e m i T t s e B

Presenter Brandon Arkin Patrick Clifford barkin@solkoff. co m office@cliffordseniorlaw. com Host Scott Solkoff ssolkoff@elderlawcollege. c om

The Best Time to Plant a Tree… This Photo by Unknown Author is licensed under CC BY

Webinar 5 of a Series Expanding Your Practice with Aid & Attendance Benefits

Part One Advantages of Adding Aid & Attendance to Your Practice

Another Valuable Pot of Money for Your Clients • • Added Value No Estate Recovery Wider Range of Services Cash to Client

Raising Your Profile in the Community with Accreditation • • Long-Term Care Attorney Growing Pool of Clients Additional Legal Needs Enhanced Standing with Referral Partners Marketing Assist

Part Two What Accreditation is and Why it is Necessary

• Program Overseen by the Veterans Administration • Veterans and their Families Accreditation Properly Represented • Required by Federal Law

Three Categories • Representatives of Veterans Service Organizations (VSOs) • Claims Agents • Attorneys Accreditation

Attorneys • A Member in Good Standing of a State Bar • No Exam Requirement • Approval in 60 -90 Days Accreditation

Part Three Getting and Staying Accredited

• Complete and Submit VA Form 21 a § Get it at va. gov § 3 Character References § Certificate of Good Standing Recommended Getting Accredited

• Submit Annual Certification of Good Standing • Ongoing CLE Requirement § 3 -Hour course at Any Time in First Year § Additional 3 -Hour course in 1 st Three Years § 3 -Hour course Every Two Years Thereafter Staying Accredited

Representation Before VA Claims Procedures Basic Eligibility for VA Benefits Right to Appeal Disability Compensation § 38 U. S. C. Chapter 11 • Dependency and Indemnity Compensation (DIC) § 38 U. S. C. Chapter 13 • Pension • • • Required CLE Content

Part Four The VA Enhanced Pension Program

• Basic Pension • Housebound • Aid & Attendance Three Levels

How Benefit is Determined Calculation • Start with Earnings • Subtract Excluded Income • Subtract UMEs • Result = IVAP Example • $18, 000 SSDI, $12, 000 Pension = $30, 000/year • $0 • $18, 000 Enhanced Care at ALF, $3, 600 Part B/Sup. Premiums • IVAP = $8, 400/year (or $700/month)

MAPR – Maximum Annual Pension Rate Aid & Attendance Benefits Veteran/Spouse with or without dependents Veteran with no dependents Veteran with 1 dependent spouse or child Qualified spouse with no dependent Qualified spouse with 1 dependent Additional dependents MAPR $22, 939 $27, 195 $14, 742 $17, 586 $2, 351

How Benefit is Determined Benefit Amount Equals Calculation Example • MAPR minus IVAP • $27, 195 minus $8, 400 • Benefit Amount • = $18, 795/year or $1, 566/month

• Payments for Items or Services that § Are Medically Necessary § Improve Functioning § Prevent, Slow, or Ease Functional Decline Medical Expenses

• Pays for Assistance with ADLs and IADLs § Can be Provided by Medical Family Member Expenses § Or Other Non-Health Care Provider

• Does NOT Pay for Room and Board at ALF, unless § Health Care Provider States Custodial Care Necessary to Ensure Safety Medical Expenses

• Age 65 or Older, or • Totally and Permanently Disabled, or • Patient in a Nursing Home Receiving Skilled Nursing Care, or Qualifications • Receiving Social Security Disability Insurance (SSDI), or • Receiving Supplemental Security Income (SSI)

• Surviving Spouses § Married at Least 12 Months (or Had a Child With Veteran), and Qualifications § Married at Time of Veteran’s Death, and § Not Remarried

Eligible Wartime Periods Conflict World War II Korean Conflict Vietnam War Era (Served in the Republic of Vietnam) Vietnam War Era (Served Outside the Republic of Vietnam) Gulf War Start Date End Date 12/7/1941 12/31/1946 6/27/1950 1/31/1955 2/28/1961 5/7/1975 8/5/1964 5/7/1975 8/2/1990 Future Date

• Bedridden, or • In Need of Aid & Assistance with ADLs, or • In Need of Custodial Care, or • Have a Profound Visual Impairment Clinical Requirements

• Based on Applicant’s Net Worth • Currently $129, 094 Financial • Net Worth = Requirements § Countable Assets + Annual Income

• Personal Effects • Burial Funds • Claimant’s Home § Subject to Limits Excluded • Assets in Irrevocable Trusts Assets § Subject to Transfer Penalty • Trusts for a Disabled Child § Of the Veteran

Part Five Planning for Aid & Attendance

2018 Rule Changes • Defined Financial Qualifications • Clarified Reimbursable Expenses • New Transfer Penalty Planning

Penalty Differences Aid & Attendance Medicaid • Three Year Lookback • 5 Year Max Penalty Period • Penalty Period Starts Month After Transfer • Penalty Divisor = MAPR (Veteran + 1 dependent) • Amount Over Net Worth • Five Year Lookback • No Maximum Penalty Period • Penalty Period Starts at Date of Application • Penalty Divisor = Average Monthly Cost of SNF • All Transfers

Part Six Presenting a Claim for Aid & Attendance

Different Applications • Application for Veterans Pension § VA 21 P-527 EZ • Application for DIC, Survivors Pension, and/or Accrued Benefits § VA 21 P-534 EZ Presenting A Claim

• Appointment of Individual as Claimant Representative § VA 21 -22 a • Examination for Housebound Status or Perm. Need for Regular A & A § VA 21 -2680 • Medical Expense Report § VA 21 P-8416 Presenting A Claim

• • Income and Asset Statement for Pension or DIC § VA 21 P-0969 Authorization to Disclose Information to the VA § VA 21 -4142 General Release for Medical Provider Information to the VA § VA 21 -4142 a Request for Nursing Home Information § VA 21 -0779 Presenting A Claim

Supporting Documentation • DD-214 or Equivalent • Proof of “Other Than Dishonorable” Discharge • Proof of Income • Financial Information • Proof of UMEs Presenting A Claim

• Surviving Spouses Also Need § Certificate of Marriage § Death Certificate Presenting A Claim

When in Doubt, Include it Practice Tip

Part Seven Resources

benefits. va. gov/warms • Click on Compensation and Pension Resources

Resources

Going Forward… This Photo by Unknown Author is licensed under CC BY-SA

Patrick Clifford office@cliffordseniorlaw. co m (702) 966 -8330 Serving the Las Vegas area and Southern Nevada