SMC Aid and Attendance
A higher compensation rate tied to service-connected disability and the need for regular aid and attendance.
Review SMC Aid and AttendanceCaregiver and home-support navigation
Need help at home? VA programs are not all the same.
Some programs increase compensation or pension. Others provide caregiver support or arrange home and community services through VA health care. The right starting point depends on what help is needed and which part of VA controls the program.
Current through July 2026. Educational information only. Eligibility and availability are determined by VA.
Start with who pays and who decides
Pension Aid and Attendance
An increased pension amount for a qualifying Veteran or survivor who meets pension and care-related requirements.
Review Pension Aid and AttendancePCAFC and PGCSS
Clinical caregiver programs administered through each VA medical center’s Caregiver Support Program team.
Review caregiver support programsVeteran-Directed Care
A consumer-directed home and community service for eligible Veterans when the program is locally available.
Review Veteran-Directed CareFirst: disability compensation
Special Monthly Compensation: Aid and Attendance
SMC is a higher rate of disability compensation for specific service-connected circumstances. Regular aid and attendance can be one basis for an SMC award.
What it is
Additional monthly compensation paid to the Veteran. It is not a caregiver salary, home-care contract, or reimbursement program.
What matters
The service-connected disabilities, the Veteran’s actual need for regular personal assistance, and the evidence describing functional limitations and safety needs.
Where it is handled
The Veterans Benefits Administration. VA Form 21-2680 is commonly used to provide examination information for housebound status or regular aid and attendance.
Second: needs-based pension
Pension Aid and Attendance
Pension Aid and Attendance is an increased pension amount. It is available only when the Veteran or survivor qualifies for VA pension and also meets the applicable care-related requirements.
What it is
An addition to monthly pension. It is separate from service-connected disability compensation and separate from VA health care caregiver programs.
What matters
Pension eligibility, income and net-worth rules, qualifying wartime service, and evidence of the need for personal assistance, housebound status, nursing-home care, bedridden status, or qualifying visual impairment.
Where it is handled
The Veterans Benefits Administration through the pension claims process. VA Form 21-2680 may be used to document the medical and functional basis for the request.
VA health care caregiver support
PCAFC and PGCSS serve different caregiver needs
Program of Comprehensive Assistance for Family Caregivers
Enhanced clinical support for approved family caregivers of eligible Veterans. Current criteria include a single or combined service-connected rating of at least 70% and a need for in-person personal care services for at least six continuous months based on an activity-of-daily-living limitation, supervision or protection, or regular or extensive instruction or supervision.
Process: Joint application, clinical evaluations, eligibility determination, and continuing program requirements.
Possible supports: Training, mental health counseling, respite, health coverage when otherwise uninsured, and a monthly stipend for an approved Primary Family Caregiver.
Official PCAFC informationProgram of General Caregiver Support Services
Support for caregivers of Veterans enrolled in VA health care who need personal care because of an activity-of-daily-living limitation or a need for supervision or protection.
Process: Contact the local Caregiver Support Program team and complete a brief intake. VA states that there is no formal application and no clinical evaluation is required.
Supports: Skills training, coaching, peer support, groups, respite resources, online programs, and referrals. PGCSS does not provide the PCAFC monthly stipend.
Official PGCSS informationVA home and community services
Veteran-Directed Care
Veteran-Directed Care gives eligible Veterans a budget and counseling support to arrange needed home and community services in a consumer-directed way.
Who it is for
Veterans who need personal care or help with activities such as bathing, dressing, meals, toileting, mobility, grooming, or shopping. VA also identifies isolation and caregiver burden as circumstances the program may address.
How it works
The Veteran or representative develops a spending plan with a counselor and hires workers to meet assessed needs. Workers may include a family member or neighbor when permitted.
Important limitation
The Veteran must be enrolled, eligible for community care, meet the clinical criteria, and live where the service is available. Availability and services vary by location.
Prepare the record
Describe the help that is actually required
Program names differ, but VA evaluations often depend on concrete facts about daily function, supervision, safety, frequency, and the help another person provides.
Activities of daily living
- Bathing and shower transfers
- Dressing and prosthetic adjustment
- Eating and meal setup
- Toileting and continence care
- Mobility and transfers
- Personal grooming
Supervision and protection
- Falls, wandering, or unsafe judgment
- Medication management
- Memory, neurological, or behavioral symptoms
- Emergency response and nighttime needs
- Risks when the caregiver is not present
- Instruction required to complete tasks
Document the pattern
- What help is given
- Who provides it
- How often and how long it takes
- What happens without the help
- Changes over time
- Records that support the description
Use the correct doorway
| Need | Program or office | Starting point |
|---|---|---|
| Higher compensation because service-connected disabilities require regular personal assistance | SMC Aid and Attendance | VBA claim process; VA Form 21-2680 and supporting evidence |
| Higher pension because a qualifying Veteran or survivor needs assistance or is housebound | Pension Aid and Attendance or Housebound | VBA pension process; VA Form 21-2680 and pension evidence |
| Enhanced family-caregiver support and possible stipend | PCAFC | Local VA Caregiver Support Program team and joint application |
| Training, coaching, peer support, respite resources, and referrals without the PCAFC stipend | PGCSS | Local VA Caregiver Support Program team intake |
| Consumer-directed home and community services with a managed budget | Veteran-Directed Care | VA social worker or care team; local availability required |
Preparation tools and a complete caregiver guide
Use browser-based preparation tools to organize functional information, then use the Navigating VA caregiver-programs book for the full program-by-program framework.