BUSINESS OFFICE 44-02-005
The Division of Veterans Healthcare Services (DVHS) requires the New Jersey Veterans Memorial Homes (VMH) to develop and implement policies and procedures to assist all eligible veteran home residents to obtain any and all government benefits and annuities to which they are entitled, while residing at a New Jersey Veterans Memorial Home.
This policy sets out a process by which staff members at the VMH may assist residents to obtain various benefits and entitlements to augment their monthly income.
Aid and Attendance - A financial benefit determined by the U.S. Department of Veterans Affairs (VA) for a veteran who is in need of the regular aid and attendance of another person in order to perform the basic activities of daily living (ADL), or who is permanently housebound. Surviving spouses of wartime service veterans are also eligible for this pension.
Entitlements - Any monies or medical insurance plans which the resident is eligible for based on but not limited to age, length of stay in the armed services, financial standing, and disabilities.
Government Programs - U.S. Department of Veterans Affairs benefits are available to any eligible person who has served this country in the armed forces, who is a “Gold Star Parent”, or a widow/widower of a veteran.
Per Diem - A daily financial allotment by the U.S. Department of Veterans Affairs as a supplement for the cost of the care of veterans living in a NJ Veterans Memorial Home.
Private benefits - Any non-government benefit received by a resident from past employment; such as pension, annuities, and other income, which includes Long Term Care (LTC) insurance.
VA Form 21-527EZ - Fully Developed Claim (Pension) (attached her as 44-02-005A).
VA Form 21-4138 – Statement in Support of Claim.
VA Form 21-22 - Appointment of Veterans Service Organization as Claimant’s Representative.
VA Form 21-4142 - Authorization and Consent to Release Information to the Department of Veteran Affairs (VA).
VA Form 21-2680 - Examination for Housebound Status or Permanent Need for Regular Aid and Attendance.
VA Form 21-0779 – Request for Nursing Home Information in Connection with Claim for Aid and Attendance (attached here as 44-02-005B).
VDVA Form 10 - VA Form Medical Statement for Consideration of Aid & Attendance.
VA Form 21-686 – Declaration of Status of Dependents
NJVMH letter of verification - A letter signed by the CEO that tells the VA that our patient (resident) is here permanently for long-term and daily skilled care.
VA Witness Form - A form where the claimant signs the form with two witnesses present.
VA Form 21-8416 - Medical Expense Report.
VA Form 21-0516 – Improved Pension Eligibility Verification Report (Veteran with No Children).
All these claim forms can be found at: http://www4.va.gov/vaforms/search_action.asp
Revised: June 2011