The A&A Benefit

Reprinted from PN April 2011

  • "Aid and Attendance" is a monetary benefit to help compensate veterans unable to care for themselves.

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Most of us in the veteran community know the Department of Veterans Affairs (VA) attempts to ease the financial burden that may arise when an eligible veteran, or an eligible dependent of a veteran, becomes disabled. The fulfillment of monetary obligations can be challenging in the best of times.

However, the stress of these obligations is usually compounded when a family member’s medical needs require regular assistance—particularly for around-the-clock care to keep that person safe in his/her environment or to manage his/her activities of daily living

(ADL). Consequently, VA can increase service-connected compensation or nonservice-connected pension to help compensate veterans unable to care for themselves. This monetary benefit is commonly referred to as Aid and Attendance (A&A).

It is worthwhile to emphasize certain aspects of A&A before discussing the evidentiary requirements that must be submitted in order to support a claim before VA. Foremost, as mentioned above, A&A is a monetary benefit paid directly to the veteran or his/her survivor in some instances. As a national service officer (NSO) with the Paralyzed Veterans of America, I occasionally receive a call with a request such as: “My condition has worsened, and I now would like to have VA send medical personnel to my home several days per week to care for me. Can you file a claim with VA on my behalf for A&A so medical personnel can be sent to my home?” I have to explain to the veteran that A&A is a monetary benefit that helps compensate for the loss of the ability to care for oneself. 

In some cases, VA can provide in-home care to veterans who require it. However this has nothing to do with A&A benefits. It is important to understand that A&A does not provide medical care in the beneficiary’s home.

Another aspect of A&A that must be clarified is that it can be awarded to:

-A veteran receiving service-connected compensation or nonservice-connected pension

-A veteran on behalf of the needs of his/her spouse

-A surviving spouse or parent who receives Dependency and Indemnity Compensation (DIC)

Pursuant to Title 38, Code of Federal Regulations 3.352(a), the following elements are considered when determining the need for regular A&A:

(1) The inability to dress or undress oneself or to keep ordinarily clean and presentable

(2) A frequent need for assistance with the adjustment of any special prosthetic or orthopedic appliances that cannot be done without aid

(3) The inability to feed oneself through loss of coordination of upper extremities or through extreme weakness

(4) An inability to attend to the wants of nature

(5) Incapacity, physical or mental, that requires assistance on a regular basis to protect oneself from the hazards or dangers incident to one’s daily environment.

Significant language in this section of the code clearly states all of the disabling conditions listed do not have to exist in order to grant A&A.

In addition, the aforementioned regulation states A&A will also be granted if it is found the claimant is bedridden. However, strict criteria exist for a determination in this circumstance. The code says “bedridden” will be found if the person’s condition actually requires him or her to stay in bed. According to the regulation, “bedridden” does not exist if the person has voluntarily taken to bed or if a physician has prescribed bed rest to aid in convalescence.

Conversely, A&A is not a VA benefit that will be granted to veterans or dependents because they cannot perform chores around the home. Although some disabilities hinder or prevent people from doing routine—yet necessary—activities such as cleaning the kitchen or shopping for groceries, this does not meet the criteria for a grant of A&A.

Congress recently demonstrated vigilance regarding the needs of our country’s veterans. This is evident in legislation that will increase the amount of service-connected compensation for veterans with traumatic brain injury

(TBI) who need regular A&A. The bill, H.R. 3219, was passed as Public Law 111-275. This law will allow veterans with service-connected TBI who require regular A&A, to receive an additional amount of monetary compensation. This change in law will become effective October 1, 2011.

If you believe you or someone you know may be eligible for this or any other benefit, contact the Paralyzed Veterans of America Veterans Benefits Department at 800-424-8200


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