How to Get Aid and Attendance Approval (The Insider’s Guide)

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In this Insider’s Guide, VA disability expert Brian Reese reveals and explains How to Get Approved for VA Aid and Attendance in 2025, covering everything you need to know—basic eligibility for VA pension benefits, clinical criteria, income and net worth limits, example calculations, and step-by-step application instructions to help you understand how the process works.

Veterans Aid and Attendance eligibility is multi-faceted and based upon the following three criteria:

• #1. You must be eligible for VA pension benefits

• #2. You must be so helpless that you literally require the “aid and attendance” of another person to perform the personal functions required in everyday living

• #3. You must meet the VA pension income and net worth limitations for 2025

Okay, let’s explore the step-by-step process to get Aid and Attendance approval!

Summary of Key Points

• VA Pension Benefits Eligibility Requirements: To qualify for VA Aid and Attendance benefits, veterans must meet three criteria: eligibility for VA pension benefits, a need for regular aid and attendance due to helplessness, and adherence to 2025 VA income and net worth limits of $159,240.

• Clinical Requirements for Aid and Attendance: Applicants must demonstrate the need for regular assistance due to severe disabilities such as being bedridden, requiring help with daily living activities, or residing in a nursing home due to physical or mental incapacity.

• Income Limit and Pay Rate Calculation: Aid and Attendance benefits are based on the difference between a veteran’s countable income and the Maximum Annual Pension Rate (MAPR), adjusted annually. For example, a veteran with $10,000 in countable income and an MAPR of $33,548 would receive $23,548 annually or $1,962 monthly.

• To Apply for VA Aid and Attendance Benefits: Complete the VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance) and submit it to your state’s Pension Management Center (PMC) along with supporting evidence, like medical reports and daily activity details. If you’re in a nursing home, include VA Form 21-0779 (Request for Nursing Home Information). You can also apply in person at your local VBA regional office.

Basic Eligibility for VA Pension Benefits

The first requirement to be eligible for Aid and Attendance benefits is you must first be eligible for VA pension benefits.

You may be eligible for the Veterans Pension program if you meet the following requirements:

Both must be true:

• You didn’t receive a dishonorable discharge, and

• Your yearly family income and net worth meet certain limits set by Congress. Your net worth includes all personal property you own (except your house, your car, and most home furnishings), minus any debt you owe. Your net worth includes the net worth of your spouse.

AND at least one of these must be true:

• You started on active duty before September 8, 1980, and you served at least 90 days on active duty with at least 1 day during wartime, or

• You started on active duty as an enlisted person after September 7, 1980, and served at least 24 months or the full period for which you were called or ordered to active duty (with some exceptions) with at least 1 day during wartime, or

• You were an officer and started on active duty after October 16, 1981, and you hadn’t previously served on active duty for at least 24 months

AND at least one of these must be true:

• You’re at least 65 years old, or

• You have a permanent and total disability, or

• You’re a patient in a nursing home for long-term care because of a disability, or

• You’re getting Social Security Disability Insurance or Supplemental Security Income

What are the Eligible Wartime Periods for VA Pension Benefits Eligibility?

Under current law, the VA recognizes the following wartime periods to decide eligibility for VA pension benefits:

• Mexican Border period (May 9, 1916, to April 5, 1917, for Veterans who served in Mexico, on its borders, or in adjacent waters)

• World War I (April 6, 1917, to November 11, 1918)

• World War II (December 7, 1941, to December 31, 1946)

• Korean conflict (June 27, 1950, to January 31, 1955)

• Vietnam War era (November 1, 1955, to May 7, 1975, for Veterans who served in the Republic of Vietnam during that period. August 5, 1964, to May 7, 1975, for Veterans who served outside the Republic of Vietnam.)

• Gulf War (August 2, 1990, through a future date to be set by law or presidential proclamation)

What are the Clinical Requirements for Veterans Aid and Attendance Benefits?

The second requirement to be eligible for Aid and Attendance is you must be so helpless that you literally require the “aid and attendance” of another person to perform the personal functions required in everyday living.

CFR Title 38 § 3.351 defines the clinical requirements for VA Aid and Attendance eligibility.

Need for Aid and Attendance:

The need for aid and attendance means helplessness or being so nearly helpless as to require the regular aid and attendance of another person.

Clinical Criteria for Aid and Attendance:

The veteran, spouse, surviving spouse or parent will be considered in need of regular aid and attendance if he or she (must meet at least one of these clinical criteria):

• Be permanently bedridden except for routine medical appointments, or

• Have severe visual impairment, eyesight limited to a corrected 5/200 visual acuity or less in both eyes or concentric contraction of the visual field to 5 degrees or less, or

• Reside in a nursing home because of physical or mental incapacity, or

• Require the literal “aid and attendance” of another person to perform the personal functions required in everyday living, such as: dressing, bathing, eating, bathroom, etc.

What Does Permanently Bedridden Mean for VA Aid and Attendance?

Here’s the basic criteria for regular aid and attendance and permanently bedridden status.

The following will be accorded consideration in determining the need for regular aid and attendance under 38 CFR § 3.351(c)(3):

• Inability of claimant to dress or undress himself (herself), or to keep himself (herself) ordinarily clean and presentable;

• Frequent need of adjustment of any special prosthetic or orthopedic appliances which by reason of the particular disability cannot be done without aid (this will not include the adjustment of appliances which normal persons would be unable to adjust without aid, such as supports, belts, lacing at the back, etc.);

• Inability of claimant to feed himself (herself) through loss of coordination of upper extremities or through extreme weakness;

• Inability to attend to the wants of nature; or incapacity, physical or mental, which requires care or assistance on a regular basis to protect the claimant from hazards or dangers incident to his or her daily environment.

What Does Bedridden Mean for Aid and Attendance Pension Benefits?

For the purpose of this paragraph “bedridden” will be that condition which, through its essential character, actually requires that the claimant remain in bed.

The fact that claimant has voluntarily taken to bed or that a physician has prescribed rest in bed for the greater or lesser part of the day to promote convalescence or cure will not suffice.

It is not required that all of the disabling conditions enumerated in this paragraph be found to exist before a favorable rating may be made.

The particular personal functions which the veteran is unable to perform should be considered in connection with his or her condition as a whole.

It is only necessary that the evidence establish that the veteran is so helpless as to need regular aid and attendance, not that there be a constant need.

Determinations that the veteran is so helpless, as to be in need of regular aid and attendance will not be based solely upon an opinion that the claimant’s condition is such as would require him or her to be in bed.

They must be based on the actual requirement of personal assistance from others.

What is the Income Limit for VA Aid and Attendance Benefits?

The third requirement to be eligible for Aid and Attendance is you must meet certain income and net worth limitations.

• From December 1, 2024, to November 30, 2025, the net worth limit to qualify for VA pension benefits, including Aid and Attendance, is $159,240.

• Your net worth includes your assets and your income for VA purposes (IVAP).

Example of Net Worth Calculation:

Let’s say you have:

• $121,000 in assets, and

• $14,000 in annual income for VA purposes.

• Your net worth would be calculated as: $121,000 (assets) + $14,000 (income) = $135,000.

Since your total net worth of $135,000 is below the 2025 net worth limit of $159,240, you would meet the financial eligibility requirements for VA pension benefits, including Aid and Attendance.

View the VA pension benefit net worth limitations HERE.

What are the 2025 VA Aid and Attendance Rates?

The 2025 VA Aid and Attendance pay rate depends upon the difference between your countable income and a limit that Congress sets called the Maximum Annual Pension Rate (MAPR).

• Your countable income is how much you earn, including your Social Security benefits, investment and retirement payments, and any income your dependents receive. Some expenses, like non-reimbursable medical expenses (medical expenses not covered by your insurance provider), may reduce your countable income.

• Your MAPR amount is the maximum amount of pension payable. Your MAPR is based on how many dependents you have, if you’re married to another Veteran who qualifies for a pension, and if your disabilities qualify you for Housebound or Aid and Attendance benefits. MAPRs are adjusted each year for cost-of-living increases. You can find your current MAPR amount using the tables below.

Example: The VA calculates your Maximum Annual Pension Rate (MAPR) to determine your benefit amount. The MAPR is the income threshold that depends on your specific circumstances, such as dependents or eligibility for Aid and Attendance benefits.

Example of MAPR and VA Pension Calculation:

• MAPR Amount: $33,548 (Veteran with one dependent and Aid and Attendance eligibility).

• Annual Income for VA Purposes: $10,000.

• VA Pension Benefit: $33,548 – $10,000 = $23,548/year or $1,962/month.

This calculation shows how the VA subtracts your income from the MAPR to determine your pension benefit amount.

How to Apply for Aid and Attendance Benefits

You can apply for VA Aid and Attendance as follows:

#1. Send a completed VA form to your pension management center (PMC):

Fill out the VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance) and mail it to the PMC for your state.

You can have your doctor fill out the examination information section. 

• Download the VA Form 21-2680

• Find your PMC

You can also include with your VA form:

• Other evidence, like a doctor’s report that shows you need Aid and Attendance care

• Details about what you normally do during the day and how you get to places

• Details that help show what kind of illness, injury, or mental or physical disability affects your ability to do things, like eat, get dressed, or take a bath

Learn about the medical evidence you’ll need to support your Aid and Attendance claim

#2. If you’re in a nursing home, you’ll also need to fill out a Request for Nursing Home Information in Connection with Claim for Aid and Attendance Download the VA Form 21-0779.

#3. Apply in person, you can also bring your printed information to VBA regional office near you.

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