In This Issue

	Veterans Benefits Can Make Long Term Care Affordable
	If you answer yes to any of these questions, Hurley Elder Care Law can help
	Life Care Planning Goals
	The 2007 Hurley Elder Care Law Handbook of Resources

Veterans Benefits Can Make Long Term Care Affordable

	Consider this scenario. A wizened older man can no longer take care of himself. He has moved into his daughter’s house. Besides the daughter, there are several grandchildren ranging in age from 15 to 22, not to mention the son-in-law. This man feels that he has lost control of his life and states that he no longer wishes to continue living. These are classic signs of clinical depression. Being a child of the Depression Era, he refuses counseling or prescription medications that may improve his condition. This is a proud man, but he has very little income, only about $1,000 per month and very few assets, only about $10,000. He needs a change, but what can be done? During a conversation, he lets out that he served in the army during World War II and was at the Battle of the Bulge. As soon as I heard that, I thought that this man is an ideal candidate for the VA Aid and Attendance pension.
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If you answer yes to any of these questions, Hurley Elder Care Law can help.

		Has the elder been diagnosed with a mentally or physically debilitating disorder such as Alzheimer’s, Parkinson’s, ALS, stroke or a decline in functional capacity?
		Is the elder isolated due to the recent death of a spouse, or have family that either lives too far away or is too busy to provide adequate care?
		Is the elder soon to be discharged into a care facility or currently receiving in-home care?
		Does the elder have a variety of healthcare providers and need coordination and advocacy for quality care?
		Does the elder seem unusually concerned about costs of medication and services, indicating he or she may be having financial troubles?
		Does the elder have assets that fall between $50,000 and $400,000 – enough to finance a short stay in a care facility but not enough for an extended stay?
		Does the elder have a spouse whose financial needs must be considered in light of the elder’s medical condition?

Life Care Planning Goals

1. Meeting the elders’ immediate health care and long-term care needs.
2. Making sure the elder/family is making good health care and long-term care decisions.
3. Helping the elder/family sort through the maze of their long-term care options including residential options.
4. Identifying and accessing public benefits and resources to pay for care should the elder meet the qualifying criteria.
5. Help with asset management, including the burden of home ownership and personal property.
6. Providing the entire family the peace of mind that comes from knowing their loved one is monitored by a team that combines legal and financial expertise with specialized knowledge of the elders’ physical, mental and emotional health.
7. Ensuring the highest level of independence the elder can achieve, while ensuring safety.

Veterans Benefits Can Make Long Term Care Affordable

With his situation, he should be able to qualify for the maximum pension $1,545 per month (2007 figure). When he received those additional funds, his care and custodial living opportunities would change. Amazingly, just the mention of a possible move out of the daughter’s house caused a change in his outlook. He became even better after touring some assisted living facilities. Today, he has moved into a facility, VA is paying the pension and he now looks forward to waking up in the morning and socializing with other residents. This just shows how important it can be to be aware of the benefits that may be available to individuals, in this case, VA benefits. If you know someone who has served our country through military service who now needs long term care, then please make sure that he is aware that benefits may be available through the Veterans Administration (VA). There are three basic types of benefits that are available: 1) benefits for veterans with service-connected disabilities, 2) the use of state veterans homes and 3) veterans disability payments. The service-connected benefits include home care, respite, assisted living, geriatric assessments, nursing home care and hospice. To qualify for these services, the veteran must be enrolled in VA’s health care system. Veterans with service-connected disabilities have priority for health care enrollment acceptance. Some veterans wishing to join the VA health care system may be refused application because their income is too high or they do not qualify under other enrollment criteria. There are many service-connected benefits that may be available and priority is given based on disability ratings. State veterans homes are run by the VA in conjunction with the states, which help build and support the homes. The Federal Government provides funding to help with construction and a daily subsidy for each veteran using these nursing homes. These homes are generally available for any veteran once again with preference being given to rated veterans. There are generally waiting lists to get into the state homes. Veterans disability payments are broken down into two basic categories: Compensation and Pension, together with survivors’ benefits associated with compensation and pension. Compensation is meant to award the veteran a certain amount of monthly income to compensate for potential loss of income in the private sector due to a disability or injury or illness incurred in the service. In order to receive compensation a veteran has to have evidence of a service-connected disability. However, some veterans may have record of being exposed to extreme cold, having an in-service non-disabling injury, having tropical diseases, tuberculosis or other incidents or exposures that at the time may not have caused any disability but years later have resulted in medical problems. Also if a condition has worsened, the veteran may qualify for a higher disability rating. There is no income or asset test for compensation and the benefit is nontaxable. Pension is available to all active-duty veterans who served at least 90 days, at least one day must have been during a period of war. Discharge from the service must be other than dishonorable. Applicants younger than 65 must be totally disabled. The purpose of this benefit is to provide supplemental income to disabled or older veterans who have a low income. If the veteran's income exceeds the pension amount then there is no award. However, income can be adjusted for unreimbursed medical expenses allowing veterans with greater incomes to qualify for a monthly benefit. Compensation and pension claims are submitted on the same form and VA will consider paying either benefit. Generally, for applications associated with the cost of home care, assisted living or nursing home care, the pension benefit is a better option. Surviving single spouses of these veterans are also eligible for lesser benefits and for the allowances, provided that there was no remarriage or divorce. The VA states that this benefit is only for low income veterans but a quirk in the way the benefit is calculated for recurring medical expenses (long term care costs associated with home care, assisted living or nursing homes) may allow households earning between $2,500 and $5,000 or more a month to qualify. Actual awards are based on financial needs and life expectancy. For 2007 the maximum monthly pensions are $1,801 for a married veteran, $1,545 for an unmarried veteran and $976 for a surviving spouse. The following are a few of the misunderstandings and truths regarding veteran’s benefits. Misunderstanding: The Veterans Service Organizations will help all veterans get their benefits. Truth: The VA admits that on phone inquiries they give wrong information 40% of the time. They estimate only 25% of the eligible veterans are getting the benefits and less than 17% of the widows. And they are not allowed to give any advice of what actions can be taken to qualify. Misunderstanding: A veteran or widow cannot qualify if they have over $80,000 in assets. Truth: There is no specific dollar limitation on assets. The veteran or widow cannot have more assets than they can reasonably be expected to use during their lifetime. Generally the VA will not approve anyone with more than $50,000 unless justification can be shown that a higher amount is appropriate. There are no rules against gifting away assets prior to applying; however, care must be given that this does not cause tax problems that are greater than the benefit to be gained. Misunderstanding: No one can help the Veteran or widow apply for Aid & Attendance Pension expect VA employees. Truth: The VA has made it impossible for employees of assisted living homes, caregivers and other volunteers to help Veterans or widows apply for Aid & Attendance Pension, but they cannot stop attorneys from helping. Misunderstanding: No one can charge the Veteran or widow a fee for helping them apply for Aid & Attendance Pension. Truth: This is true. However, there is no prohibition against an attorney charging for Medicaid, financial, legal and tax advice or for preparing documents such as deeds, wills, trusts, power of attorneys, etc.