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Barnstable District Veterans Services
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One of our two primary functions is to provide financial assistance to veterans and their dependents/widows who establish need and worthiness and are residents of a town within the District.  These benefits are administered for honorably discharged veterans and dependents on fixed incomes and for veterans who are temporarily out of work through no fault of their own.  During the year, the District provided local aid to qualified veterans totaling more than $1,500,000 for housing, food, heat, medical and other related costs.  These benefits are paid by the Accounting office of the town of residency and are  reimbursed to the town at a rate of 75% by the Commonwealth.
We also provide services to veterans in obtaining the full range of federal government (Veterans’ Administration), state government and local government benefits.  Over the past year this office obtained $50,663,854 in VA federal cash benefits for District veterans and widows/widowers.  These benefits were for VA Compensation for service-connected injuries, VA non-service-connected Pensions for those totally disabled but not due to service and Aid and Attendance for those in need of health care assistance.
We have a full-time office in Barnstable and five part-time offices across the Cape for the convenience of our veterans.  Please click on the “Contacts” link for our office locations, hours and contact information.
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VA Medical Application

VA Aid and Attendance

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VA Medical Applications
Application Restrictions
The VA is currently accepting applications from five groups of veterans:
  1. Iraq/Afghanistan era within five years of discharge
  2. Service-connected disabilities of 10% or greater
  3. Gross income of less than $51,000 (single) or $54,000 combined (married)
  4. “Boots-on-the-ground” in Vietnam
  5. Camp Lejeune, 1957 to 1987
Fill out the Medical Application form,  http://www4.va.gov/vaforms/medical/pdf/vha-10-10EZ-fill.pdf   including the financial information on page 3 and mail with a copy of your honorable discharge to:
                                    Eligibility office
                                    VA Medical Center
                                    830 Chalkstone Avenue
                                    Providence, RI 02908
If you have any problems with the form, we will be happy to make an appointment to fill it out or can assist you by phone.
If you meet the VA’s criteria, you will receive a call within 2 to 3 weeks to set up an appointment with a primary care provider at either the Hyannis or New Bedford clinic.
If you do not meet the criteria, you will receive a letter from Atlanta informing you of that fact.

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Dear Veteran:
You or a family member has made an inquiry about assistance in paying for costs associated with visiting nurses, home health aides, assisted living or long-term care.
Attached is a two-page handout describing a VA benefit available to wartime veterans and their spouses/widows and known as Aid and Attendance/Homebound.  Please review the information to determine if it applies to you, your spouse or both.  If it appears to apply, please complete the two forms (VA Forms 21-2680 and 21P-8416) which are available at the links provided and then contact our office to complete the final application form (VA Form 527EZ).  Following are instructions for the two forms.
This form must be filled out by a medical doctor and describe the specific tasks or daily routines with which you require assistance.  If you do not require assistance with any of these tasks, the VA will not approve the benefit.
This form is a summary of all out of pocket medical expenses incurred by you or your spouse during the previous 12 calendar months.  These costs may include medical premiums such as your Medicare B premium which is deducted from your Social Security, your Medigap premium, Part D premium, all co-pays for treatments or prescriptions, dental costs, eyeglasses etc.
If you are incurring actual costs for home health care or for assisted living, you may report these costs as well.  You may not include expected future costs if they are not currently being incurred.
Enter one provider per line.  For example if you or your spouse incur co-pays from CVS every month, enter a single line for the full yearly amount and enter “annual” in column C. 
After you have reviewed the description of the benefits, determined that the benefit is applicable  and completed both forms, contact our office and we will assist you in completing the rest of the application process.

Pension with Aid and Attendance/Housebound

(Applies to either Veteran or Widow)

General Description of the Benefit

Wartime veterans and spouses/widows who are seriously disabled may qualify for Aid and Attendance or Housebound benefits.  These benefits are intended to assist with expenses for visiting nurses or to defray assisted living costs. 
This benefit may also be applied for by those with service-connected compensation provided that the compensable injury is causing the need for the Aid and Attendance. 

Widow’s who are eligible for VA Widow’s pension may also file for Aid and Attendance if they meet the criteria.
 

Initial Screening
Net worth:  Gross income plus gross assets (excluding primary home) may not exceed $80,000.  If slightly higher, the VA recommends filing and allowing them to decide on a case-by-case basis.
 
Countable Income:
Income received by the veteran and his or her spouse, from most sources.  Includes earnings, disability and retirement payments, interest and dividends, and net income from farming or business.  VA will not count SSI but it should be reported. 

Assets:  Includes bank accounts, stocks, bonds, mutual funds and any property other than the primary veteran’s residence.   
Calculation of Benefit
The VA uses a benchmark of approximately $1,100/month (widow), $1,300 (spouse of living vet), $1700/month (single veteran) or $2,000/month (couple), subtracts all incomes for both parties and pays the difference as a benefit.

Medical premiums and expenses will be counted by the VA to reduce gross incomes.  Medical expenses include Medicare B for both parties, supplemental premiums, all co-pays, dental expenses, Visiting nurses and assisted living costs.

The VA will total all countable income and subtract allowed medical deductions.    The remaining countable income after deductions is subtracted from the appropriate benchmark limit.  The resulting benefit is paid directly to the veteran. 
Supporting Documentation
Physician’s Report – Must report in detail exactly what services must be performed by nursing assistants including the ability to dress and undress, to feed oneself, to attend to sanitary needs, and to keep oneself ordinarily clean and presentable.
In addition, it is necessary to determine whether the claimant is confined to the home or immediate premises.
Whether the claim is for Aid and Attendance or Housebound, the report should indicate how well the individual gets around, where the individual goes, and what he or she is able to do during a typical day.
If in Nursing home - statement from nursing home with date of admission and status.

Considerations

A veteran or widow may be eligible for A&A when applicant:
  • Requires aid of another person to perform personal everyday functions (bathing, feeding, dressing, wants of nature, adjusting prosthetic devices, or protection from the hazards of daily environment,    -or-
  • Is bedridden, in that disabilities require remaining in bed apart from any course of convalescence or treatment,   -or-
  • Is a patient in a nursing home due to mental or physical incapacity,   -or-
  • Is blind, or nearly blind (corrected acuity of 5/200 or less, in both eyes, or visual field of 5 degrees or less.
A veteran or widow may be eligible for Housebound benefits when the veteran has:
  • A single permanent disability evaluated as 100-percent disabling and, due to such disability, is permanently confined to immediate premises,   -or-
  • A single permanent disability evaluated as 100-percent disabling and, another disability evaluated as 60 percent or more disabling.
A veteran/widow cannot receive both Aid and Attendance and Housebound benefits at the same time.