The unconscionable delays by the Department of Veterans Affairs in processing benefit applications are well known (and continuing). Less publicized are the hurdles the department has erected to prevent millions of wartime veterans and their spouses from receiving their earned aid and attendance (A&A) benefits (sometimes referred to as “enhanced monthly benefits”).

Veterans and their spouses are entitled to A&A benefits (as much as $2,054 per month in 2013 for an eligible veteran who is married) if one or both of them need someone’s help with an activity of daily living (such as eating, bathing, dressing, going to the bathroom, or adjusting a prosthetic device).

A December 2011 Government Accounting Office report estimated that up to 925,000 veterans and 1.38 million surviving family members are not receiving VA pension benefits to which they’re entitled. The GAO cited a VA study estimating that 62 percent of pension recipients may be eligible for enhanced monthly benefits but only 22 percent are receiving them, mainly because they’re not aware that the benefits are available.

Instead of raising awareness of A&A benefits, the VA’s website discourages applicants from applying for them by saying that veterans can obtain such benefits only if they’re eligible for a basic pension. Which isn’t true. Veterans and surviving spouses ineligible for a basic pension because their income is too high may nevertheless be eligible for A&A benefits because the income limits for A&A benefits are significantly higher (e.g., $24,652 vs. $16,324 in 2013 for an eligible veteran who is married). There’s also a limit on the amount of money and other property that an applicant may own, but the VA lets everyone guess what it is.

The income limits don’t exclude as many people as you might think because a veteran’s countable income is reduced by unreimbursed medical expenses (which the application doesn’t say include amounts paid for someone’s help with an activity of daily living). Caregiver expenses can easily amount to thousands of dollars each month.

Filling out an application form is a daunting task for anyone, let alone someone who needs A&A benefits. Applicants need the veteran’s military service records and detailed information about monthly income, assets, and unreimbursed medical expenses for the year (including the date, amount, and recipient of each payment). Proof of all those items should be submitted with the form.

Applicants also need to have a doctor fill out a form certifying that they need assistance. If their doctor works for a VA hospital, they can’t just give the form to their doctor. They first have to send the form to the medical records department — and then expect to have to contact a social worker for help getting the form out of the medical records department and into the hands of the doctor.

If a veteran (or the veteran’s spouse) qualifies for A&A benefits but needs help managing financial affairs, payments will be delayed until the VA appoints someone it trusts to manage payments. The VA doesn’t have to honor any state-authorized durable power of attorney.

When the VA denies an application, it doesn’t explain why the application was denied. The VA will tell applicants that they can file a formal appeal, but appeals can take a long time (currently averaging almost three years). The VA doesn’t tell applicants that it’s best for them to file a statement in support of their claim or a notice of disagreement. That way, a decision review officer will be assigned to review the claim and explain why it was denied.

If, as often happens, an applicant dies before starting to receive A&A benefits, the VA is quick to send a condolence letter closing the case. The VA doesn’t tell surviving family members that they can collect benefits that should have been paid. Unfortunately, to collect those benefits the survivors have to reapply and prove that the original application would have been approved.

The federal government has spent millions of dollars to sign up a record number of individuals for food stamps. But no similar effort has been made to make sure veterans receive the benefits that they’ve earned through wartime service. It’s shameful that so many individuals dealing with the Veterans Benefits Administration have characterized its modus operandi as “delay, deny, and hope that I die.”

David Gibberman, a lawyer, writes about legal and financial matters for professionals, college students, and the general public.