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Chapter: 1800 Income Program: MSSI, SFP 27 1840.0906.04 Veterans Administration Improved Pension (MSSI, SFP) Other than for exceptions listed in Rule 65A-1.713 F.A.C., the Department follows the SSI policy specified in 20 C.F.R. § 416.1100, including exclusionary policies regarding Veterans Administration benefits such as VA Aid and Attendance, Unreimbursed Medical Expenses, and reduced VA Improved pensions, to determine what counts as income and what is excluded as income.

The Veterans and Survivors Pension Improvement Act changed the method of determining the pension payable and pension rates effective January 1979, but the new rates of payment are not automatic. Since the new rates are not automatic, the veteran or survivor who was receiving benefits prior to January 1979 must apply to VA to establish entitlement under the Act. All individuals who apply for or receive Medicaid benefits must apply for the Veterans Administration Improved Pension Program (VAIP). An individual who receives a VA pension under the old law must apply for improved pension under the new law unless the individual's VA benefit would be lowered under the improved pension. If an individual's pension would be lower under the improved pension, he may continue to receive the pension under the old law. VAIP includes allowances for aid and attendance, housebound, and unreimbursed medical expenses.

Section 8003 of the Omnibus Budget Reconciliation Act of 1990 (OBRA '90) provides for a reduction in Veterans Administration Improved Pensions (VAIP) for single veterans and surviving spouses residing in Title XIX nursing facilities who have no dependents and who are Medicaid eligible. The pension will be reduced to $90 or less per month, which is all considered aid and attendance and is not counted as income for the eligibility determination. Also, it's not added back into the patient responsibility.

However, if the veteran is enrolled in the Medically Needy Program in the nursing home and Medicaid is not paying for nursing home care, the veteran is entitled to the full VA benefit, and must apply to receive it. 1840.0906.05 VA Aid and Attendance (MSSI, SFP) The policy does not apply to OSS.

The VA provides additional compensation when the individual needs routine aid and attendance by another. This compensation may be paid to disabled veterans and to spouses, widows, widowers, and parents of veterans. Aid and attendance payments provided to an eligible individual and paid by the individual to his ineligible spouse, parent, or child living in the same household in return for taking care of him are excluded from income for deeming purposes. Aid and attendance payments made directly to the ineligible spouse, parent or child on behalf of the eligible individual are also excluded as income for deeming purposes.

Note: If an ineligible spouse or parent receives payments for services provided to anyone other than his eligible spouse or child, the payments are included as earned income subject to deeming to the eligible individual.

VA considers an individual in need of regular aid and attendance if the individual is categorized as one of the following:

1. blind or nearly blind, 2. a nursing home patient due to mental or physical incapacity, 3. unable to keep clean and presentable without assistance, 4. unable to dress or undress without assistance, or 5. has frequent need of adjustment of any prosthetic or orthopedic device and the adjustment cannot be made without assistance.