Aid and Attendance is a VA pension add-on for wartime veterans who need help with daily activities, and it is judged on income, assets, and medical need together.[1] The house is usually the largest item on that list. It also generates the repair invoices, tax statements, and insurance papers the family will be asked to produce. This guide covers how to keep those records in one place so the file can answer questions without a scramble. It is written for the son building the file. It is not legal, medical, or financial advice, and this site is not affiliated with the U.S. Department of Veterans Affairs.

The three gates

Gate one is wartime service and discharge character. The DD Form 214 shows the active-duty dates and the characterization of service.[2] Gate two is medical need. The exam form asks a clinician to describe help with daily activities, and the family does not write that answer. Gate three is financial. VA looks at income and net worth over a set period, and the house is treated under VA's asset rules, not as simply one more bank balance.[3]

The forms

Four forms show up in most files. Check the version number on VA.gov before you print, since VA revises forms.[4]

  • VA Form 21P-527EZ, the pension application, which names the claimant and lists dependents and assets.
  • VA Form 21-2680, the examination for Housebound or Aid and Attendance, completed by the treating clinician.
  • VA Form 21P-0969, the Income and Asset Statement, which needs the house value, mortgage balance, and any transfers.
  • VA Form 21-0845, the authorization to disclose records, used only if VA needs records from a provider on Dad's behalf.

Build the house file first

Before any form is filled in, collect four things for the house: the deed or title showing who owns it and whether a spouse is on title; the most recent property tax statement; the homeowner's insurance declarations page; and a list of mortgage or equity loans with current balances. Ask the county assessor or the lender for copies if they are not at hand.

Then sort upkeep bills into two piles. A repair that keeps the house working is a household cost. A modification made because of a specific medical need is a different case, and whether it counts as an expense should be checked against VA's medical expense rules before the invoice is listed.[3] Keep every invoice, even the ones you think will not count, because the file asks for the total and the reason.

How long

There is no fixed time from filing to decision. The time depends on how complete the first packet is, how quickly records arrive, and whether VA needs more information. The practical advantage of a complete house file is that fewer follow-up requests come back. Keep the binder current through the whole process, not only at filing.

Who files it free

A claim can be filed without paying a fee through a VA-accredited Veterans Service Organization representative, which costs the veteran nothing.[5] Check any representative against VA's accreditation search before handing over documents. The St. Louis offices and how to reach them are listed on Local Help: St. Louis Offices. The reading order for this site is on Start Here: The Order to Read.

Two VA doors

The family can file through a VA-accredited representative, or file directly with VA by mail or online. The direct route puts all the form work on the son. The representative route means an accredited person checks the packet before it goes in. Neither route changes the rules. It changes who checks the paperwork. Compare the two against the house file you have built, and pick the route you can keep current.

Survivors

If Dad dies while the claim is pending, a surviving spouse or other eligible survivor may have a separate claim path. Do not assume the pending file transfers automatically. Keep the house records in the form that path would require, and ask an accredited representative which path applies.[6]

Expenses

Unreimbursed medical expenses paid out of pocket can reduce countable income under VA's rules, but only expenses that meet those rules count.[3] Keep receipts for care, equipment, and transportation. Keep caregiver payment records separate from estimates. A quote is not a paid expense, and the file should show only what was actually paid.

Medicaid

Medicaid is a separate state program with its own income and asset rules, and it can interact with the VA pension. Its treatment of the house, and any look-back on asset transfers, is set by the state, not by VA. Before any change of title or transfer of the house, check with the state office and a qualified advisor. Nothing in this guide is a Medicaid determination.

Sources: [1] VA.gov, Aid and Attendance and Housebound pension page. [2] VA.gov, guidance on requesting a DD Form 214 and discharge characterization. [3] VA.gov, pension income, net worth, and medical expense deduction guidance. [4] VA.gov, pension claim forms listing. [5] VA.gov, accredited representatives and Veterans Service Organization information. [6] VA.gov, survivor benefits guidance.