VA Aid and Attendance in Maryland: Eligibility & Rates

To qualify for Aid and Attendance, a veteran must have an honorable or general discharge under honorable conditions from active military service. The veteran must have served on active duty for at least 90 days, with at least one day during a wartime period, or have a service-connected disability rated by the VA at 50% or higher by the rating schedule, or 100% permanent and total disability from service-connected causes.

Qualifying service eras include World War II, the Korean War, the Vietnam War, the Gulf War, and all subsequent operations. The veteran must require regular aid and attendance of another person to perform personal functions required in everyday living, such as bathing, dressing, eating, toileting, or grooming due to a service-connected disability or non-service-connected disability for wartime veterans. Alternatively, the veteran may qualify if they are housebound due to a service-connected disability.

38 U.S.C. § 1114(r) and (s) establish the Aid and Attendance benefit. The service-connected condition must be rated at 50% or higher, or the veteran may qualify under special monthly compensation if they have specific service-connected disabilities such as loss of limbs, blindness, or other serious disabilities. For non-service-connected Aid and Attendance under 38 U.S.C. § 1521(i), wartime veterans with non-service-connected disabilities may also qualify if they meet income and asset limits.

Income limits apply for the non-service-connected Aid and Attendance pension. Dependent income is also counted when determining eligibility. Net worth limitations exist; as of 2024, the net worth limit is approximately $80,000 for a single veteran, though this is adjusted annually. Surviving spouses and dependent children of eligible veterans may also qualify for Aid and Attendance benefits if the deceased veteran would have been eligible. The determination of need for Aid and Attendance is made by a VA physician or health professional during a Compensation & Pension examination.

As of 2024, the maximum monthly Aid and Attendance rates are:

Service-Connected: - Veteran alone: $3,737 - Veteran with spouse: $3,977 - Veteran with one dependent child: $4,115 - Each additional dependent child: $155 added

Non-Service-Connected Wartime Pension (Aid and Attendance): - Veteran alone: $2,280 - Veteran with spouse: $2,992 - Veteran with one dependent child: $3,193 - Each additional dependent child: $201 added

Surviving spouse of service-connected veteran: - Alone: $2,441 - With one dependent child: $3,156 - Each additional child: $201 added

These amounts are effective as of January 2024 and are adjusted annually by COLA (Cost of Living Adjustment). The 2024 COLA increase was 3.2% from 2023. All Aid and Attendance payments are tax-free. Payment is made monthly via direct deposit.

Maryland does not provide a separate state-level Aid and Attendance benefit or supplement beyond the federal VA Aid and Attendance program. This benefit is entirely administered by the federal Veterans Benefits Administration and is available uniformly to all eligible veterans regardless of state residency.

However, Maryland does offer robust support through its state veterans services infrastructure. The Maryland Department of Veterans Affairs operates 23 county veterans service offices across the state, staffed by trained veterans benefits counselors who are free and accredited to help veterans navigate the Aid and Attendance application process. These county veterans service officers can assist with gathering medical evidence, completing VA forms, and submitting claims to the VA on behalf of Maryland veterans.

Additionally, Maryland recognizes Aid and Attendance as a qualifying factor for various state-level elder care and disability support programs. Veterans receiving Aid and Attendance may become eligible for state Medicaid planning services, long-term care facility funding coordination, or property tax relief programs if they meet additional state criteria. The Maryland Veterans Commission also partners with nonprofit veteran service organizations across the state that provide free claims assistance and can help ensure all available state resources are coordinated with federal benefits.

While Maryland does not augment the federal Aid and Attendance payment itself, the state's comprehensive veterans service network significantly eases the application process and helps veterans understand how Aid and Attendance integrates with other Maryland programs.

Aid and Attendance claims are frequently denied or delayed due to insufficient medical evidence of the need for personal assistance. The VA requires clear documentation that a physician or healthcare provider determined the veteran needs regular aid and attendance with activities of daily living such as bathing, dressing, eating, or toileting. Medical records must explicitly state the specific functional limitations and why assistance is required. Vague statements like 'veteran has arthritis' without describing inability to dress or bathe are insufficient.

Another common denial reason is failure to establish the required disability rating. A veteran must have a service-connected condition rated at 50% or higher. If the rating determination is pending or if the disability was not claimed in the original claim, the Aid and Attendance claim will be denied. The veteran must first establish service-connection and receive a disability rating of at least 50% from the VA before Aid and Attendance is eligible.

Incorrect discharge character is also a frequent denial reason. Only veterans with an honorable or general discharge under honorable conditions qualify; dishonorable discharges, bad conduct discharges, or discharges under other than honorable conditions disqualify from Aid and Attendance. Insufficient documentation of military service, including missing DD Form 214s, can delay or deny claims.

For non-service-connected Aid and Attendance pensions, income and net worth limits are a primary denial reason. If the veteran's countable income exceeds the maximum allowed or if net worth is above the limit (approximately $80,000), the claim will be denied. Many veterans do not disclose income properly or fail to account for dependent income.

To build a stronger claim, request a detailed statement from your treating physician that specifically addresses your inability to perform activities of daily living without assistance. Use a nexus letter from a VA-accredited healthcare provider linking your service-connected disability to the current need for aid and attendance. Include recent medical records, hospitalization documentation, and physician notes that explicitly describe functional limitations. Submit copies of all prior VA medical examinations and compensation decisions. Consider requesting a higher-level review or appeal if initially denied.

If your Aid and Attendance claim is denied or you disagree with the decision, you have three appeal options under the VA's modernized system established by the Appeals Modernization Act (38 U.S.C. § 7100 et seq.).

The first option is the Supplemental Claim lane (38 U.S.C. § 7103). If you have new and relevant medical evidence that was not submitted with the original claim, you may file a Supplemental Claim. This is effective within one year of the initial decision. Use VA Form 20-0995, Supplemental Claim for Entitlement Benefits. This option is ideal if you obtained a new physician's statement supporting your need for aid and attendance or additional medical documentation. Processing time is typically 60–120 days. You do not receive a hearing in this lane.

The second option is the Higher-Level Review lane (38 U.S.C. § 7102). If you believe the decision was based on an incorrect interpretation of existing evidence, file a Higher-Level Review using VA Form 20-0996. You must file within one year of the decision. A VA senior rater will review your claim without adding new evidence. You may request a hearing by video or phone with the reviewer. Processing time is typically 90–180 days. This lane is appropriate if the VA misinterpreted your medical records or disability rating.

The third option is the Board of Veterans' Appeals (BVA) lane (38 U.S.C. § 7104). You may request a review by an administrative law judge at the BVA using VA Form 20-0998, Notice of Disagreement. File within one year of the initial decision. You may request an in-person, video, or phone hearing before a judge. The BVA is appropriate for complex cases or when you disagree with the VA's factual findings about your disability or need for assistance. BVA hearings typically occur 2–4 years after filing due to the large backlog, but you may request an expedited hearing if you are over 75 or terminally ill.

For all appeal lanes, you may seek free representation from an accredited VA service officer through your county veterans service office in Maryland or a nonprofit Veterans Service Organization. Do not pay for appeals assistance; it is illegal for anyone to charge veterans for VA representation. The VA provides free representation through the VA Office of the General Counsel and through approved VSOs. Contact your county veterans service office at mva.maryland.gov or call 1-410-960-0739 for free appeals help.