Pension

The VA’s pension program provides monthly benefit payments to certain wartime veterans, or their surviving spouses, with financial need. 

Non-Service Connected Pension

Survivor’s Pension

Forms

There are several forms listed below that may be required to be filled out in order to apply for a VA pension depending on your circumstances. Please read the explanation of each form to determine whether or not you need to fill it out.

Workbook

Pension Workbook

The pension workbook needs to be completed in full as this information is required to complete the application. This is not the application; it’s only a workbook that will assist us when we apply for the benefit. We strongly encourage you to contact us for an appointment to file the claim. It can be a very complex application process so we don’t recommend filing the claim on your own.

Examination for Housebound Status or Permanent Need for Regular Aid and Attendance

VA form 21-2680

In order for the VA to determine whether or not a veteran or surviving spouse who receives in-home care or is in an assisted living facility meets the criteria for housebound or aid and attendance, their primary care provider must fill out and sign a VA form 21-2680. Along with the form, the provider must state due to a physical, mental, developmental, or cognitive disorder, the veteran or surviving spouse requires the health care or custodial care that an in-home attendant or assistant living facility provides. The specific disability or disabilities should also be provided in the statement.

Request for Nursing Home Information in Connection with Claim for Aid and Attendance

VA form 21-0779

Any veteran or surviving spouse permanently residing in a nursing home must have their nursing home fill out this form. If a veteran is married, a separate form is required for their spouse, too.

Worksheet for an Assisted Living, Adult Day Care, or a Similar Facility

VA form 21P-527EZ, Page 10 (for veteran) VA form 21P-534EZ, Page 12 (for survivor)

Any veteran or surviving spouse permanently residing in a assisted living facility or who attends adult day care or a similar facility must have the facility fill out this form. If a veteran living in an assisted living facility is married, a separate form is required for their spouse, too. Along with this form, a current statement showing the fees the veteran or surviving spouse pays to the assisted living facility and a breakdown of the care received is also required.

Worksheet for In-home Attendant Expenses

VA form 21P-527EZ, Page 11 (for veteran) VA form 21p-534EZ, Page 13 (for survivor)

This will need to be completed by the veteran or surviving spouse if they are permanently in need of a caregiver. If a caregiver is paid to perform at least two Activities of Daily Living (ADLs), the VA may count the cost of in-home care as a medical expense.  ADLs are defined as basic self-care, including bathing or showering, dressing, eating, transferring (getting in or out of bed or a chair), and using the toilet.

Attendant Affidavit / In-Home Attendant Breakdown

Attendant Affidavit/In-Home Attendant Breakdown

This will need to be completed by the veteran’s or surviving spouse’s caregiver, if applicable.  If a caregiver is paid to perform at least two Activities of Daily Living (ADLs), the VA may count the cost of in-home care as a medical expense.  ADLs are defined as basic self-care, including bathing or showering, dressing, eating, transferring (getting in or out of bed or a chair), and using the toilet.

Questionnaire for Farm Income

VA form 21P-4165

If the veteran or surviving spouse owns a farm, this form is needed to report income from that farm.

Income From Property or Business

VA form 21P-4185

If the veteran or surviving spouse owns rental property or a business, this form is needed to report that income.