NY Times Article on VA Aid and Attendance – Just a Little Misleading (Part 2)

Last week I was discussing the recent New York Times article, which profiled a World War II veteran, Henry Schaffer.  Mr. Schaffer, according to the journalist, paid a VA accredited attorney to get him VA benefits, only to find out that he doesn’t qualify because his income is too high.  But is that really true?

First, we have to look at some inaccuracies in the article.  The NYT journalist, Jessica Silver-Greenberg, has completely misunderstood the VA’s income limits.  The VA calculates what it calls “income for VA purposes ( IVAP)”, in its determination as to whether someone qualifies for a pension or not.  Ms. Silver-Greenberg only tells us what Mr. Schaffer’s income is from Social Security.  The VA subtracts “recurring unreimbursed medical expenses” from that income to get the IVAP number.

Silver-Greenberg suggests that he won’t qualify because he has too much income but that’s not true.  The VA doesn’t have a strict income cap like Medicaid.  His “problem” is that he doesn’t have enough medical expenses.  If he had medical expenses that would reduce his IVAP below $12,465 then he could qualify for a pension.

Silver-Greenberg goes on to point out that “[m]ore money is available for veterans who are unable to cook or bathe on their own. . .”, a reference to the Aid and Attendance part of the VA benefit.  There are 3 levels of pension.  Mr. Schaffer applied for the base pension but it appears that he was too healthy.  For the same reason, Silver-Greenberg states, he can’t qualify for the highest level, the Aid and Attendance.

But, most likely, as he continues to age and need increased care he will be able to qualify.  He moved into a senior living complex.  Although not entirely clear from the article, I am sure it is an independent living facility.  If it qualifies as an assisted living facility then the cost of that facility would count as an unreimbursed medical expense and would very likely enable him to qualify, not only for the base pension, but the higher Aid and Attendance pension of $21,096 per year.

Mr. Schaffer’s mistake is in counting on the VA pension now to help pay for the cost of his housing.  But, he moved to senior housing because he could no longer live alone, so it is possible that the cost of that housing should have counted as an unreimbursed expense.

In other words, it is entirely possible that he was wrongfully denied VA benefits.  It happens all the time, especially when an applicant, who doesn’t know the rules and can’t tell when the government misapplies the rules, files the application himself.

At worst, Mr. Schaffer applied too early.  If he had come to my office, I would have set up a plan to help him qualify for this benefit, either now or as soon as he has enough medical expenses.  Tapping into this benefit will help increase the odds that he won’t need to move into a nursing home but can stay in the retirement community he moved to, by stretching out his own savings.  We just don’t know how long he will live.  $21,000 of additional income means he is using his own savings at a less rapid rate, lessening the risk that he’ll run out of money.  if he runs out of money he runs out of options.

The New York Times journalist got a lot of her facts wrong, but I do agree with her on one point.  There are some so called “experts”, with VA accreditation , who don’t understand  the VA benefit and are either negligently or intentionally steering seniors down the wrong path, for their own financial gain.  How widespread the problem is I don’t know.

But, it’s just like anything else where you are dealing with a subject area in which specialized knowledge and expertise is necessary.  Abuses occur.  It comes down to finding the right advisor who knows what he/she is doing and can guide his/her client through the maze of long term care options and benefits.

In Mr. Schaffer’s case, maybe there is a lack of communication with his attorney.  But, it sounds to me like his move was a necessity to protect his health and wellbeing.  He and his daughter just need the right guidance on his long term care plan and the decisions he must make now and in the coming years.  The right advisors can make all the difference.