M21-1, Part IV, Subpart iii, Chapter 2, Section B – Special Monthly Benefits for Survivors

In This Section

Introduction

• considering disability or nursing home status as a basis for a claim for A&A or housebound benefits
• evidence on which to base A&A and housebound determinations
• when a rating decision is required, and
• adjusting A&A and housebound benefits following discharge from a nursing home.

Change Date

IV.iii.2.B.1.a.  Considering Disability or Nursing Home Status as Basis for a Claim for A&A or Housebound Benefits

IV.iii.2.B.1.b.  Evidence on Which to Base A&A and Housebound Determinations

• Examinations of survivors by VA are not generally conducted except at the discretion of the Pension Management Center Manager (PMCM).
• Statements by licensed health care professionals meeting the requirements of 38 CFR 3.326(b) and 38 CFR 3.159(a)(1) are acceptable for rating purposes.
• Statements by responsible officials of nursing homes are acceptable to establish resident status without the need for a physical examination and may be provided on VA Form 21-0779, Request for Nursing Home Information in Connection with Claim for Aid and Attendance.  Pertinent or missing information may also be obtained by telephone and documented on VA Form 21-0820b, Report of Nursing Home or Assisted Living Information.
• VA Form 21-2680, Examination of Housebound Status or Permanent Need for Regular Aid and Attendance, for survivors may be
  • accepted, and
  • issued to claimants, as needed, for completion by their medical providers.

• medical doctor (MD)
• doctor of osteopathy (DO)
• nurse practitioner (NP), or
• physician’s assistant (PA)
• certified nurse practitioner (CNP), or
• clinical nurse specialist (CNS).

IV.iii.2.B.1.c.  When a Rating Decision Is Required

• the A&A rate, when the surviving spouse is not a patient in a nursing home, or
• the Housebound rate.

IV.iii.2.B.1.d.  Adjusting Special Monthly Benefits Following Discharge From a Nursing Home

Introduction

• who may qualify for A&A benefits under 38 CFR 3.351
• who may qualify for housebound benefits under 38 CFR 3.351(d), and
• authorizing A&A without a rating decision.

Change Date

IV.iii.2.B.2.a.  Who May Qualify for A&A Benefits Under 38 CFR 3.351

• Survivors Pension, including protected pension and Old War Service Pension,
• DIC, or
• Death Compensation.

IV.iii.2.B.2.b.  Who May Qualify for Housebound Benefits Under 38 CFR 3.351(e) and (f)

IV.iii.2.B.2.c.  Authorizing A&A Without a Rating Decision

• evidence establishes the claimant is a patient in a nursing home or,
• the surviving spouse was in receipt of A&A benefits on the Veteran’s award prior to the Veteran’s death.