--- kind: "range" citation: "38 C.F.R. §§ 3.551–3.556" title: "38" from: "3.551" to: "3.556" count: 4 url: "https://uscodex.org/cfr/38/3.551..3.556" --- # §3.551. Reduction because of hospitalization. - (a) **General.** Pension is subject to reduction as specified below when a veteran who has neither spouse, child nor dependent parent is hospitalized, unless the veteran is hospitalized for Hansen's disease. The provisions of this section apply to initial periods of hospitalization and to readmissions following discharge from a prior period of hospitalization. If the veteran is hospitalized for observation and examination, the date treatment began is considered the date of admission. Special rules governing discontinuance of aid and attendance allowance are contained in [§ 3.552](/cfr/38/3.552.md). Except as otherwise indicated the terms “hospitalized” and “hospitalization” in [§§ 3.551 through 3.556](/cfr/38/3.551..3.556.md) mean: - (1) Hospital treatment in a Department of Veterans Affairs hospital or in any hospital at Department of Veterans Affairs expense. - (2) Institutional, domiciliary or nursing home care in a Department of Veterans Affairs institution or domiciliary or at Department of Veterans Affairs expense. - (b) **Old-law pension.** - (1) Old law pension in excess of $30 monthly for a veteran who has neither spouse, child nor dependent parent shall continue at the full monthly rate until the end of the sixth calendar month following the month of admission for hospitalization. The rate payable will be reduced effective the first of the seventh calendar month to $30 monthly or 50 percent of the amount otherwise payable, whichever is greater. The reduced rate will be effective the first day of the seventh calendar month following admission. Payment of the amount withheld may be made on termination of hospitalization, as provided in [§ 3.556](/cfr/38/3.556.md). ([Sec. 306(b)](/cfr/38/306.md?p=b)) - (2) **Readmission following regular discharge.** Where a veteran has been given an approved discharge or release, readmission the next day to the same or any other VA institution begins a new period of hospitalization, unless the veteran was released for purposes of admission to another VA institution. - (3) **Readmission following irregular discharge.** When a veteran whose award is subject to reduction under this paragraph has been discharged or released from a VA institution against medical advice or as a result of disciplinary action, reentry within 6 months from the date of previous admission constitutes a continuation of that period of hospitalization and the award will not be reduced prior to the first day of the seventh calendar month following the month of original admission, exclusive of authorized absences. Reentry 6 months or more after such discharge or release shall be considered a new admission. - (c) **Section 306 pension.** - (1) Where any veteran having neither spouse nor child, or any veteran who is married or has a child and is receiving pension as a veteran without dependents, is being furnished hospital, nursing home or domiciliary care by the Department of Veterans Affairs, no pension in excess of $50 monthly shall be paid to or for the veteran for any period after the end of the second full calendar month following the month of admission for such care. - (2) No pension in excess of $50 monthly shall be paid to or for a veteran having neither spouse nor child, or to a veteran who is married or has a child and is receiving pension as a veteran without dependents, for any period after the month in which the veteran is readmitted within 6 months of a period of care for which pension was reduced under [paragraph (c)](#c) (1) of this section. - (3) Where [section 306](/cfr/38/306.md) pension is being paid to a married veteran at a rate for a veteran without dependents all or any part of the monthly amount of pension withheld in excess of $50 may be apportioned for a spouse as provided in [§ 3.454(b)](/cfr/38/3.454.md?p=b). - (d) **Improved pension prior to February 1, 1990.** - (1) Where any veteran having neither spouse nor child, or any veteran who is married or has a child and is receiving pension as a veteran without dependents, is being furnished domiciliary care by VA, no pension in excess of $60 monthly shall be paid to or for the veteran for any period after the end of the second full calendar month following the month of admission for such care. ([38 U.S.C. 5503(a)](/usc/38/5503.md?p=a)) - (2) Where any veteran having neither spouse nor child, or any veteran who is married or has a child and is receiving pension as a veteran without dependents, is furnished hospital or nursing home care by VA, no pension in excess of $60 monthly shall be paid to or for the veteran for any period after the end of the third full calendar month following the month of admission for such care. ([38 U.S.C. 5503(a)](/usc/38/5503.md?p=a)) - (3) No pension in excess of $60 monthly shall be paid to or for a veteran having neither spouse nor child, or to a veteran who is married or has a child and is receiving pension as a veteran without dependents, for any period after the month in which the veteran is readmitted within 6 months of a period of care for which pension was reduced under paragraph [(d)(1)](#d-1) or [(2)](#d-2) of this section. ([38 U.S.C. 5503(a)](/usc/38/5503.md?p=a)) - (4) Where improved pension is being paid to a married veteran at the rate prescribed by [38 U.S.C. 1521(b)](/usc/38/1521.md?p=b) all or any part of the rate payable under [38 U.S.C. 1521(c)](/usc/38/1521.md?p=c) may be apportioned for a spouse as provided in [§ 3.454(b)](/cfr/38/3.454.md?p=b). ([38 U.S.C. 5503(a)](/usc/38/5503.md?p=a)) - (5) The provisions of [paragraphs (d)](#d) (1), (2), and (3) of this section are not applicable to any veteran who has a child, but is receiving pension as a veteran without a dependent because it is reasonable that some part of the child's estate be consumed for the child's maintenance under [38 U.S.C. 1522(b)](/usc/38/1522.md?p=b). - (6) For the purpose of [paragraphs (d)](#d) (1), (2), and (3) of this section, if a veteran is furnished hospital or nursing home care by VA and then is transferred to VA-furnished domiciliary care, the period of hospital or nursing home care shall be considered as domiciliary care. Similarly, if a veteran is furnished domiciliary care by VA and then is transferred to VA-furnished hospital or nursing home care, the period of domiciliary care shall be considered hospital or nursing home care. - (e) **Improved pension after January 31, 1990.** - (1) Where any veteran having neither spouse nor child, or any veteran who is married or has a child and is receiving pension as a veteran without dependents, is furnished domiciliary or nursing home care by VA, no pension in excess of $90 monthly shall be paid to or for the veteran for any period after the end of the third full calendar month following the month of admission for such care. - (2) No pension in excess of $90 monthly shall be paid to a veteran having neither spouse nor child, or to a veteran who is married or has a child and is receiving pension as a veteran without dependents, for any period after the month in which the veteran is readmitted within six months of a period of domiciliary or nursing home care for which pension was reduced under [paragraph (e)(1)](#e-1) of this section. - (3) Where improved pension is being paid to a married veteran at the rate prescribed by [38 U.S.C. 1521(b)](/usc/38/1521.md?p=b) all or any part of the rate payable under [38 U.S.C. 1521(c)](/usc/38/1521.md?p=c) may be apportioned for a spouse as provided in [§ 3.454(b)](/cfr/38/3.454.md?p=b). - (4) For the purposes of [paragraph (e)(1)](#e-1) of this section, if a veteran is furnished hospital care by VA and then is transferred to VA-furnished nursing home or domiciliary care, the period of hospital care shall not be considered as nursing home or domiciliary care. Transfers from VA-furnished nursing home or domiciliary care to VA-furnished hospital care then back to nursing home or domiciliary care shall be considered as continuous nursing home or domiciliary care provided the period of hospitalization does not exceed six months. Similarly, if a veteran is transferred from domiciliary or nursing home to a VA hospital and dies while so hospitalized, the entire period of VA care shall be considered as domiciliary or nursing home care. Nursing home or domiciliary care shall be considered as terminated effective the date of transfer to a VA hospital if the veteran is completely discharged from VA care following the period of hospitalization or if the period of hospitalization exceeds six months. - (5) Effective February 1, 1990, reductions of improved pension based on admissions or readmissions to VA hospitals or any hospital at VA expense shall no longer be made except when required under the provisions of [38 CFR 3.552](/cfr/38/3.552.md). - (6) The provisions of [paragraphs (e)](#e) (1) and (2) of this section are not applicable to any veteran who has a child, but is receiving pension as a veteran without a dependent because it is reasonable that some part of the child's estate be consumed for the child's maintenance under [38 U.S.C. 1522(b)](/usc/38/1522.md?p=b). - (f) **Computation of period.** For purposes of computing periods of hospitalization in [paragraph (c)](#c) of this section, authorized absences of 96 hours or less will be included as periods of hospitalization, and those of over 96 hours excluded. Also, for purposes of that paragraph, periods of treatment or care of 60 total days will be considered two calendar months of hospitalization and periods of 90 total days considered three calendar months, exclusive of authorized absences in excess of 96 hours. - (g) **Proof of dependents.** The veteran will be considered to have neither spouse, child nor dependent parent in the absence of satisfactory proof. Statements contained in the claims folder concerning the existence of such dependents will be considered a prima facie showing. If the necessary evidence is not received: (1) Within 60 days after the date of request where the award is subject to reduction under [paragraph (b)](#b) of this section, or (2) prior to the effective date of reduction under [paragraph (c)](#c) of this section, the veteran's award will be reduced on the basis of no dependents. The full rate may be authorized from the date of reduction if the necessary evidence is received within 1 year after the date of request. - (h) **Hospitalization—** - (1) **General.** The reduction required by paragraphs [(d)](#d) and [(e)](#e), except as they refer to domiciliary care, shall not be made for up to three additional calendar months after the last day of the third month referred to in paragraphs (d)(2) or [(e)(1)](#e-1) of this section, or after the last day of the month referred to in paragraphs (d)(3) or [(e)(2)](#e-2) of this section, under the following conditions: - (i) The Chief Medical Director, or designee, certifies that the primary purpose for furnishing hospital or nursing home care during the additional period is to provide the veteran with a prescribed program of rehabilitation under chapter 17 of title 38, United States Code, designed to restore the veteran's ability to function within the veteran's family and community; and - (ii) The veteran is admitted to a Department of Veterans Affairs hospital or nursing home after October 16, 1981. - (2) **Continued hospitalization for rehabilitation.** The reduction required by paragraph [(d)](#d) or [(e)](#e) of this section shall not be made for periods after the expiration of the additional period provided by [paragraph (h)(1)](#h-1) of this section under the following conditions: - (i) The veteran remains hospitalized or in a nursing home after the expiration of the additional period provided by [paragraph (h)(1)](#h-1) of this section; and - (ii) The Chief Medical Director, or designee, certifies that the primary purpose for furnishing continued hospital or nursing home care after the additional period provided by [paragraph (h)(1)](#h-1) of this section is to provide the veteran with a program of rehabilitation under chapter 17 of title 38, United States Code, designed to restore the veteran's ability to function within the veteran's family and community. - (3) **Termination of hospitalization for rehabilitation.** Pension in excess of $60 monthly or $90, if reduction is under [paragraph (e)(1)](#e-1) payable to a veteran under this paragraph shall be reduced the end of the calendar month in which the primary purpose of hospitalization or nursing home care is no longer to provide the veteran with a program of rehabilitation under chapter 17 of title 38, United States Code designed to restore the veteran's ability to function within the veteran's family and community. - (i) **Certain beneficiaries receiving Medicaid-covered nursing home care.** This paragraph (i) applies to a veteran without a spouse or child, to a surviving spouse without a child, and to a surviving child. Effective November 5, 1990, and terminating on the date provided in [38 U.S.C. 5503(d)(7)](/usc/38/5503.md?p=d-7), if such a beneficiary is receiving Medicaid-covered nursing home care, no pension or survivors pension in excess of $90 per month will be paid to or for the beneficiary for any period after the month in which the Medicaid payments begin. A beneficiary is not liable for any pension paid in excess of the $90 per month by reason of the Secretary's inability or failure to reduce payments, unless that inability or failure is the result of willful concealment, by the beneficiary, of information necessary to make that reduction. # §3.552. Adjustment of allowance for aid and attendance. - (a) - (1) When a veteran who is already entitled to the aid and attendance allowance is hospitalized, the additional compensation or increased pension for aid and attendance shall be discontinued as provided in [paragraph (b)](#b) of this section except as to disabilities specified in [paragraph (a)(2)](#a-2) of this section. (See [paragraph (k)](#k) of this section for rules applicable to a veteran who establishes entitlement to the aid and attendance allowance on or after date of admission to hospitalization). - (2) The allowance for aid and attendance will be continued during hospitalization where the disability is paraplegia involving paralysis of both lower extremities together with loss of anal and bladder sphincter control, or Hansen's disease, except where discontinuance is required by [paragraph (b)(2)](#b-2) of this section. In addition, in pension cases only, the aid and attendance allowance will be continued where the pensionable disability is blindness (visual acuity 5/200 or less) or concentric contraction of visual field to 5 degrees or less. Awards are, however, subject to the provisions of [§ 3.551](/cfr/38/3.551.md) (except where the disabling condition is Hansen's disease) . - (3) Additional compensation for dependents under [§ 3.4(b)(2)](/cfr/38/3.4.md?p=b-2) is payable during hospitalization in addition to the rates authorized by this section. The rates specified will also be increased by amounts authorized under [38 U.S.C. 1114(k)](/usc/38/1114.md?p=k) based on independently ratable disability, subject to the statutory ceiling on the total amount of compensation payable as set forth in [§ 3.350(a)](/cfr/38/3.350.md?p=a). - (b) - (1) Where a veteran is admitted for hospitalization on or after October 1, 1964, the additional compensation or increased pension for aid and attendance will be discontinued effective the last day of the month following the month in which the veteran is admitted for hospitalization at the expense of the Department of Veterans Affairs. - (2) When a veteran is hospitalized at the expense of the United States Government, the additional aid and attendance allowance authorized by 38 U.S.C. [1114(r)(1)](/usc/38/1114.md?p=r-1) or [(2)](/usc/38/1114.md?p=r-2) or [38](/usc/38/38.md) U.S.C. 1114(t) will be discontinued effective the last day of the month following the month in which the veteran is admitted for hospitalization. - (3) Where a veteran affected by the provisions of [paragraph (b)](#b) (1) and (2) or [paragraph (k)](#k) of this section is discharged or released from the hospital against medical advice or as the result of disciplinary action, and is readmitted to such hospitalization within 6 months after that date, the allowance, additional compensation, or increased pension will be discontinued effective the day preceding the date of readmission. A readmission 6 months or more after such discharge or release will be considered as a new admission. - (c) Reduction will not be made where the same monthly rate of compensation would be payable without consideration of need for regular aid and attendance. This can only be determined after careful review of the current maximum entitlement without regard to any amount for aid and attendance. - (d) Where entitlement by reason of need for regular aid and attendance is the basis of the monthly rate under [38 U.S.C. 1114(1)](/usc/38/1114.md?p=1) the award will be reduced to the rate payable under [38 U.S.C. 1114(s)](/usc/38/1114.md?p=s). - (e) Where a veteran is in receipt of [section 306](/cfr/38/306.md) pension, the aid and attendance allowance shall be reduced to the housebound rate of $61 monthly (or $76.25 if the veteran was age 78 or older on December 31, 1978). Where a veteran is in receipt of old-law pension, the total amount payable shall be reduced to $100 monthly. Where a veteran is in receipt of improved pension, the applicable aid and attendance rate shall be reduced to the otherwise applicable rate under [38 U.S.C. 1521(e)](/usc/38/1521.md?p=e). No reduction shall be made, however, for any case involving the disabilities specified in [paragraph (a)(2)](#a-2) of this section. - (f) Where entitlement to the rate in [38 U.S.C. 1114(o)](/usc/38/1114.md?p=o) is based in part on need for regular aid and attendance reduction because of being hospitalized will be to the rate payable for the other conditions shown. - (g) Where a veteran entitled to one of the rates under 38 U.S.C. [1114 (l)](/usc/38/1114.md?p=l), [(m)](/usc/38/1114.md?p=m), or [(n)](/usc/38/1114.md?p=n) by reason of anatomical losses or losses of use of extremities, blindness (visual acuity 5/200 or less or light perception only), or anatomical loss of both eyes is being paid compensation at the rate under [38 U.S.C. 1114(o)](/usc/38/1114.md?p=o) because of entitlement to another rate under [section 1114(l)](/cfr/38/1114.md?p=l) on account of need for aid and attendance, the compensation will be reduced while hospitalized to the following: - (1) If entitlement is under [section 1114(l)](/cfr/38/1114.md?p=l) and in addition there is need for regular aid and attendance for another disability, the award during hospitalization will be at the rate under [38 U.S.C. 1114(m)](/usc/38/1114.md?p=m) since the disability requiring aid and attendance is 100 percent disabling. - (2) If entitlement is under [section 1114(m)](/cfr/38/1114.md?p=m), at the rate under [38 U.S.C. 1114(n)](/usc/38/1114.md?p=n). - (3) If entitlement is under [section 1114(n)](/cfr/38/1114.md?p=n), the rate under [38 U.S.C. 1114(o)](/usc/38/1114.md?p=o) would be continued, since the disability previously causing the need for regular aid and attendance would then be totally disabling entitling the veteran to the maximum rate under [38 U.S.C. 1114(p)](/usc/38/1114.md?p=p). - (h) If, because of blindness, a veteran requires regular aid and attendance, but has better vision than “light perception only” the award under [38 U.S.C. 1114(m)](/usc/38/1114.md?p=m) will be reduced while hospitalized to the rate payable under [38 U.S.C. 1114(1)](/usc/38/1114.md?p=1). - (i) If the disability meets the aid and attendance requirements of [38 U.S.C. 1114(l)](/usc/38/1114.md?p=l) and the intermediate or next higher rate was assigned for disability independently ratable at 50 percent or 100 percent, the award based on such entitlement will be reduced because of hospitalization to the amount payable under [38 U.S.C. 1114(s)](/usc/38/1114.md?p=s). - (j) The [section 306](/cfr/38/306.md) pension aid and attendance allowance authorized by [§ 3.252(f)](/cfr/38/3.252.md?p=f) is subject to reduction for hospitalization under the provisions of this section in the same manner as the regular [section 306](/cfr/38/306.md) pension aid and attendance allowance. The amount payable shall not be reduced to less than the housebound rate of $61 monthly (or $76.25 monthly if the veteran was age 78 or older on December 31, 1978). - (k) - (1) This paragraph is applicable to hospitalized veterans who were not entitled to the aid and attendance allowance prior to hospital admission but who establish entitlement to it on or after the date of hospital admission. - (2) If the effective date of entitlement to the aid and attendance allowance is on or after the date of admission to hospitalization, the aid and attendance allowance shall not be paid until the date of discharge or release from hospitalization, unless the aid and attendance allowance is based on a disability specified in [paragraph (a)(2)](#a-2) of this section. If the aid and attendance allowance is based on a disability specified in [paragraph (a)(2)](#a-2) of this section, the aid and attendance allowance shall be paid during hospitalization. - (3) If the aid and attendance allowance is not payable to a veteran under [paragraph (k)(2)](#k-2) of this section, the veteran shall receive the appropriate reduced rate under [paragraphs (d) through (j)](#d..j) of this section while hospitalized. # §3.553-3.555. Reserved # §3.556. Adjustment on discharge or release. - (a) **Temporary Absence—30 days.** - (1) Where a competent veteran whose award was reduced under [§ 3.551(b)](/cfr/38/3.551.md?p=b) is placed on non-bed care status or other authorized absence of 30 days or more the full monthly rate, excluding any allowance for regular aid and attendance, will be restored effective the date of reduction. The full monthly rate for an incompetent veteran, or for a competent veteran whose pension was reduced under [§ 3.551(c)](/cfr/38/3.551.md?p=c), will be restored effective the date of departure from the hospital. In all instances, any allowance for regular aid and attendance will be restored effective the date of departure from the hospital. - (2) Upon the veteran's return to the hospital, an award which is subject to reduction under § [3.551 (b)](/cfr/38/3.551.md?p=b) or [(c)](/cfr/38/3.551.md?p=c) will again be reduced effective the date of the veteran's return to the hospital. In all instances, any allowance for regular aid and attendance will be discontinued, if in order, effective the date of the veteran's return to the hospital. - (b) **Temporary absence—less than 30 days.** A temporary absence of less than 30 days, including the day of departure, will not require adjustment of the award. This applies to any approved absence. Any allowance for regular aid and attendance for such periods will be authorized after the veteran has been discharged from the hospital. - (c) **Adjustment based on need.** Where an award of pension was reduced under [§ 3.551(c)](/cfr/38/3.551.md?p=c), the full rate covering absences of less than 30 days may be restored, subject to prior payments, prior to discharge from hospitalization at the request of the Director of the hospital, center or domiciliary, where this action is necessary to meet the veteran's financial needs, if the veteran has been hospitalized for more than 6 months and the periods of absence exceed a total of 30 days. - (d) **Irregular discharge.** When a competent veteran is given an irregular discharge, the full rate will be restored effective the date of release from the hospital. Payment of any amount withheld under [§ 3.551(b)](/cfr/38/3.551.md?p=b) will not be authorized until the expiration of 6 months after termination of hospitalization unless the prior release is changed to a regular release. However, amounts not paid under [paragraph (c)](#c) of this section covering absence of less than 30 days where the award was reduced under [§ 3.551(c)](/cfr/38/3.551.md?p=c) will be authorized immediately. - (e) **Regular discharge.** When a veteran, either competent or incompetent, is given a regular discharge or release, the full rate, including any allowance for regular aid and attendance will be restored effective the date of release from the hospital, subject to prior payments. The award will be based on the most recent rating and, where the award was reduced under [§ 3.551(b)](/cfr/38/3.551.md?p=b), will include, any amounts withheld because of hospitalization. Any institutional award will be discontinued effective date of last payment, as provided in [§ 3.501(j)](/cfr/38/3.501.md?p=j). Where an apportionment made under [§ 3.551(c)](/cfr/38/3.551.md?p=c) is not continued, the apportionment will be discontinued effective the day preceding the date of the veteran's release from the hospital, or, if adjusted, effective the date of the veteran's release from the hospital, unless an overpayment would result. Where an apportionment was made under [§ 3.551(c)](/cfr/38/3.551.md?p=c), the apportionment will be discontinued effective the day preceding the date of the veteran's release from the hospital, unless an overpayment would result. In the excepted cases, the awards to the veteran and apportionee will be adjusted as of date of last payment. - (f) **Types of discharges.** A discharge is considered regular if it is granted because of having received maximum hospital benefits. A discharge for disciplinary reasons or because of the patient's refusal to accept, neglect of or obstruction of treatment; refusal to accept transfer, or failure to return from authorized absence, is considered irregular.