Veterans

July is SANDWICH GENERATION AWARENESS MONTH  

The Sandwich Generation refers to those caregivers, generally between the ages of 45 and 59, who are caring for aging parents while also caring for young children or dependent young adult children.  

One of the issues facing many of those caregivers is how to pay for the aging parent’s long-term care needs.  Long-term care refers to ongoing assistance to meet some of the basic activities of daily living, such as bathing, eating, dressing, using the toilet, transferring from bed or chair, caring for incontinence or eating.  The type and cost of long-term care depends on the services necessary for the health and safety of the person.

Keep in mind that Medicare does not pay for long-term custodial care.
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Joe, an 89-year-old veteran served in WWII.  He and his wife, Mary, have been living in an assisted living facility for three years and Joe has been receiving VA Pension with Special Monthly Pension for Aid and Attendance.  Joe recently fell, and his physician has decided Joe cannot return to the assisted living facility.  Joe is now in a Nursing Home and needs to apply for Medicaid to cover the cost of his care.   

VA Pension Benefits can be a lifesaver for veterans or their surviving spouses who need home care or assisted living facility care.

Steve, a veteran who receives service-connected compensation for ALS, amyotrophic lateral sclerosis, often known as Lou Gehrig’s disease, has trouble walking up the stairs and it is getting increasingly difficult for him to get in to the bathtub.  His wife, Jane, can no longer lift him into the tub.

Steve may be eligible for a grant from the VA to adapt his house to accommodate his disability.  The VA provides grants to Service members and Veterans who have total service-connected disabilities to help modify a home, purchase an already adapted home, build an adapted home on land already acquired, or pay down the unpaid principal on the mortgage of an adapted home the Service member or Veterans has already acquired. 

There are two types of grants, with unfortunately similar acronyms:  the Specially Adapted Housing (SAH) Grant, which provides up to $67,555 or the Special Housing Adaptation (SHA) Grant, which provides a maximum of $13,511 in 2014.

What is a Fiduciary and why does the VA want to appoint one for my dad?

George, a veteran of WWII who now lives in an assisted living facility, applied for Improved Pension with Aid & Attendance.  After a few months, the VA sent him a letter explaining that George had been awarded the Pension, but would not receive his retroactive check until the VA determined whether he was competent to handle his affairs and whether the VA should appoint a fiduciary to manage his checks. What is a Fiduciary and why does the VA want to appoint one for my dad?

George, a veteran of WWII who now lives in an assisted living facility, applied for Improved Pension with Aid & Attendance.  After a few months, the VA sent him a letter explaining that George had been awarded the Pension, but would not receive his retroactive check until the VA determined whether he was competent to handle his affairs and whether the VA should appoint a fiduciary to manage his checks. 

Often veterans or their surviving spouses applying for VA Pension or Compensation benefits have some mental disease or injury that affects their ability to manage their financial affairs.

Who is a spouse for VA benefit purposes?

The United States Code and the Code of Federal Regulations – the rulebook for the VA – state that a spouse is a person of the opposite sex, whose marriage meets the requirements of the state in which the parties resided at the time of the marriage.  [1]

The Supreme Court recently struck down a provision in the Defense of Marriage Act that stated that for federal purposes, a marriage between members of the same gender could not be valid.  Why did the Supreme Court strike this down?  Primarily because marriage has historically been a state law question.  In other words, each state has defined the rules for marriage as that state sees fit.

Most of us know someone who served in the military at some point in time.  We’ve seen pictures of them in uniform posted on their walls, or we’ve heard them talk about when they were in Korea, or Viet Nam, or Fort Benning. 

Today, there is a lot of anxiety about healthcare costs, education costs, and long-term care costs.  Have you ever asked someone who served in the military whether they are receiving any benefits or have thought about receiving benefits?  Often veterans or their families will say, “When my dad came back from the war, he never wanted to talk about the war and the VA just reminded him of a really bad time in his life. “  Or, my dad visited a VA hospital and it was too confusing and overwhelming for him.

The VA provides “Community Living Centers”, or what used to be called Nursing Homes.  These are operated by the VA, and are usually in a Veterans Administration Hospital.  These Community Living Centers (CLC’s) provide rehabilitation for veterans recovering from injury and illness in the short-term, but also provide long-term skilled nursing care for veterans who need care for long periods of time for a service-connected injury.

For veterans rated at 70% service-connected or higher, or for those who need nursing home care for their service-connected injuries, the VA pays for their nursing home placement as part of their package of healthcare benefits.

The CLC’s are available for non-service connected veterans who are enrolled in VHA healthcare, and need short term services such as rehabilitation, hospice, respite, and for those waiting for placement in the community.

As the veteran population ages, and as veterans come back from war with increasing numbers of traumatic brain injury (TBI), the number of veterans who are legally blind or have low vision is increasing exponentially.  Low vision and blindness can be caused by accidents, and brain injuries, but many veterans are losing their vision because of age and disease-related factors, such as macular degeneration and diabetes.

President Franklin D. Roosevelt signed an Executive Order on January 8, 1944, which declared:  “No blinded serviceman from World War II (WWII) would be returned to their homes without adequate training to meet the problems of necessity imposed upon them by their blindness.”   After the war ended, the VA accepted the responsibility of adjustment training for blinded veterans.

What are vocational rehabilitation benefits?

The Department of Veterans Affairs provides services for qualified veterans with service-connected disabilities who need assistance to become suitably employed or to maintain employment or who need assistance or training in order to become independent in daily living.

The services provided may include counseling, as well as education and specialized training. 

Which veterans are qualified?

In order to qualify for the program, the veteran must either have, or will receive, an honorable or other than dishonorable discharge, have more than a 10% service-connected disability rating, and must apply for vocational rehabilitation services.

Generally, the veteran must apply for the vocational rehabilitation within 12 years from the separation from active duty, or from the date the veteran was first notified of a service-connected disability rating.

Once the veteran applies, a VA Vocational Rehabilitation Counselor provides a Comprehensive Evaluation, which assesses the veteran’s interests, aptitudes and abilities to determine whether the veteran is entitled to the vocational rehabilitation services and whether the service-connected disability impairs the veterans ability to find or hold a job with the skills the veteran already has.

The Department of Veterans Affairs administers many benefits to veterans and their spouses and families, but some benefits are available only to those who are classified as “Service-Connected” veterans.

Service-connected means that the veteran was injured or developed or contracted a disease or aggravated a pre-existing injury or disease while he or she was on active duty with one of the branches of service – the Navy, the Army, the Marines, the Air Force or the Coast Guard, or their Reserve Components- and that the injury or disease caused a present disability.   Some disabilities or diseases are presumed to have been caused by the veteran’s service if he or she develops the disease or becomes disabled after leaving the service.  We will discuss presumed service connection in a later post.

Some benefits available to service-connected veterans are financial, and the VA pays the veteran a certain amount of money each month based on the level of disability.

If so... 

Who pays what?  Do I need insurance if I’m eligible for VA healthcare?

You’ve been approved for VA Pension or Compensation, and you will be receiving healthcare and prescription drugs at the VA facility.  You also have Medicare part B and Medicare part D.