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Veterans Independence Program (VIP) Expansion

Application Package for the Veterans Independence Program (VIP) Housekeeping and Grounds Maintenance Services for Survivors 2008 VIP Expansion

We are presently working to ensure our Web site is compliant with new Government of Canada standards. These new standards will help make our Web site as accessible as possible for all Canadians. However, some documents have not yet been updated. These documents will continue to be available in their previous format until the new standards are met. If you have any questions or concerns, please contact communications@vac-acc.gc.ca. We apologize for any inconvenience and are working to resolve this issue as quickly as possible.

Complete Package PDF Version (Help, Opens a New Window) 207 KB

This application package includes the following:

Application Form PDF Version (Help, Opens a New Window) 110 KB
Guidelines for Completing Your Application
Authority to Release Personal Information Form PDF Version (Help, Opens a New Window) 116 KB

Please note, for the purposes of this application package, the use of the term "Veteran" applies equally to:

A Veteran Pensioner
A Civilian Pensioner
An Income Qualified Veteran
An Income Qualified Civilian

ELIGIBILITY CRITERIA

VETERANS INDEPENDENCE PROGRAM HOUSEKEEPING AND GROUNDS MAINTENANCE SERVICES FOR SURVIVORS 2008 VIP EXPANSION

The disabled or low income survivors of the following Veterans may qualify:

Veteran and civilian pensioners: This means Veterans and civilians must have wartime service (First World War, Second World War or Korean War) and were entitled to a disability pension (Pension Act or Civilian War-Related Benefits Act);

Income qualified war Veterans and civilians: This means Veterans and civilians must have wartime service (First World War, Second World War or Korean War) and were in receipt of an allowance (War Veterans Allowance Act or Civilian War-Related Benefits Act);

Veterans and civilians who would have received an allowance from Veterans Affairs Canada (VAC) if they had not been receiving benefits under the Old Age Security Act (Guaranteed Income Supplement or Old Age Security benefits).

The deceased Veteran must not have received Veterans Independence Program (VIP) housekeeping or grounds maintenance services at the time of death in order for the survivor to qualify.

If the deceased Veteran did receive other VIP services (e.g., personal care), but not housekeeping or grounds maintenance, the survivor is eligible under the 2008 VIP Expansion as long as the eligibility criteria is met.

If the deceased Veteran ever received VIP housekeeping or grounds maintenance services and you are not now receiving these services, please call VAC at 1-866-522-2122 for further information.

A survivor is the adult individual who:

immediately before the Veteran died or was admitted to a health care facility, was primarily responsible, without remuneration, for ensuring care was provided to the Veteran,

AND

for a continuous period of at least one year prior to the Veteran's death or admission to a health care facility, resided in the principal residence of the Veteran and maintained the Veteran or was being maintained by the Veteran.

The survivor then must meet the following criteria:

Low income or disability:

Low income:
In receipt of the Guaranteed Income Supplement (GIS),

Disability:
Approved for the Disability Tax Credit (DTC) under section 118.3 of the Income Tax Act.

AND

Health needs:
Services are required for health reasons in order to assist the survivor to remain self-sufficient in his/her principal residence.

AND

Availability:
Services are not available as insured services under a provincial health care system or a private insurance policy.

AND

Residency:
Must be a resident of Canada.

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Guidelines for completing the Veterans Independence Program (VIP) Housekeeping and Grounds Maintenance Services for Survivors Application 2008 VIP Expansion

To apply, please complete the application form and return it to:

Veterans Affairs Canada
Centralized Processing Centre
PO Box 7700
Charlottetown, PE C1A 8M9

Please print clearly when filling out this application. If we need more information, we will contact you.

The following instructions are to help you fill out the application. If you do not have all the necessary details, please provide as much information as you can. If you need help, please call 1-866-522-2122.

Veteran's file number: If known, please provide the late Veteran's file number. The file number is the number Veterans Affairs Canada (VAC) assigned to the Veteran. This will assist in identifying the Veteran's account.

Applicant's language of choice: Please indicate your language of choice.

SECTION A: DECEASED VETERAN INFORMATION

Veteran's full name: Please provide the Veteran's full name. List aliases/nicknames if used at any time, under "Other name(s) used".

Date of birth: Please provide the Veteran's date of birth.

Date of death: Please provide the Veteran's date of death (it is required for eligibility purposes).

Service and/or regimental number(s): If known, please provide the Veteran's service and/or regimental number(s) assigned when he/she entered the Forces.

SECTION B: VETERAN'S INFORMATION AT TIME OF DEATH

Indicate if the Veteran was residing in a health care facility at the time of his/her death. Please provide the name and location of the facility and the date the Veteran began living there. Indicate if the Veteran received VIP housekeeping or grounds maintenance services from VAC at the time of his/her death or admission to a health care facility. Indicate if the Veteran received a Disability Pension or War Veterans Allowance from VAC.

SECTION C: SURVIVOR INFORMATION

Full name: Please provide survivor's full name.

Home telephone number: Please provide survivor's home telephone number or other contact number.

Date of birth: Please provide survivor's date of birth to set up your current file.

Residential address: Please provide survivor's street address and postal code.

Mailing address: Please provide the survivor's mailing address and postal code.

Please indicate whether immediately prior to the Veteran's death or admission to a health care facility, whichever is earlier:

if you were you 18 years of age or older;
if there was an emotional and financial dependency between you and the Veteran and for what period of time;
if you personally cared for or arranged for the Veteran's care, (e.g., you looked after/cared for the Veteran until he/she was admitted to the hospital). Detail the type of care you provided or arranged;
indicate the length of time you continuously lived with the Veteran.

Wages/Remuneration: If you received a wage/remuneration for caring for, or ensuring care was provided to the Veteran, explain the nature of the wage/remuneration you received (e.g., room and board) for looking after the Veteran.

Guaranteed Income Supplement (GIS): Is part of the Old Age Security Act and provides money, on top of the Old Age Security (OAS), to seniors living in Canada and who meet specific income requirements. If you receive the GIS, attach proof (see below). For more information please call 1-800-277-9914 or visit the Service Canada website at www.servicecanada.gc.ca.

Proof of receipt of the GIS is a photocopy of a:

Cheque stub - a recent payment under the Old Age Security Act;
Statement of Old Age Security T4A (OAS); or
Confirmation letter from Human Resources and Social Development Canada (HRSDC).

Disability Tax Credit (DTC): A credit provided under the Income Tax Act is a non-refundable tax credit available to those with severe and prolonged mental or physical impairments. To receive it, individuals must complete the DTC Certificate form and have a qualified practitioner complete and sign it. After review by the Canada Revenue Agency (CRA), a letter is sent to indicate whether the disability amount can be claimed on their tax return. For more information, please call 1-800-959-8281 or visit the CRA website at www.cra-arc.gc.ca.

Proof you or someone on your behalf is eligible for the DTC is a photocopy of a:

Letter of confirmation from CRA.

SECTION D: SURVIVOR'S RESIDENCE INFORMATION

If none of the choices apply, explain your present living arrangements. For the purpose of this Program, senior assisted living means rental housing that includes limited services to residents to enable them to live independently.
Please indicate whether someone lives with you and identify who lives with you.
Indicate whether you share your residence with anyone, including relatives or non-relatives. Indicate whether they are capable, available and willing to do the necessary housekeeping or grounds maintenance.
VAC does not usually cover services that could be expected of a capable individual living with the client (e.g., cutting the grass, shovelling snow off a walkway or vacuuming carpets).
If you indicate "No", please explain.
Please indicate if anyone living with you has applied for, or has received benefits and services from VAC and provide his/her name, file and/or service number(s).

SECTION E: INFORMATION ABOUT YOUR NEEDS

Please indicate if you need help or currently pay someone to help you with housekeeping or grounds maintenance. Examples of these duties are listed in section "E" of the application. Indicating "Yes" does not mean that you are not able to perform the task; it simply means that you have difficulty.
In some cases, you may not require help even though you cannot perform the duties and you also do not pay someone else to perform the duties. For example, you may not require help if you are in a senior housing facility which provides these services.
Please indicate the health reasons which require the help with housekeeping and grounds maintenance duties. VAC reimburses eligible clients for services that are required due to health problems.
- You may be asked to provide evidence of your present health condition (e.g., high blood pressure, arthritis).
Please indicate whether there is a provincial health care system or private insurance company that will provide housekeeping or grounds maintenance services for you. Please provide details (e.g., name of provider, maximum payable, etc.).

SECTION F: DECLARATION

The declaration must be signed and dated by the survivor. Completing and returning the application to VAC does not mean your application will be approved. Eligibility will be determined when your application is reviewed. Your needs will be based on your responses to questions on the application form and other information provided.