
So Parkinson's or Parkinsonismnow is even considered a
service-connected disability foranybody that served in an area
(03:18):
that was exposed to Agent Orange, even diabetes and things like
that.
The other one, which is oftenoverlooked, is if you're
eligible for discounted or freemedical services, and not every
veteran is.
A lot of veterans assume thatthey can get free or discounted
medical services through the VAmedical, and it's not everybody
(03:42):
is.
But if you are eligible forfree veterans medical with
health services, the VA has moreflexibility in offering some
home care help, whereas underMedicare and your insurance
generally that's just going tobe short-term skilled care.
With the VA they can actuallyauthorize a home care person
(04:05):
that is paid through the VA.
So really great opportunitiesto think about.
Not the topic for today.
Today we're going to be talkingspecifically about this aid and
attendance benefit.
So I always like to talk aboutwell, what does it pay for?
Well, it doesn't really pay foranything, and that's what I
mean by that is it's actually areimbursement program.
They actually call it a pensionof all things.
(04:27):
Most people call it aid andattendance, but the VA calls it
a pension, or sometimes theycall it improved pension.
And why is it a pension?
Well, it was designed after theCivil War and they were worried
because there was a lot ofveterans that didn't have any
income.
And so they said, well, ourveterans of a wartime period are
going to get a minimal incomeif they don't have any other
source of income, and that's thekey.
(04:48):
And so then it kind of fell outof favor because once health
security came in, most elderlyfolks would have some form of
income because they had socialsecurity and that was going to
kind of offset this veteransimproved pension.
And then in the 90s theyactually changed it to say, well
, for veterans of a wartimeperiod, we're going to look at
their income as income minusmedical expenses, and that's how
(05:12):
this all came about and whyit's considered a pension
program.
Is it's actually areimbursement?
It's an income because you'respending all your money on
long-term care services.
You're spending all your moneyon medical services, home health
aid, assisted living, nursinghome, whatever it is you're
spending all your income.
So your income for VA purposesis zero.
So it can help pay forindependent living.
(05:34):
There's a couple of specialrules with regard to that I'll
come back to.
You can certainly pay forassisted living, nursing home,
in-home care and if you do itright, you can even pay a family
member.
There's two things that are youneed more information about
regarding you know who, you who,what the money can be used.
To consider a medical expense,first of its independent living,
(05:54):
you have to have the doctor'sstatement specifically identify
the independent living as aProtected environment.
So we really want the doctor'sstatement to specifically say
hey, they're in this independentliving, they need to be there
because it's a protectiveenvironment.
The second thing is you have tobe paying for two ADL.
(06:15):
So, especially if you're anindependent living, you have to
be paying in addition to justyour rent.
Can't just be rent.
If you're just paying rent,you're not gonna.
It's not gonna be counted as amedical expense.
But if you're paying rent andyou're paying for assistance
with two activities of dailyliving dressing, bathing,
toileting, eating, gettingaround, you know those types of
(06:37):
things, then you know showering,then you can the the rent will
count as a medical expense.
Also, with regard to paying afamily member or any kind of
in-home care, I highly, highly,highly recommend that you have a
lawyer like us draft what'scalled a care contract,
specifically and mostimportantly, if it's a family
(06:59):
member, because, well, the VAdoes not require that Medicaid
currently does.
Now I'm hoping that Medicaidrule changes someday, but
currently Medicaid requires thatif you're gonna pay a caregiver
at home, we need to havenotarized contract.
There's a bunch of rules wehave to follow, so just be aware
of those couple of things.
(07:20):
Okay, so basic rules about thisprogram.
One of the basic rules is youhave to have 90 days of active
duty.
What's interesting about thatis only one day has to have been
during a more time period.
So this is for wartime vets andI'm gonna get to those dates in
just a second here.
But there has to have been 90days of active duty and that's
important because a lot of timesI've actually seen a few cases
(07:45):
where somebody just had exactly90 days of active duty and then
they got a medical discharge orsomething like that, or they had
a family you know Discharge orwhatever.
It is general discharge, but ifyou got to that 90-day mark
then you're qualified.
It can even be where it was 45days here, and then another
(08:07):
situation is 45 days here.
An example of that might be ifyou were in the Army reserves or
if you were in the NationalGuard and the National Guard get
called up for federal activeduty.
So if it is active, if it isNational Guard or if it is
reserves, you have to have beenactivated for 90 days and it has
to be federal activation.
(08:27):
So if it was, you know, back inthe 70s and 60s, national Guard
usually didn't get activated bythe federal government.
In fact people used to say,well, they went into National
Guard to avoid having to getdrafted.
That's them, you know.
Sometimes that was maybe true,sometimes it wasn't.
But the idea is that NationalGuard doesn't count unless it's
(08:49):
federally activated.
Nowadays, if you're in theNational Guard, it's pretty good
chance you're gonna getactivated by the federal
government and you're gonna getactive duty for federal, federal
duty.
I've also had Situationsactually this has come up a lot
when somebody served more than90 days of active duty and they
don't think that they servedduring a wartime period at all.
(09:09):
They served maybe between Koreaand Vietnam or you know.
Just the dates of service don'tcomply, you know, don't line up
with the dates of service ofwhat they consider active duty
or wartime.
I'm sorry, and one of thethings we look at is well, if
you did, were you in thereserves where you're in the
National Guard afterwards andwhere you ever called up?
(09:30):
So there is a A lot of folksaround here that were in the
reserves or National Guard in1968 or 1969 and they were not
active duty at the time but thenthey were called up because of
riots.
So there were riots in 68-69and the federal of the you know
(09:52):
National Guard reserves were alot of them were called up for
10 days and that counts becauseyou only have to have one day
during a wartime period.
68-69 was wearing the Vietnamera and so if, because they were
activated for 10 days, eventhough they otherwise didn't
serve during wartime period, itcounts because they served for
10 days in 1968 or whatever,have to have a discharge other
(10:14):
than dishonorable.
So any discharge other thandishonorable it's dishonorable.
We'd have to get that changedbefore we could apply for this
benefit, and sometimes there'sways to change that and there's
attorneys that can help withthat.
A medical discharge, a generaldischarge, anything like that.
This is generally for folksover age 65 and so in theory you
(10:36):
could get it if you're not 65,but then you'd probably qualify
under the disability rules.
So if you're over age 65, youdon't have to prove disability
or anything like that.
All right, so here's the datesthat we were talking about.
We don't really see I'm notsure that there's any World War
I veterans left.
(10:56):
Maybe there are some widows,possibly over World War I that
could still qualify, or widowers, in theory, world War II.
We have the dates listed thereand you'll notice those are not
the dates that line up with thehistory, but they always have
some cleanup afterwards, likesome time, that they count as
part of the wartime period, evenafter the war was officially
(11:18):
over.
The Korean conflict we see fromJune of 1950 through January
1955.
And then Vietnam has a specialrule that if you served during
this time period you qualify.
If you served between August of64 and May of 75.
However, there's someadditional dates for those
people that actually served inVietnam.
(11:40):
So we had our advisors,advisors that carried guns and
shotguns, presumably starting inFebruary of 1961.
Technically, we weren't part ofthe Vietnam conflict at that
time because they, for whateverreason.
So if you served in Vietnam, orif you're a client or the
person you're looking at, yourpatient, your resident were to
(12:07):
have served in Vietnam betweenFebruary 61 and August of 64,
they would also qualify, even ifthey didn't serve after August
5th of 64.
Everybody else that did notserve in Vietnam but they served
in Germany or they were inKorea or they were wherever else
, then they have to have servedat least a single day between
August 5th 1964 and May 7th 1975.
(12:30):
This does not relate to thatother thing where at service,
connected disability, age andorange exposure, anything like
that.
This is specifically for thisaid and attendance benefit.
Okay, so what is the VAeligibility measure?
Well, we have to have a medicalneed as determined by your
doctor, not by the VA's doctor.
So, unlike some of the otherprograms through the VA where
(12:53):
you have to go to a VA doctor,this does not require you to go
to a VA doctor.
You can use your personaldoctor.
Your doctor certifies that youhave a medical need, that you
name the regular aid andattendance of another person.
We are gonna you have to look atincome.
Now.
Income's usually easy to dealwith.
A lot of times I'll haveveterans say, oh, I can't
qualify because they make toomuch income.
Well, that's not true.
(13:13):
You just don't spend enoughBecause remember, the way that
the VA calculates income isincome minus spending.
So if you're spending $6,000 onassisted living or memory care
or someplace like that a monthand your income's less than
$6,000 a month, you may havereally good income.
You may have $5,000 in income.
You'd still qualify for thisprogram.
In fact, if you had $6,000 inincome and you're spending
(13:37):
$6,000, you'd still qualify forthis program.
In other words, we're justbasically saying that in order
to get the maximum benefit, yourmedical expenses or your
long-term care expenses have tobe more than what you bring in
from your pension and socialsecurity.
And then assets.
We're gonna talk about assetshere.
Before we talk about assets,let's talk about the numbers.
So these are the numbers.
(13:59):
If you're a veteran and youhave a dependent, usually a
spouse, you can qualify fortax-free, $2,295 every month.
And if you're a single veteran,you can qualify for $1,936
every month, tax-free, survivingspouse $1,244.
(14:20):
And then we have this unusualcategory Well, the veteran's
healthy, the veteran's stillalive.
So my spouse number is theveteran has passed away,
veteran's still alive andhealthy, doesn't need care, but
their spouse needs care.
So let's say a veteran'shealthy and the spouse has
dementia or something like that,well then the veteran can
qualify for $1,520 asreimbursement of the money that
(14:43):
they're spending on their spouse.
If it's the veteran that neededthe care, they'd get $1,936,
I'm sorry, if the veteran neededthe care, they get the $2,295
because the veteran and thespouse.
But if it's the spouse thatneeds the care and the veteran's
healthy, it's $1,520.
These are all tax-free.
I just heard, I just read anarticle earlier today that it's
(15:05):
expected that these are gonna goup by about 6%.
So people always love it whenthey seems like they're getting
a raise in their social securityor their veteran's benefits and
that's great.
It also generally means thatinflation, that the value of
your dollar, is going down, andthat's why you're getting a
raise is because the inflation,and so what's gonna?
(15:26):
They're trying to keep up withcost of living, and so I have
heard.
Obviously, this isn't official,we won't know until about
November 1st, but the article Iread said it's very likely that
it's gonna be in the 6% range ofthe increase that will occur
for next year.
All right, so then I promisedyou we'd talk about assets here,
(15:49):
right?
So here's what you can keep.
These rules changed dramaticallyas of October 18th of 2018.
So almost three years ago andthat three years is important,
we'll talk about that.
So almost three years ago, theydrastically changed these rules
.
Before this, they were not veryclear on how much money you
(16:11):
could still have and qualify forthis.
In fact, they basically saidwell, we're going to look at all
these factors.
There's your age and what youractual health is and what your
diagnosis is and what your lifeexpect, all of this stuff.
And I used to say, well, intheory, what they would tell you
is they're going to put allthat in a can, stir it up and
(16:31):
then pull out a number and Iknow that sounds kind of funny,
but I mean that's the way theydescribed it.
The VA described it.
So we kind of knew, generally,if you're married, that
somewhere between $60,000 and$80,000.
If you were single somewherebetween $30,000 and $40,000.
(16:51):
So those were the rules ofthumb, but the VA would never
say those numbers.
They would just say well, ifyou have too much, you can apply
and we'll deny you.
So this is better in thatregard, and that not only did
they increase the numbersubstantially, they defined it.
So, just like the other stuff,this will be adjusted for
(17:14):
inflation.
You can have a house with up totwo acres.
Well, what if you have a housewith three acres?
Well, the house and two acresare going to be exempt, and then
the other acre is going to haveto be counted into the other
assets.
So you can have a house and twoacres.
That's exempt.
You can have cars.
(17:35):
You can have multiple cars.
Unlike Medicaid, they don't sayhow many cars.
In fact, they even say familycars.
So in theory the thought is atleast the way the VA wrote this
rule you could have cars foryour kids.
I'm not saying that's a goodidea or that I would recommend
that, but it seems to be what isimplied by the wording of the
(17:58):
rule with regard to this.
So you can have cars, multiplecars, you can have a house in
two acres and you can have$130,733 in other assets, and
that would include bank accountsor investments, other things.
Big change is they do not allowgifting.
So prior to October 18, theydidn't have a look back like
(18:22):
Medicaid does.
So they didn't have a giftingrule.
You could gift and then applyfor benefits.
So now what they said was thatthey were going to grandfather
anybody in that had made a giftprior to October 18, 2018.
So they say the look back isthree years, but technically the
look backs only three years, upuntil October of 18, 2021.
(18:45):
And then we'll say it's threeyears.
In other words, we still haveit's actually two years and 11
months, and how many ever daysit is that you're watching this
video but as of October 18, 2021, it'll be a three year look
back because anything happenedbefore that was grandfathered in
.
So when I say no transfers, nogifting.
(19:06):
If you put your kids in thehouse, they're going to penalize
you.
If you took money out and gaveit to your granddaughter,
they're going to penalize you.
There is not an exemption Intheory, and under Medicaid,
there's an exemption if youdidn't do it for Medicaid
purposes.
In other words, you neverexpected to go to a nursing home
.
They happened to give a nicegift to your granddaughter was
(19:27):
getting married and gave a fewthousand dollars.
The Medicaid has a rule thatsays well, if you can prove that
it wasn't for Medicaid purposes, then VA does not have that
rule.
They basically it's a strictliability.
You gave it away, you addedyour kids names to the deed, to
the house.
You got a problem.
You're going to have a penalty.
Now the house deed.
(19:48):
Hopefully the kid would givethe house back and we can fix
that and still have it exempt.
So this is a big deal.
With regard to the house, though, we do have some planning
opportunities because, if youthink about it a lot of times,
somebody needs to qualify forthis benefit.
They have the house.
They might be eligible, butthey move into an assisted
(20:11):
living or independent living Nowthey have an empty house.
Would make sense maybe to sellthe house, but now if we sell
the house, it's gonna put themover assets.
If you have something like that, send them our way, send them
to us, and we can help them withthat and help them stay
qualified and not bedisqualified from the proceeds
from the sale of the house.
So the other big one is noincome annuities after October
(20:34):
18th 2018.
An income.
Annuity is where you take money$100,000, whatever it is and
you put it into this investmentthat pays you back a monthly
income stream, okay.
And they said, if you do that,we're going to penalize you.
You took $100,000 and you putit into a monthly income stream
that's gonna pay you $1,000 amonth.
They're gonna treat that as ifit was a $100,000 gift.
(20:58):
Doesn't really make a whole lotof sense.
They have their rationalebehind it.
There was a bunch of peopleselling these annuities that
were selling annuities toveterans that didn't need
annuities and it was probably apoor product, a poor financial
product for veterans, and theywere kind of trying to combat
that.
There was a bunch of people outthere selling annuities to
(21:20):
veterans tell them they need toget this annuity in order to get
veterans benefits, which wasnot true, but there was a whole
bunch of people doing it, and sothe VA.
One of the reasons why theychanged the rule was because
they wanted to stop these peoplefrom selling inappropriate
investments to veterans and thentelling them that's what they
needed to do to get theseveterans benefits.
Why annuities?
(21:42):
I can't say for sure, but Ihave a suspicion and that's
because they get a bigcommission on annuities.
The salesperson got a bigcommission on annuities and they
get their entire commission upfront.
Most financial products theyget an ongoing commission and so
they have a reason to continueto be your financial advisor.
With annuities like this, thesalesperson would often get a
(22:07):
big commission up front and thenhave nothing after that, so
they have no incentive toactually help you out in the
future.
They sold the thing, they gottheir money, they abandoned you
basically, or at least that wasthe problem or the concern that
was had.
Okay, so that's the two bigthings.
First of all, they've increasedthe dollar amount.
They've clarified you know youcan't have 100 acres.
(22:29):
Before it wasn't 100% clear asto how much acreage you could
have, so now they said a houseof two acres.
What's weird about that, ofcourse, is you could have a $2
million house on two acres andit's exempt.
Seems a little odd.
That's the rule.
That doesn't work for Medicaidpurposes.
That does work for VA purposes.
And then so the two otherthings is no gifting, there's
(22:51):
three year, look back, and notalways income annuities.
All right, a couple of myths.
A lot of times I've heard thesethings.
I'm a veteran, but I can't getthis benefit, this pension
because I didn't get hurt duringservice.
Nope, that's not required.
That's a different program.
That's what the VA callscompensation.
You'll hear people say I've got20% from the VA or I get 100%
(23:15):
from the VA.
That's compensation.
Service-connecteddisability-service-connected
illness, agent-orange, hearingloss, PTSD, whatever it is.
They tie that to your serviceand that's a different program
altogether.
I did not serve in combat notrequired.
(23:35):
A lot of the folks that we getthe aid and attendance benefit
for never served in combat andsome of them never left the
United States.
They served in a non-combatarea.
They never really had to carrya gun.
It doesn't require you to servein combat for this program.
You just have to serve during awartime period, those dates
that we talked about earlier.
(23:56):
Income is too high?
Nope, can't be, you're just notspending enough.
The VA defines income for thisprogram as income minus medical
expenses or income minuslong-term care expenses.
So if your home health aidcosts more than your social
security check, if your assistedliving or home health aid plus
(24:16):
independent living costs morethan your social security and
pension check, then your incomefor VA purposes is zero.
So I do hear people say all thetime oh, I have too high of
income.
Sometimes people mix up thosewords income and assets, and for
this program, for Medicaid,there's a clear distinction
between income meaning what youhave coming in every month, your
pension and social security andassets, which is a whole
(24:38):
different set of rules, and Ihave too many assets.
We just went through thoseasset issues there, all right.
So last thing to think about iscan you protect assets?
Is there anything that we cando as lawyers to protect assets?
And there are a few things alot less things than I could do
back before October of 2018, butthere's still a number of
(25:01):
things.
Now.
If you have $1 million unlessyou buy a $1 million house,
there's not a heck of a lot I'mgoing to do.
I could do, except if we do theplanning three years in advance
.
So legal planning can still bedone, but I say up to three
years in advance, because if youonly have $300,000 and you're
spending $5,000 a month and yourincome is $2,000, we're going
(25:24):
to do the math.
We're going to figure out, ok,what things can we do to not
have to wait the three years toqualify for veterans benefits,
and there are options.
It gets a little bit morecomplicated, but that's why you
have lawyers because it getscomplicated and we figure out
all the math and we figure outwhether we can protect assets
and if we protect assets, willwe get qualified faster than the
(25:44):
three years?
And the answer is yes.
If you're in that example that Ijust gave you, so if you're
under $500,000 of accountableassets meaning the house doesn't
count, the cars don't count,things like that it's probably
worth a review.
You're up to $1 million inassets.
If you want to apply for thisprogram, we can protect assets,
(26:05):
wait three years and then apply.
But if your low asset already,if you have a less than $130,000
in assets, then this is aprogram that you just have to
look at.
You have the medical need, areyou spending money on care and
assets aren't going to be aproblem.
So let's see if we have anyquestions.
(26:25):
And if we don't have any typedin questions, then Savannah is
going to tell us how you can getyour questions answered in the
future here.
So she's going to give you acouple of different options for
getting questions answered.
I know I think we maybe have afew social workers on the call
and we're watching this video.
(26:46):
We always want to be able to behelpful if it's something that
a social worker has a questionabout this.
Please follow up with us.
Savannah is going to give yousome details about how to do
that.
Savannah Meksto (26:59):
Thanks, Bob.
As Bob mentioned, we do have acouple of easy ways for you to
contact our team.
Whether you're a social worker,as he mentioned, or you just
want some help, we're here.
I have our phone number and alink.
Our 1-800 number is1-800-990-6030.
You can call that number andtalk to our team.
(27:23):
We'll ask you a few questions,get some more information, and
then you can ask us questionstoo.
We are here to help.
You can also email info atmannorlaw.
com, and that's justI-N-F-O-@-M-A-N-N-O-R-L-A-W dot
com.
Thanks again, everyone, forjoining us today and we look
(27:46):
forward to seeing you next time.
Thanks for listening.
To learn more, visitmannorlawgroup.
com and we'll see you next time.
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