My mom is getting Aide & Attendant but the bulk of it goes to the company that is keeping her 'in compliance'. If I could just get a clear idea of how to do that, I could use all of the money for her care instead of the few hours she gets from the healthcare company that is handling it.
To receive the maximum amount the claimant must have Net Income for VA Purposes (IVAP) of $0.
To calculate IVAP begin with GROSS income from all sources.
The claimant then deducts from gross income eligible Unreimbursed Medical Expenses (UME) which may include virtually any ongoing, regular medically related expense including the cost of Medicare insurance premiums (Part B, D, and supplements), life alert systems, physician and Rx co-pays, transportation expenses, durable medical equipment rentals, the cost of home care (provided by an agency or privately), and assisted living facility room and board.
Private household expenses are not deductible.
A deductible of $35.95 per month is then applied. If the net result is $0 or less, the full pension award will be granted. If the net result is below the maximum pension benefit of $1,149, then a partial award may be granted.
The benefit is paid directly to the claimant by monthly electronic transfer. The claimant then pays their expenses from these funds. The claimant is free to use any provider they choose and may change providers at will. The VA must be notified of any changes in income or expenses.
I am very interested to learn what you mean by "the bulk of it goes to the company that is keeping her in compliance". What does that mean? Is she receiving services from a home care company that applied for the benefit for her?
Veterans Home Care (VHC), as you probably know, is not affiliated with the VA. They are a private company and the deal is essentially this:
The veteran or surviving spouse signs a contract with VHC. VHC has contracts with home care agencies. VHC files the application for benefits and arranges for home care to be delivered to the claimant through one of their contracted agencies while the application is being processed. Once approved, any retroactive benefit goes to VHC to reimburse VHC for the care delivered.
The contract with VHC, however, usually requires that you continue to retain them to deliver home care services for a period of time after approval. VHC claims to provide care at "no up front cost" to the claimant but "no up front cost" does not mean "no cost". How do they make money if they don't charge the claimant (they are, to be sure, a for-profit enterprise)?.
The answer is that they pay the agency a certain fee and add a premium to the hourly rate being charged the claimant. VHC's profit is the "spread", or the difference between, what the claimant is charged for services and what VHC pays the agency. So, in reality, the claimant is indeed "paying" for VHC's services in that if it were not for the premium going to VHC, the claimant would have more of the VA award to spend on service hours.
I caution against this arrangement for this very reason. The claimant can usually do better by negotiating their own rate with a home care agency or other provider of services. The true cost of VHC's services must be carefully weighed against other alternatives.
For instance, the primary benefit of VHC's services is that the claimant does not have to wait to receive care if the claimant cannot otherwise afford to pay for care while the claim is pending. In this case, securing a low cost loan for this purpose might be a better alternative in that the claimant has freedom of choice of care provider, no restrictive ongoing obligation, and will probably end up with more service hours in the long run.
There are other companies that operate in a similar manner to VHC and all claim to be helping claimants for "free" or with "no up front cost". They can easily be discerned by their willingness to provide care while the claim is pending.
If the veteran is eligible and qualifies for VA Improved Pension with Aid and Attendance the maximum monthly benefit for a single veteran in 2015 is $1,788 per month.
The Veterans Healthcare Administration may also provide some nominal home care services through the Geriatric Extended Care program. This is accessed through the veteran's VA primary care physician.
Your best bet is to find a Veteran Service Officer (VSO) to assist you in determining what might be available and under what circumstances.
You can find a VSO in your area by doing a search or by going here:
http://nacvso.org/find-a-service-officer/