BUSINESS OFFICE                                                                                                 44-02-005

BENEFIT ENTITLEMENTS

POLICY STATEMENT.

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.

PURPOSE.

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.

DEFINITIONS.

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.

PROCEDURE.

  1. Per Diem -
    1. On a monthly or quarterly basis throughout the fiscal year, the Business Office receives funding from the U.S. Department of Veterans Affairs, based on a monthly or quarterly recap of the monthly census of the veteran population in the VMH.
    2. These funds are deposited in the General State Treasury Revenue Account, and utilized by the State of New Jersey as general revenue.
  2. Aid and Attendance -
    1. The process for applying for Aid and Attendance is as follows:                  
      1. As soon as possible following admission, the Social Service Department (the Veterans Entitlement Officer) will assist the resident in completing the VA application forms for Aid and Attendance.  The application is given to the appropriate Social Worker for the resident’s signature. 
      2.  The application is given back to the Veterans Entitlement Officer who submits the application and all other required documentation to the U.S. Department of Veterans’ Affairs.           
      3. If the Aid and Attendance is approved by the U.S. Department of Veterans Affairs, the Veterans Entitlement Officer will inform the Resident Accounts department.  The Resident Accounts staff personnel will recalculate the resident’s monthly maintenance fee, inclusive of the Aid and Attendance determination.
      4. The following are the VA forms that must be completed and sent to the VA to make an initial application for Aid and Attendance:

        5. 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.

      5. Each year, once the resident has been initially approved for Aid and Attendance, the VMH must complete and send in the following VA forms to continue the Aid and Attendance benefits for the resident:

        6. 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

  3. Private Benefits:
    1. For those residents without personal resources, the Social Services Department will research any private benefits that the resident might be entitled to receive (pension, etc).

Revised:   June 2011

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