File the VA Aid and Attendance Claim Yourself or Hire Help: Check the Accreditation and the Fee Terms First
Filing the VA aid and attendance claim yourself, using a free accredited representative, or paying a fee-based representative turns on the forms, the accreditation check, and the fee terms you get in writing.
Aid and attendance is an add-on to the VA pension. It can help a wartime veteran, or a surviving spouse, who needs the regular help of another person with daily activities. Before you decide who does the paperwork, confirm the service history and the program rules on VA.gov (VA), because the forms and limits are set and revised by the VA.
Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.
What the claim is made of
The claim is a bundle, not one form. The pension application is VA Form 21P-527EZ. The need for aid and attendance is documented on VA Form 21-2680, which a physician or designee completes. The discharge record, usually the DD-214, proves the service. Income, medical expenses, and household assets are reported with the application. Every form in the bundle is free from the VA, so the real question is who fills it out and who answers for it.
Route one: file it yourself
Gather the DD-214, the exam form, the income statements, and receipts for the care costs you pay out of pocket. Pull the current version of each form from VA.gov before you sign, because an outdated version can be returned. Keep a copy of everything you send, along with the proof of mailing or upload.
Route two: a free accredited representative
A county veterans service officer or a veterans service organization can file the claim at no charge. You appoint the representative on VA Form 21-22. Before the first meeting, look the person up in the VA accreditation search (VA), and ask directly whether the office charges anything. An office that asks for money at intake is one to leave.
Route three: a fee-based representative
An accredited attorney or claims agent can charge a fee, but the VA sets when a fee may be charged and how it may be calculated, and the rule depends on where the claim stands. Ask for the fee agreement in writing before you sign anything. Ask which event makes the fee payable, what share of any back payment it takes, and whether the fee comes from you or from the award. Compare that answer with the VA's published fee rules. Attorneys and agents are appointed on VA Form 21-22a. A lawyer's standing in Missouri can be checked with the Missouri Bar.
Keep the Medicaid question separate
A VA answer does not decide a Medicaid answer. Missouri DSS counts income and assets under its own rules (Missouri DSS), and Medicaid.gov describes the federal framework that Missouri administers (Medicaid.gov). Do not move any asset to meet a limit without a lawyer's review. For local counseling that fits the household, Local Help With Paying for Care lists the offices in the region, and Aging Ahead can point you to the right one.
Where this stops
A denied claim, an appeal, or a dispute over a fee is the point where a lawyer or a VA-accredited attorney takes over. The medical exam belongs to the physician who completes the form. You choose the route, and the paper trail is yours to keep.