Aid and attendance depends on a medical record that shows Dad needs regular help from another person with daily activities. VA can gather that evidence through its own examination, and a clinician who knows the veteran can also complete the VA examination form for aid and attendance, VA Form 21-2680.1 Before anyone books a visit, the family should know whether the clinic will complete that form, what it will say, and who will send it.

Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.

Questions to put to the office

  • Does the practice complete VA Form 21-2680 for aid and attendance, or does it only write a letter? Ask for the answer in writing.
  • Which daily activities will the statement address? VA's criteria include whether the veteran can dress or undress, keep himself clean, feed himself, and attend to the needs of nature, and whether he needs protection from the hazards of his surroundings.2
  • Will the statement describe what the clinician observed, or will it only check boxes? A checkbox with no observation behind it gives the reviewer less to work with.
  • Will the clinician examine the veteran in person for this purpose, or is the form being completed from the existing chart?
  • Is there a fee? Get the amount and the billing step in writing before the visit, not after.
  • Who sends the completed form to VA, and will the family receive a copy?
  • Has the office completed this form before? Ask about the experience in general terms, and do not expect the staff to promise an outcome.

What the clinic should not be asked to do

A clinician can only document what the clinician can observe or has reviewed. Do not ask the office to state needs it has not seen, to reach a conclusion about eligibility, or to describe a level of help that Dad has not been shown to require. A statement that goes beyond the record can be discounted, and it can cost the family credibility on the rest of the file.

Bring the right material to the visit

Bring a short written list, in the family's own words, of what help Dad needs and how often, plus any changes in the home that affect daily routine. Bring copies of any earlier VA letters so the office can see what has already been asked. The list is a prompt for the clinician, not a replacement for the clinician's own observations.

This is not medical advice. The clinic decides what it can document. The St. Louis local help page lists offices that can answer process questions about the paperwork.

This desk is not affiliated with the U.S. Department of Veterans Affairs.

1 VA.gov, VA Form 21-2680, Examination for Housebound Status or Permanent Need for Regular Aid and Attendance.
2 VA.gov, aid and attendance criteria under the pension benefit (38 CFR 3.352).