**Hospitalization Adjustments**

3.551 Reduction because of hospitalization 3.551-1

3.552 Adjustment of allowance for aid and attendance 3.552-1

3.553--3.555 \[Reserved\]

3.556 Adjustment on discharge or release 3.556-1

3.557 \[Removed and reserved\] 3.557-1

3.558 Resumption and payment of withheld benefits; incompetents

with estates that equaled or exceeded statutory limit 3.558-1

3.559 \[Removed and reserved\] 3.559-1

**§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. Except as otherwise
indicated the terms "hospitalized" and "hospitalization" in §§3.551
through 3.556 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. (Authority: 38 U.S.C. 5503(a))

\(b\) *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. (Sec. 306(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. (Authority: 38
U.S.C. 5503(a))

\(c\) *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. (Authority: 38 U.S.C. 5503(a))

\(2\) 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) (1) of this section. (Authority: 38 U.S.C. 5503(a))

\(3\) Where section 306 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).

\(d\) *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))

\(2\) 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))

\(3\) 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) or (2) of this section. (38 U.S.C. 5503(a))

\(4\) Where improved pension is being paid to a married veteran at the
rate prescribed by 38 U.S.C. 1521(b) all or any part of the rate payable
under 38 U.S.C. 1521(c) may be apportioned for a spouse as provided in
§3.454(b). (38 U.S.C. 5503(a))

\(5\) The provisions of paragraphs (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).

\(6\) For the purpose of paragraphs (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. (Authority: 38 U.S.C. 5503(a))

\(2\) 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) 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) all or any part of the rate payable
under 38 U.S.C. 1521(c) may be apportioned for a spouse as provided in
§3.454(b). (Authority: 38 U.S.C. 5503(a))

\(4\) For the purposes of paragraph (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.

\(6\) The provisions of paragraphs (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).

\(f\) *Computation of period*. For purposes of computing periods of
hospitalization in paragraph (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) of this section, or (2) prior to the effective date of
reduction under paragraph (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 for rehabilitation*:

\(1\) *General*. The reduction required by paragraphs (d) and (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) of this section, or after the
last day of the month referred to in paragraphs (d)(3) or (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) or (e) of this section shall not be made for
periods after the expiration of the additional period provided by
paragraph (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) 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) 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),
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. (Authority: 38 U.S.C. 5503(a))

\(i\) *Certain veterans and surviving spouses receiving Medicaid-covered
nursing home care.* Effective November 5, 1990, and terminating on
September 30, 2011, if a veteran having neither spouse nor child, or a
surviving spouse having no child, is receiving Medicaid-covered nursing
home care, no pension or death pension in excess of \$90 per month shall
be paid to or for the veteran or the surviving spouse for any period
after the month in which the Medicaid payments begin. A veteran or
surviving spouse 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 veteran or surviving spouse of information
necessary to make that reduction. (Authority: 38 U.S.C. 5503)

\[27 FR 7677, Aug. 3, 1962, as amended at 27 FR 8793, Sept. 1, 1962; 37
FR 19133, Sept. 19, 1972; 39 FR 32988, Sept. 13, 1974; 40 FR 45169, Oct.
1, 1975; 41 FR 18412, May 4, 1976; 44 FR 45941, Aug. 6 1979; 45 FR
35327, May 27, 1980; 46 FR 47541, Sept. 29, 1981; 47 FR 24551, June 7,
1982; 56 FR 25045, June 3, 1991; 56 FR 65848, Dec. 19, 1991; 57 FR 8578,
Mar. 11, 1992; 58 FR 32445, June 10, 1993; 59 FR 62584, Dec. 6, 1994; 64
FR 32807, June 18, 1999; 66 FR 48560, Sept. 21, 2001; 68 FR 34542, June
10, 2003\]

**Cross references:** Time limits. See §3.109. Apportionment. See
§3.400(e). Reductions and discontinuances; general. See §3.500.
Incompetents; resumption. See §3.558.

**Supplement *Highlights* references:** 8(2d), 14(2), 38(4), 47(2),
57(1).