The Great Life Assisted Living

Application for VA Benefit Program

To begin the application process for the VA payment assistance funds that can aid in offsetting the cost of assisted living, please print and fill out the Application form available for download below:

Click here to get the VA Benefit Application form in Word document format
or:
Click here to get the VA Benefit Application form in pdf format

Once completed, you can get the form to us using your choice of the following methods:

Fax the form to us at 951-346-3542
Email the form information to sandrajw@roadrunner.com
Bring it to us in person at your appointment

Required Documents for Filing a VA Claim

In addition to your Application for VA funds, please have the following documents ready when you come in to the office for an appointment.

Copy of DD214 Discharge Papers (www.vetrecs.archives.gov is a good source if the discharge papers can not be located)
Copy of Marriage License (if currently married or a surviving spouse)
Copy of Death Certificate (if surviving spouse)
Copy of Social Security Award Letter
Copy of Direct Deposit information
Verification of all Finances: Bank, CD, Annuities, etc.

If currently receiving VA benefits, a recent statement from the VA showing what type of benefit and the monthly amount.

This project requires a little effort but it is worth the effort to get this benefit!

Questions? Contact Sandra Williams
Phone 951-965-0373 or E-Mail: sandrajw@roadrunner.com