Tag Archives: Elder Law

Benefits for Veterans

| rfatoullah@queenscourier.com

Veterans with limited income who are permanently and totally disabled or 65 years or older may receive an improved pension. To receipt this benefit, the veteran must have been discharged under other than dishonorable conditions and served 90 days or more of active duty, one day of which was during World War II, the Korean War, Vietnam War or Gulf War. A Veteran Administration’s improved pension has three levels: Basic Pension, Housebound Pension and Aid & Attendance.

The first level is the Basic Pension, for which veterans 65 and older are eligible. The Veterans Administration (“VA”) classifies any veteran who reaches the age of 65 as permanently and totally “disabled.” This classification entitles the veteran or his widow to a Basic Pension. A doctor’s assessment is not necessary to confirm disability.

In order to receive the Basic Pension, the veteran must be financially eligible for the pension after a review of income and assets. The VA must determine that the veteran’s assets, excluding his home, furnishings and vehicles, are not sufficient to support him for his lifetime. A commonly used measure is whether there is $80,000 or less in assets, regardless of whether the veteran is married or single. The current maximum monthly basic pension is approximately $1,201 monthly ($12,255 annually).

The second level of pension is the Housebound Pension. To be eligible for Housebound Pension, the individual need not require assistance with activities of daily living per se, but must require some assistance as confirmed by the veteran’s personal physician. The veteran must have a single permanent disability that is 100 percent disabling and be permanently confined to his premises or have a single permanent disability that is 100 percent disabling and another disability that is 60 percent or more disabling. The maximum housebound pension is $1,248 per month ($14,977 annually). The veteran cannot receive Aid and Attendance and Housebound benefits at the same time.

The highest level awarded is Aid & Attendance. Aid & Attendance is a benefit for veterans and surviving spouses who need assistance with activities of daily living, without which they would not be able to function independently. To qualify medically, a veteran or surviving spouse must need the assistance of another person to perform daily tasks, such as eating, dressing, undressing, taking care of the nature’s needs, etc. Being blind or in a nursing home for mental or physical incapacity, or residing in an assisted living facility also qualifies. The attending physician must certify that the individual’s physical limitations are such that he cannot live independently without assistance. The current maximum monthly Aid & attendance benefit is $1,703 ($20,446 annually).

If Medicaid is covering a nursing home resident’s care, the facility will receive the pension and Aid & Attendance and the resident will receive $90 monthly for his personal needs. Due to the complex nature of benefits for veterans, it is advisable to consult a professional who can provide advice regarding what benefits may be available, and to ensure that the Veteran has his legal house in order.

Ronald Fatoullah is a leading expert in the field of elder law. He is the founder and managing attorney of Ronald Fatoullah & Associates, a law firm concentrating in elder law, Medicaid eligibility, estate planning, special needs, trusts, guardianships, & probate. He is certified as an elder law attorney by the National Elder Law Foundation, and he is the current Legal Committee Chair of the Long Island Alzheimer’s Association. This article was written with the assistance of Yan Lian Kuang-Maoga, Esq. Ms. Kuang-Maoga speaks Mandarin and Cantonese and assists with the firm’s Chinese speaking clientele. The firm’s offices are conveniently located in: Long Island, Queens, Manhattan & Brooklyn and can be reached at: 1-877-Elder Law 1-877-Estates.

The Elder Law Minute: How End of Life Wishes Can Control Extreme Medical Expenses

By Queens Courier Staff | editorial@queenscourier.com

A new study finds that when medical personnel know what kind of care a patient wants at the end of life, fewer Medicare funds will be expended and the patient will be more likely to die at home rather than in a hospital – at least in certain areas of the country.

The study, published in the October 5, 2011 issue of the Journal of the American Medical Association, found that in regions of the U.S. that tend to spend the most on end of life care, patients with “advance directives” ended up costing Medicare about $5,600 less per person.  Advance directives, such as a Health Care Proxy and Living Will, allow patients to communicate  their end of life wishes if they are unable to do so themselves.  These patients’ quality of life also appeared to be better, as they were more likely to receive hospice care and to be at home when they died.

However, the differences in spending and care were not as dramatic in regions of the country with low to average end of life expenditures. The researchers speculated that in these areas, less aggressive care at the end of life is already the norm and more in line with most patients’ wishes.  In high spending regions, by contrast, an advance directive may embolden caregivers to go against the local norm of aggressive treatment and prolonged hospital care. In 2006, treatment during the last year of life accounted for more than one quarter of Medicare expenditures.

Advance directives typically include a Health Care Proxy and a Living Will. A Health Care Proxy is a document in which an individual appoints another person to make health care wishes on his/her behalf in the event that the individual does not have the capacity to do so. A Living Will is a document that gives instructions regarding treatment that the individual would want, especially if the individual becomes terminally ill or is in a persistent vegetative state. A Living Will may contain directions to refuse or remove life support in the event the individual is in a coma or vegetative state, with no expectation of recovery. By the same token, it may provide instructions to use all efforts to keep the person alive, no matter the circumstances. Most participants in the study who had advance directives specified that they wanted to limit treatment.

Each state has its own laws regarding advance directives. The study highlights the importance of planning for potential incapacity and long–term care needs. In addition to discussing end of life wishes with your health professional, it is advisable to consult an elder care attorney who can memorialize those issues in the appropriate documents.

Ronald Fatoullah is a leading expert in the field of elder law& estate planning. He is the founder and managing attorney of Ronald Fatoullah& Associates, a law firm concentrating in elder law, Medicaid eligibility, estate planning, special needs, trusts, guardianships, & probate. This article was co-written by Stacey Meshnick, Esq. who heads the Medicaid department at the firm.The firm’s offices are conveniently located in: Queens, Long Island, Manhattan& Brooklyn and can be reached at: 718-261-1700, 516-466-4422, or Toll Free at: 1-877-Elder Law 1-877-Estates.