Adult Children Can Be Paid for Caring for Parents Applying for VA Pension Even if  the Children Are Not Licensed Care Professionals

Under regulations governing needs-based pension benefits provided by the Department of Veterans Affairs, adult children providing care to an applicant veteran or his or her spouse can be paid for work performed even if the children are NOT licensed care professionals as long as the applicant has been rated either Housebound or A&A.

The regulation follows:

M21-1, Part V, Subpart iii, Chapter 1, Section G – Pension – Deductible Expenses

V.iii.1.G.3.o.  In-Home Attendants for a Disabled Person in Need of A&A or Housebound Allow all fees paid to an in-home attendant as long as the attendant provides medical services, nursing services, or custodial care for the disabled person.

The attendant does not have to be a licensed health professional when the disabled person

  • is rated A&A or housebound, or
  • is not eligible to be rated for A&A or housebound and a licensed physician states that the person requires custodial care.


  • Examples of medical and nursing services are physical therapy, administration of injections, placement of indwelling catheters, and the changing of sterile dressings.
  • Examples of custodial care include assisting a person with ADLs and may include assisting a person with IADLs alone when the person has a physical, mental, developmental, or cognitive disorder.

All reasonable fees paid to the attendant for personal care of the disabled person and maintenance of the disabled person’s immediate environment may be allowed.  This includes such services as cooking for the disabled person, housecleaning for the disabled person, and other IADLs.

It is not necessary to distinguish between medical and non-medical services. However, services that are beyond the scope of personal care of the disabled person and maintenance of the disabled person’s immediate environment, may not be allowed.

Example:  A Veteran is rated in need of A&A by VA.  The Veteran pays an attendant to administer medication and provide for the Veteran’s personal needs.  The attendant also cooks the Veteran’s meals and cleans house.

Allow the entire amount paid to the attendant as a deductible medical expense.  It makes no difference whether the attendant is a licensed health professional

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