VA Benefits Decision Tree

Pathway 1: Aid & Attendance (A&A)

Who it is for: wartime veterans and surviving spouses who need help with the activities of daily living (bathing, dressing, meals, mobility) or are house-bound or in an assisted-living facility.

What it pays: up to about $2,727 per month for a veteran (2026), $1,478 for a surviving spouse, tax-free. The exact number changes annually with cost-of-living adjustments.

Eligibility ladder:

1. Wartime service (at least 90 days active duty with at least 1 day during a defined wartime period)
2. Honourable discharge
3. Income + net worth under the annual limit (2026: about $155,356 net worth)
4. Medical need for aid and attendance, documented by a physician

Timeline: 4–9 months from application to first payment, retroactive to application date.

Pathway 2: Program of Comprehensive Assistance for Family Caregivers (PCAFC)

Who it is for: veterans of any era with a serious injury or illness incurred or aggravated in the line of duty (post-9/11 originally; expanded in 2020 and 2022 to all eras). Pays the family caregiver, not the veteran.

What it pays: a monthly stipend to the primary family caregiver based on VA GS rating scale (typically $1,800–$3,500/month depending on caregiver tier and geography), plus health insurance (CHAMPVA) for the caregiver, plus respite and mental health support.

Eligibility ladder:

1. Veteran with 70% or greater service-connected disability rating (or complex needs)
2. Veteran requires 6+ months of continuous personal care in the home
3. An eligible family caregiver commits to providing that care

Timeline: ~90 days from application to approval.

Pathway 3: VA Community Care Network (CCN)

Who it is for: veterans enrolled in VA health care who need home health care and either (a) live more than a certain distance from a VA medical facility or (b) whose local VA cannot provide the service in a timely fashion. In Houston, Michael E. DeBakey VA Medical Center is the anchor facility.

What it pays: the VA pays the community provider directly at contracted rates for approved home-health episodes. Not paid to the veteran.

Eligibility ladder:

1. Veteran enrolled in VA health care
2. Referral from VA provider
3. Provider is in the VA Community Care Network (we can advise on how to become or find one)

Pathway 4: Veteran-Directed Care (VDC)

Who it is for: veterans with complex care needs who want to direct their own care budget rather than have the VA assign a provider.

What it pays: the VA gives the veteran a monthly budget (varies, often $1,500–$3,500/month) to spend on care as they see fit — including paying a family member as a caregiver.

Eligibility ladder:

1. Veteran enrolled in VA health care
2. Nursing home eligibility per VA assessment
3. Willing to self-direct care (VDC is not right for veterans who prefer to delegate)

How to figure out which one applies to your family

1. Is the veteran a wartime veteran with limited income? Start with Aid & Attendance.
2. Is the veteran service-disabled at 70%+ with a family caregiver committed to full-time care? PCAFC.
3. Is the veteran enrolled in VA health care and does he/she need home health after a hospitalisation or a specific episode? Community Care Network via VA referral.
4. Does the veteran want to hire and manage caregivers themselves? Veteran-Directed Care.
5. Not sure or overlapping? Multiple pathways can apply simultaneously (e.g. A&A + CCN). A VA-accredited attorney can help sort it out. We can refer you to one in Houston.

Common Houston pain points

• Wartime dates are precise; a veteran who served 1975–1978 (post-Vietnam) does not qualify for A&A on wartime alone.
• Aid & Attendance income test looks at income minus unreimbursed medical expenses (UME) — home-care costs count as UME and often bring income under the limit.
• Surviving-spouse claims require documentation of the marriage and the veteran’s discharge — track down the DD-214 early.
• Michael E. DeBakey VAMC is the anchor facility; approval delays are common. If time-sensitive, private-pay-then-reimburse-through-CCN is sometimes the fastest path.

Where to start

The fastest, cheapest starting point is a call with our team. We are not a VA-accredited attorney, but we know which pathway typically fits which situation, we know the Houston-specific pain points, and we know when to refer to a VA-accredited attorney for the actual filing.

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