Assistance Options to Plan, Apply and Appeal VA Benefits Claims & Pensions

Introduction to Veterans Benefits Planning

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:

  • If they require veterans benefits planning assistance or if they can go it alone
  • Which type of veterans benefits advisor is appropriate for their needs
  • Whether or not they should pay for planning assistance or pursue free of charge options

 If one simply wants to find a veterans benefits advisor, they can do so here.



What is a Veterans’ Benefits Planner?

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 understanding benefits, but do not offer advice on how to qualify. 


What is Accreditation?

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.

 Can I Self-Plan for Veterans Benefits?  Absolutely, yes!  There are no laws prohibiting veterans from doing this or from representing themselves before the VA.  However, there are many reasons why one might wish to work with a professional for planning purposes.

What Services They Provide?

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.


Pre-Application Education

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.

 WARNING - Planning for veterans’ benefits for aging care purposes should never be done without considering the possibility of planning for Medicaid. One should not do anything to gain eligibility for veterans’ benefits that may eventually compromise their ability to qualify for Medicaid. This may be the single strongest argument for working with a qualified planning professional. 

Application Preparation

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.


Post-Application / Pre-Decision

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.


Post-Decision / Appeal

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.


Why and When Are They Important

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.  

    • Almost all claims with the VA are retroactive to the effective date of the claim. Meaning, although it can take many months to receive a determination, once you do, you receive a lump sum check for your benefits back to your application date.  Therefore, the sooner one files a completed application, the greater amount of financial compensation they are due.  Since veterans benefits advisors are very effective at gathering evidence and organizing paperwork, they can enable a claimant to file sooner and therefore receive more compensation.  In this way, veterans’ benefits advisors can easily pay for themselves (if they even charge fees).
    • For most claims where a veteran (or their surviving spouse) applies for assistance independently, it takes 8 - 10 months to reach a determination. Any hiccups in the complicated process can easily delay a decision to 18 months or even 2 years. A veterans’ benefits advisor, by properly assisting with the documentation, helps to prevent these obstacles and ensures that claims can be processed in the minimum time possible. Expert VA planners have told us that with their assistance, a determination can be made and assistance received within six months. 
    • Avoiding hiccups in the application process is important not just because a family receives the compensation sooner but also because it minimizes the time in which a complication can occur.  For example, if the veteran were to die while waiting for a determination, the Department of Veterans Affairs will consider the "case closed". The widow or the family members will have to re-file or open a new claim to receive the backlogged amount of compensation that is due back to the original claim's effective date.
    • Veterans benefits advisors can help families meet the eligibility requirements for some benefits they would not otherwise be eligible and / or increase the amount of compensation they receive. For example, veterans’ pensions have limits on both the income and the assets of the candidate. Yet, there are many exceptions to what is and is not counted as income and what is counted towards the assets limit. For example, the home in which one lives, their vehicle, and life insurance policies are generally not counted towards one’s asset limit.  A knowledgeable advisor can ensure a veteran receives the maximum benefit for their situation. 
    • Obtaining records as supporting evidence for a claim, whether they are military or medical records, can be a major challenge for claimants.  Benefits advisors can greatly facilitate these processes because they know what to ask for and how to ask for it.  Furthermore, some physicians can inadvertently hamper a veteran's claim by providing conflicting information and advisors are proficient at spotting these potential areas of conflict and working to circumvent them.  


Different Types of Veterans’ Benefits Planners
Think of the phrase "veterans’ benefits advisor" as an umbrella term that covers all persons who provide information, advice, or consul about veterans’ benefits.  Within that group, there are several different types of veterans’ benefits advisors.  Some are qualified to assist at any stage in the process, while others have honed their services specifically for, for example, the planning stage or for appeals.

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

Types of Claims

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. 


Costs / How Planners Charge

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 trusts 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.


Finding a Veterans Benefits Planner

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.