Page Reviewed / Updated - Oct. 2018
Readers should be aware that there is more than one type of veterans’ benefits advisor / planner and not all are appropriate for every situation. This article is focused on obtaining veterans benefits in the context of paying for long term care, be that at home, in assisted living, or in a long term care facility, such as a nursing home or state veteran's home.
The goal of this article is to help families understand:
One should think of the phrase "veterans benefits planning" as a generic term that covers multiple specialties. A planner / advisor can be anyone who provides the veteran (or their surviving spouse) with assistance and understanding about the benefits to which they are entitled. While not all advisors offer assistance at all stages of the claim process, they can step in and help an applicant at any of the various stages— from planning and preparation of the application materials to representation and appeal if necessary. VA benefits planners can be employed by the Department of Veterans Affairs, be volunteers for a Veteran’s services organization, or they can be individual advisors working independently. The services they provide vary based on who is employing them. Generally, those being paid by the VA provide assistance with understanding benefits, but do not offer advice on how to qualify.
What is a VA accredited advisor and is accreditation important? Accreditation by the VA means that the advisor can officially represent a veteran before the VA. Accreditation is by no means an endorsement by the VA or any official recognition that an advisor is competent or even capable. It is simply a legal designation that allows an individual to stand in for the veteran making a claim.
Is accreditation important? Accreditation is only important if the veteran making the claim wants someone to officially represent them. There are many highly competent veterans’ benefits advisors without accreditation just as there are many accredited advisors who are incapable. Furthermore, a private individual, such as a friend or family member, can represent a veteran even without accreditation so long as they are only representing one veteran.
The roles and responsibilities of a veteran’s benefits advisor or planner change based on the stage of the VA claim and the point at which they become engaged in the process. To better understand what an advisor does it is helpful to break down the life of a claim in to various stages, and define the types of assistance provided within those stages.
First and foremost, an advisor at this stage helps a veteran, their spouse, or other family member to identify the benefits, monies, pensions, and/or compensation to which they are or could be eligible, and which of those to pursue. While this may seem a straightforward process, it can be very complicated and varies by case. Certain benefits may preclude other types of benefits. For example, while one can technically be eligible for both disability compensation and the Aid and Attendance pension, one cannot concurrently receive both benefits.
In addition to setting target claims, many advisors help veterans structure their finances in such a way that will maximize the benefits they receive. Some veterans’ pension benefits have defined income and assets limits, but what is considered countable income and countable assets has a degree of flexibility. Similar to Medicaid planning Veterans’ benefits planners can make a significant difference in the amount of compensation a veteran or their surviving spouse can receive, and can even make a difference as to whether the applicant is eligible for the pension benefit at all.
However, new rules published by the VA in September of 2018 will impact how assets and income will be looked at, and in effect, will impact financial planning strategies. One such rule is that effective 10/18/18 there will be a set limit of $123,600 in assets (also referred to as net worth) for applicants, regardless of marital status. Previously there had been no clearly defined asset limit, although it was recommended that single applicants have no more than $50,000 in assets, and married couples, no more than $80,000 in assets. Another important rule to mention, also effective 10/18/18, is that an applicant’s annual income (after deducting eligible medical expenses) will be added to one’s net worth. Unfortunately, the addition of income to one’s assets to establish net worth might push some applicants over the net worth limit. Yet another new VA rule that impacts financial planning strategies is a 36-month look back period. The look back rule is also effective 10/18/18 and immediately precedes one’s pension application date. Simply stated, the VA looks back 3 years to ensure assets were not gifted or sold for less than they are worth in order to meet the new look back rule. If one has violated this rule, there will be a period of VA ineligibility. Please note: Asset transfers made prior to the effective date of 10/18/18 will not violate the look back rule. Also, there is no penalization if the applicant did not have assets greater than $123,600 in the first place.
The three new VA rules discussed above make it all the more important to seek professional VA assistance for financial assistance to ensure income and assets meet the eligibility requirements, and if not, to employ financial strategies to meet the limits without violating VA’s new look back rule.
The pension application is just one small part of the application process. The VA requires additional forms and supporting documentation with a pension claim. For example, one might need to provide discharge papers, proof of insurance premiums, a physician statement regarding one’s medical diagnosis, proof of income, etc. Knowing which forms and records are needed—and which can be omitted—is critical in receiving a timely determination. An advisor can make a significant difference with the application process because their experience allows them to know how to correctly gather and complete all of the application materials without error.
One may be tempted to provide the Department of Veterans Affairs with every medical and military record available and to let them sort it out. However, this strategy does not work and often backfires making a determination even slower. This approach can overwhelm, confuse, and even aggravate the Veterans Service Representative assigned to review the case, which can result in the need for additional forms and reviews. A benefits planner knows what to provide VA, how to "package" it, as well as what not to include.
A veterans’ benefits planner engaged at this stage provides many of the same services as one who engages during the application preparation stage. The difference being if one works with a planner at the pre-application stage, everything should be in order and there is no need for additional planning assistance at this point. However, for those individuals who have already submitted their claim and have received "requests for additional evidence", a planner can be of great assistance. If an applicant doesn’t provide the correct information requested by the VA, the claim could get stalled for many months (or years). It is in these cases that the guidance of an advisor can be invaluable when collecting and preparing the additional evidence needed to support one's claim.
Many veterans choose to retain an advisor if and when their claim has been denied. These advisors tend to be specialized, often they are attorneys and frequently they are accredited. Advisors at this stage review the reason for a denied claim (in the "Statement of Case") and they assess whether there are solid grounds for an appeal. If the decision is made to proceed, an advisor will assist with Form 9 (appeal paperwork), may gather additional supporting evidence and may also attend the Personal Hearing with a Board Member to present the case.
In summary, the case for advisors is that they help veterans receive more compensation in less time with fewer hassles. Aside from the obvious fact that VA disability and pension claims are complicated, working with a veterans benefits advisor has some less obvious but extremely importance benefits detailed below.
|Type of Advisor||Stage||Services||Association with the VA||Fees / Comments|
|Veterans Pension Planners||Pre-Application Education / Planning||Help families understand pension rules and structure their finances to receive the maximum benefit amount||Not typically associated though some are "accredited"||Some provide services free of charge and make money based on referrals. Other charge clients directly. Be sure free providers are working in the vet’s best interest|
|Veterans Service Officers (VSO)||Application, Decision Pending, Appeals||Assist in application preparation, filing, re-opening and appealing claims||Employed by the VA or by veterans groups (American Legion, VFW)||Salaries are paid by the VA or non-profit organization. Consequently, VSOs cannot advise on how to structure finances to meet eligibility requirements|
|Veterans Advocates||Appeals||Assist in assessing and contesting denied claims||Accredited by the VA||Bill hourly, by project or take up to 20% of accrued benefits if a denial is overturned. Some provide services free of charge but these may be untested attorneys looking to gain experience|
Veterans affairs benefits advisors assist veterans, their spouses and family members with all types of claims. Far and away the most common type of claim for which is assistance is used and the situation that requires the most assistance is planning for the Aid & Attendance or the Housebound pension. These pensions are more informally referred to as veterans assisted living benefits. Also common are claims for Dependency and Indemnity Compensation (DIC), Disability Compensation, Burial Benefits or Survivors / Death Pensions. Advisors can even assist with seemingly simple actions such as enrolling in the veterans’ health care program or seeking admissions to a state veterans’ home.
Aside from the specific benefit for which one is applying, advisors often assist with Fully Developed Claims (FDC). FDCs are not a specific type of claim, but a specific method or approach to filing in which the applicant certify during the initial submission that they have provided all relevant materials in their possession. FDCs are initially more complicated to file, but can result in a significantly reduced time to a determination (and hopefully benefits). In fact, in some cases, a determination is even made within 30 – 90 days.
Veterans benefits planners earn money in a variety of ways. Some work for non-profit organizations or the VA and have their salaries paid for by those organizations. Some attorneys work on a contingency fee basis if they are able to overturn a denied claim. Others receive compensation from third parties with whom the benefits planners have referral relationships. Finally, some advisors charge fees directly to the applicant for their assistance.
There is considerable confusion regarding the final of these methods of payment; charging veterans directly for assistance. This confusion is due largely to language from the VA's own website.
"By law, no person or organization may charge claimants a fee for assistance in preparing applications for VA benefits or presenting claims to VA."
While this is the law, there is a considerable gray area surrounding it. For example, it is very common for attorneys and other advisors to provide free "assistance in preparing applications," but to charge veterans for related legal, financial, or estate planning work, such as establishing a trust for their child who is incapable of supporting himself/herself, or long term care planning.
Another gray area: the above statement from the VA is no longer true if a claim has been denied. Once that has occurred, veterans' advocates can charge by the hour, project, and / or up to 20% of the accrued benefits should a denial be overturned on appeal.
Finally some advocates provide free application assistance with the expectation that the claim will be denied and once that has occurred, then can charge for their assistance. Approximately 30% of claims are denied and once an attorney has an established relationship with a veteran, it is very likely the veteran will remain engaged with him or her.
Our organization provides a free service that helps veterans assess whether they require planning assistance and to connect them with the most appropriate and affordable veterans benefits planning professionals. Get started here.