Medical Eligibility Requirement for Benefits

The Requirements of Medical Eligibility to Qualify for the Veterans Pension Benefit

The Medical Needs Test

If the veteran is younger than age 65, he or she must be totally disabled (mentally or physically) to receive the benefit. Medical evidence must be submitted for these types of applications. At age 65 and older there is no requirement to prove medical disability.  Age 65 automatically qualifies the veteran as disabled.  Yes, that’s right… age alone is enough.  For a surviving spouse applying for this Pension benefit, his/her deceased veteran spouse did not have to meet any disability requirements at time of death nor does the surviving spouse need to meet any medical disability requirement(s), regardless of age.

The VA provides additional income if the veteran or the surviving spouse can prove that they have a recurrent medical condition that requires enhanced and regular medical assistance due to a medically provable condition. If the spouse of a living veteran has a recurring medical need for assistance, a benefit may be available to the veteran or his spouse that otherwise would not have been available.

Allowances are also granted if the veteran or spouse is “housebound.”

A medical need justifying assistance or supervision due to disability is in most cases crucial to getting an enhanced Pension benefit or not getting it. If the medical need (or rating) that causes the disability requires the payment of medical expenses, those expenses are annualized and then subtracted from the veteran’s annual income in order to meet the income test. Most veteran households cannot qualify for the Pension benefit without proof of these medical expenses which allows the deduction of annualized medical and non-medical expenses associated with disability from the veteran’s annual income.

The high cost of medical and non-medical expenses associated with long term care such as home care, assisted living or nursing home care are usually the trigger that allows the veteran household to qualify for the Pension benefit.

Many veterans currently receiving a pension benefit have lower incomes and less in assets and have met both the income and asset tests without the need for the special provision for medical expense deductions to reduce income.

Veterans Benefits For NJ Benefits and Their Surviving Spouse

I know this material sounds very complicated to you, but in practice it’s easy to explain face-to-face. To learn more, I want you to call me personally toll-free (855) 376-5291 or email me at


Written by Fredrick P. Niemann, Esq. of Hanlon Niemann & Wright, a New Jersey Veterans Benefits Attorney

New Jersey Veterans Pension | The Medical Needs Test | NJ Veterans Benefits Attorney | Medical Expenses | Medical Need | Medical Eligibility