VA Benefits & Medicaid

Before applying for Medicaid and VA Non-Service Pension Benefits,
check to see if having both will act to disqualify getting Medicaid.

“While it’s true that the VA Non-Service Pension Benefits does help
with eldercare, which can be very costly these days, having these
benefits may greatly affect a pensioner’s ability to qualify for
Medicaid in the area of assisted living once the pensioner’s benefits
have run out,” said Michael G. Smith, a Little Rock injury lawyer and Little Rock accident lawyer, practicing personal injury law in Little Rock, Arkansas.

Having the VA Non-Service Pension Benefits really does help in terms
of having extra income, however the pensioner needs to carefully check
applying for it first, before making that decision. Having the extra
money might not be in their best interests if they think they may
require Medicaid before needing a greater level of care. “The thing to
keep in mind is that once the veteran is awarded the additional income,
the vet or surviving spouse can’t stop the benefits to qualify for
Medicaid, which may cause some significant problems,” added Smith.

Consider the example of Mary Buetel who lived in a memory care
assisted living community. That community organization helped Mary get
VA surviving spouse benefits which increased Mary’s income to roughly
$2,600 a month. That money combined with her savings helped her to pay
for the community care she received.

Unfortunately, at the going rate of about $3,850.00 a month, her
savings were running out quickly and Mary was faced with a real
dilemma. Even if the community organization participated in the
Medicaid waiver program, Mary would not qualify because the extra money
she received from the VA put her well over her state’s Medicaid
threshold. Mary doesn’t need long-term nursing home care, but because
of her income, she may have no other alternative.

What happened here is that the person who helped Mary get her
benefits in the first place didn’t pay much attention to or didn’t
understand the possibility that Mary may need Medicaid once her assets
were dried up. “The difficulty here is that when living providers
arrange for VA benefits for their residents so that they have extra
income, it is a violation of federal guidelines for an “interested”
party to pay someone on the vet’s behalf to arrange this kind of
service. In cases like that, many living providers have found
themselves in a position of being liable,” Smith explained.

In fact, the specific regulation pertaining to situations like this reads as follows:

Federal Regulation 38 CFR 14.636: Payment of fee by disinterested
third party. (i) An agent or attorney may receive a fee or salary from
an organization, governmental entity, or other disinterested third
party for representation of a claimant or appellant even though the
conditions set forth in paragraph (c) of this section have not been
met. An organization, governmental entity, or other third party is
considered disinterested only if the entity or individual does not
stand to benefit financially from the successful outcome of the claim.
In no such case may the attorney or agent charge a fee which is
contingent, in whole or in part, on whether the matter is resolved in a
manner favorable to the claimant or appellant.

It can’t be stressed enough that veterans and their families need to
know the “right” information before they make financial decisions that
may have a major impact on their life and ability to be able to find
proper care situations. “Yes, the additional income is nice, but if it
comes with a hefty price tag and penalty later, it bears some serious
research up front by a disinterested third party, such as a qualified
lawyer,” commented Michael G. Smith, a Little Rock injury lawyer and
Little Rock accident lawyer, practicing personal injury law in Little
Rock, Arkansas.

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