VA Aid and Attendance: A Senior Application Guide
Written & Reviewed by
Last updated: April 8, 2026
Bottom line: VA Aid and Attendance is extra money added to a VA pension for qualified wartime Veterans and certain surviving spouses who need help with daily activities, are in a nursing home because of disability, or meet other medical-need rules. The part that trips up many families is that this is not a stand-alone check: the person must first fit the Veterans Pension or Survivors Pension rules, and the payment amount depends heavily on income, net worth, and unreimbursed medical expenses.
Emergency help now
- Protect the date now: If the full packet is not ready, file an intent to file right away so the family does not lose a potential earlier start date for back pay.
- Get the medical form started: Ask the doctor, physician assistant, or care facility to complete the VA Form 21-2680 Aid and Attendance examination form, and if the person is in a nursing home, get VA Form 21-0779 completed too.
- Use safe help only: Work with a VA-accredited representative or Veterans Service Organization (VSO). Do not pay anyone to file an initial claim.
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What this really means for seniors
Do this first: Stop thinking of Aid and Attendance as a separate program. It is a higher pension level added to a monthly VA pension for qualified Veterans and survivors.
Many top search results still make this benefit sound simpler than it is. In real life, a family usually has to prove three things at the same time: the Veteran’s wartime-service pension eligibility, the older adult’s medical need for regular help, and the family’s true countable income after allowed deductions. The current Veteran pension rate page and the current Survivors Pension rate page both show that VA uses a Maximum Annual Pension Rate, or MAPR, and then subtracts countable income.
This is why two people in the same assisted-living building can get very different results. One family may show large unreimbursed care costs and qualify for a substantial payment. Another may have the same diagnosis but weak paperwork, a vague doctor note, or higher countable income, and get denied or approved for less.
For anxious families, the most useful approach is simple: file early, use the official forms, get the doctor to describe daily-function limits clearly, and keep every care bill and proof of payment. That human step-by-step process is what official pages often do not explain well enough.
Quick facts
Do this first: Use the current 2026 rules, not a blog post that still quotes older amounts.
- It helps qualified Veterans and survivors: The official VA page says Aid and Attendance adds to a monthly VA pension for qualified Veterans and survivors.
- It is not automatic: A move into assisted living by itself does not guarantee approval.
- You cannot get both extras together: VA says on its Aid and Attendance and Housebound page that a person cannot receive Aid and Attendance and Housebound at the same time.
- The 2026 net worth limit is $163,699: That amount appears on both the Veterans Pension rate page and the Survivors Pension rate page for December 1, 2025 through November 30, 2026.
- The home and car usually do not count: VA’s current pension rate pages say a primary residence and car are excluded when VA looks at net worth.
- Medical expenses matter a lot: The same rate pages explain that unreimbursed medical expenses above 5% of the applicable MAPR can reduce countable income.
- An intent to file can protect back pay: VA says on its intent-to-file page that the family generally has 1 year after filing that notice to submit the full claim.
- Free accredited help is available: VA says on its accredited representative page that VSO help on VA benefit claims is always free.
Who this guide is for
Do this first: Use this guide if the main problem is paying for daily help, home care, assisted living, or memory care for an older Veteran or surviving spouse.
- Older wartime Veterans who need help bathing, dressing, eating, transferring, toileting, or staying safe alone
- Surviving spouses of wartime Veterans who now need daily help or supervised care
- Adult children gathering records, calling doctors, and managing a parent’s paperwork
- Caregivers trying to understand whether home-care bills, assisted-living fees, or memory-care supervision may help a claim
- Families who got scared off by income rules before learning how medical-expense deductions work
What VA Aid and Attendance is
Do this first: Confirm whether the claim belongs under Veterans Pension or Survivors Pension. Aid and Attendance rides on top of those pension programs.
For seniors, this benefit is best understood as a higher pension rate for people with real care needs. The official VA Aid and Attendance page says it can apply when the person needs another person’s help with daily activities, must stay in bed for much of the day because of illness, lives in a nursing home because of disability-related loss of mental or physical ability, or has severe visual impairment.
That means this guide is about the pension-side benefit for wartime Veterans and survivors. Families often confuse it with other VA benefits, including disability compensation or Dependency and Indemnity Compensation. Those are separate programs with different rules.
| Benefit level | What it means | Who it is for | Can it be paid with Aid and Attendance? |
|---|---|---|---|
| Basic Veterans Pension or Survivors Pension | Needs-based monthly pension for people who meet wartime-service, age or disability, income, and net-worth rules | Wartime Veterans, or certain surviving spouses and unmarried dependent children | This is the base benefit that Aid and Attendance can increase |
| Aid and Attendance | Higher pension rate because the person needs regular help with daily activities or otherwise meets the medical-need rules on the official VA page | Qualified pension recipients with significant care needs | No. VA says it cannot be paid at the same time as Housebound |
| Housebound | Higher pension rate for a person who spends most of the time at home because of permanent disability | Qualified pension recipients whose disability keeps them homebound | No. VA says a person cannot receive Housebound and Aid and Attendance together |
Who may qualify as a Veteran
Do this first: Check service dates, discharge status, and age or disability before spending weeks on care bills.
According to the VA pension eligibility page, a Veteran may qualify for Veterans Pension if both of these are true: the discharge was not dishonorable, and yearly family income and net worth fit the pension rules. Then the Veteran must also meet both a service test and an age or disability test.
Wartime service rules that matter
The same VA eligibility page says the main service rules are:
- Started active duty before September 8, 1980: at least 90 days of active duty, with at least 1 day during a recognized wartime period
- Started active duty as an enlisted person after September 7, 1980: at least 24 months of service or the full period ordered to active duty, with at least 1 day during a recognized wartime period
- Officer cases can be more specialized: if that applies, use a VSO or the official pension rules instead of guessing
Important myth to clear up: combat service is not required. The pension rule is wartime service, not combat service. For most seniors, the relevant periods are World War II, the Korean conflict, the Vietnam era, and the Gulf War period that VA says began on August 2, 1990 and continues until a future date set by law or presidential proclamation.
Age, disability, and daily-living rules that matter
The Veterans Pension eligibility page says the Veteran must also be at least 65, permanently and totally disabled, in a nursing home for long-term care because of disability, or receiving Social Security Disability Insurance or Supplemental Security Income. Then, for the Aid and Attendance increase itself, the Aid and Attendance page says at least one medical-need rule must be met.
- Needs another person’s help with daily activities like bathing, feeding, or dressing
- Must stay in bed, or spend a large part of the day in bed, because of illness
- Lives in a nursing home because of disability-related loss of mental or physical ability
- Has severe visual impairment under VA’s listed eyesight standard
The older official VA pension Aid and Attendance page gives even more useful real-life examples, including help with toileting, adjusting prosthetic devices, or protection from daily hazards. That matters for seniors with dementia, fall risk, or confusion who may look “okay” on paper but cannot stay safe alone.
How a surviving spouse may qualify
Do this first: Check whether the spouse has remarried and whether the deceased Veteran’s service met the wartime rule.
The current Survivors Pension page says a surviving spouse may qualify if the spouse has not remarried after the Veteran’s death, the deceased Veteran did not receive a dishonorable discharge, the Veteran’s service met one of the wartime-service rules, and the household’s income and net worth fit the pension limits.
For a surviving spouse, the Aid and Attendance piece is then about medical need, just as it is for a Veteran. So a surviving spouse living alone with advanced arthritis, recovering from repeated falls, or needing dementia supervision may have a valid claim even if the spouse never served in the military.
There is another issue many families miss. If the Veteran may have died from a service-related condition, or if the family thinks there may be a service-connected death issue, the surviving spouse should also ask about Dependency and Indemnity Compensation (DIC). VA announced in February 2026 that it generally will pay the higher of DIC or Survivors Pension without delaying the lesser claim, which can speed many surviving-spouse cases. VA also said there is a narrow exception where Survivors Pension may be better for a surviving spouse with no dependents who lives in a nursing home and has applied for or is receiving Medicaid.
How income, net worth, and unreimbursed medical expenses really work
Do this first: Estimate countable income after medical deductions before assuming the family makes too much money.
The payment formula is simple in theory: Maximum Annual Pension Rate minus countable income equals the pension amount. The hard part is that “countable income” is not just salary. VA’s Veterans Pension rates and Survivors Pension rates pages explain that countable income can include Social Security, retirement income, annuities, wages, and other income, but unreimbursed medical expenses can reduce that number.
Those same pages say the 2026 net worth limit is $163,699 for both Veterans Pension and Survivors Pension, effective December 1, 2025 through November 30, 2026. They also explain that a primary residence and car generally do not count, while other assets can.
| Claimant type | Basic annual MAPR | Aid and Attendance annual MAPR | About the monthly A&A maximum |
|---|---|---|---|
| Veteran with no dependents | $17,441 | $29,093 | About $2,424 a month |
| Veteran with 1 dependent spouse or child | $22,839 | $34,488 | About $2,874 a month |
| Surviving spouse with no dependent child | $11,699 | $18,697 | About $1,558 a month |
| Surviving spouse with 1 dependent child | $15,311 | $22,304 | About $1,859 a month |
The numbers in that table come from VA’s current Veteran pension rate page and current Survivors Pension rate page. They are maximums, not guaranteed checks. The actual payment depends on countable income after deductions.
VA’s 2026 rate tables also show the 5% medical-expense deduction floor. For 2026, the first $872 of medical expenses does not count for a Veteran with no dependents, the first $1,141 does not count for a Veteran with one dependent, the first $584 does not count for a surviving spouse with no dependent child, and the first $765 does not count for a surviving spouse with one child. Everything above that floor may help lower countable income if the expense is unreimbursed and otherwise qualifies.
Simple example: A surviving spouse with no dependent child has $24,000 a year in Social Security and retirement income, and pays $15,000 a year out of pocket for qualifying care and medical costs. Using the 2026 Survivors Pension rate table, the first $584 does not count, so $14,416 may be deductible. That can reduce countable income to $9,584. Compared with the $18,697 Aid and Attendance MAPR, that could produce roughly $9,113 a year in Survivors Pension, or about $759 a month, if the rest of the case is approved.
One more major warning: both current pension rate pages explain VA’s 3-year look-back period. If a person transferred assets for less than fair market value during that period and the transfer would have pushed net worth above the limit, VA may impose a penalty period of up to 5 years. Families should be very careful about anyone selling an annuity, trust package, or asset-transfer plan as a “fast way to qualify.”
Which care settings can count
Do this first: Get bills and records that show what care is being provided, not just where the person lives.
The most important rule is this: VA cares about medically necessary help and documented expenses. The official VA Form 21P-8416 medical-expense page and the Medical Expense Report instructions say families may report unreimbursed medical and dental expenses, and that assisted-living, similar residential care, or in-home attendant expenses may need the applicable worksheet.
That means home care, assisted living, adult day care, memory care, and nursing-home care can all matter. But the proof varies by setting. The form instructions also explain that custodial care can include regular help with two or more Activities of Daily Living, or supervision because a person with a mental disorder is unsafe if left alone. That is why memory-care cases often fit the rules even when the problem is dementia supervision more than hands-on physical help.
| Care setting | Can it matter for the claim? | What paperwork usually helps most |
|---|---|---|
| Paid in-home care | Yes. In-home attendant expenses may count if the care is medically needed and documented. | Doctor’s VA Form 21-2680, the in-home worksheet attached to the expense forms, invoices, time breakdown, and proof of payment |
| Assisted living or adult day care | Yes. Some or all charges may count depending on the care provided and why the person lives there. | Facility worksheet, itemized monthly bill separating lodging and meals from care, and physician statement if needed |
| Memory care | Often yes. VA’s custodial-care instructions recognize supervision when a person with a mental disorder is unsafe alone. | Diagnosis and safety documentation, facility statement describing supervision, and itemized dementia-care charges |
| Nursing home | Yes. Nursing-home status can directly support Aid and Attendance eligibility. | VA Form 21-0779, medical records, and facility billing records |
Families should also know what usually does not help enough by itself. The in-home attendant worksheet in the official pension form instructions says VA generally does not treat shopping, housekeeping, laundering, food preparation, telephone help, or non-medical transportation by themselves as medical expenses. Those tasks may still appear in a real caregiving arrangement, but a strong claim usually needs clearer proof of help with bathing, dressing, transferring, toileting, eating, medication-related safety, or direct supervision.
How to apply without wasting time
Do this first: Protect the effective date before trying to build the perfect packet.
- Decide which claim is really being filed. A wartime Veteran usually starts with VA Form 21P-527EZ. A surviving spouse usually starts with VA Form 21P-534EZ, which can also raise DIC issues when appropriate.
- File an intent to file if the family is still gathering evidence. VA says on its intent-to-file page that this can set a potential effective date, and the family then generally has 1 year to complete the full claim.
- Get the medical evidence done early. The doctor should complete VA Form 21-2680. The form is strongest when it describes what the person cannot do safely alone, not just a diagnosis list.
- If the person is in a nursing home, add the nursing-home form. Use VA Form 21-0779 completed by the facility.
- Build the money and care file. Gather income records, bank or asset information, care bills, insurance-premium records, prescription costs, and any ongoing unreimbursed medical expenses. The VA Form 21P-8416 Medical Expense Report is the form families use to report qualifying medical expenses.
- Submit one organized packet. VA’s Veterans Pension application page and Survivors Pension page allow online filing, online upload through QuickSubmit, mail, in-person filing at a regional office, or help from an accredited representative. For a new paper pension application, VA currently lists the Pension Intake Center in Janesville, Wisconsin. If a supporting form prints a different address, follow the address on that form.
- Keep copies and watch the mail. VA may send letters asking for more evidence. Missing those requests can slow the case or sink it.
| Form | Who uses it | What it does |
|---|---|---|
| VA Form 21P-527EZ | Veteran | Application for Veterans Pension |
| VA Form 21P-534EZ | Surviving spouse or child | Application for DIC, Survivors Pension, and/or Accrued Benefits |
| VA Form 21-2680 | Veteran or survivor | Medical exam form for Housebound status or need for regular Aid and Attendance |
| VA Form 21-0779 | Nursing-home cases | Nursing-home information for Aid and Attendance claims |
| VA Form 21P-8416 | Veteran or survivor | Medical Expense Report for unreimbursed medical expenses |
| VA Form 21-0966 | Veteran or survivor | Intent to file to protect a possible earlier effective date |
| VA Form 21P-0969 | Veteran or survivor if instructed | Income and Asset Statement for pension-related income and net-worth details |
Checkbox-style document checklist
Do this first: Start with the papers that are hardest to replace.
- ☐ DD214 or other separation papers showing dates of service and discharge status
- ☐ Marriage certificate for a surviving spouse claim
- ☐ Veteran’s death certificate for a surviving spouse claim
- ☐ VA Form 21-2680 signed by the medical provider
- ☐ VA Form 21-0779 if the person is in a nursing home
- ☐ Social Security, pension, annuity, and other income records
- ☐ Bank, investment, and other asset information
- ☐ Monthly care invoices, insurance-premium records, prescription costs, and other out-of-pocket medical expenses
- ☐ VA Form 21P-8416 if reporting medical expenses
- ☐ Itemized assisted-living, memory-care, or home-care statements showing what part of the bill is care
- ☐ Copies of everything sent to VA and proof of mailing or upload
Reality checks before sending anything
Do this first: Slow down before moving money, signing forms, or hiring paid help.
- This is usually not fast emergency money. VA’s official pages say decision times vary and depend on the claim and evidence.
- A diagnosis alone is rarely enough. Families need functional proof of why another person’s help is required.
- Do not transfer assets just because someone says it will make the person qualify. VA’s current rate pages warn about the 3-year look-back and possible penalty period of up to 5 years.
- Do not trust anyone who promises approval, wants a blank signed form, or asks for payment to file the initial claim. VA’s fraud-prevention page warns about these tactics.
Common mistakes to avoid
Do this first: Fix preventable paperwork problems before they turn into a denial.
- Applying only for “Aid and Attendance” and not the pension claim itself
- Using outdated rate tables instead of the 2026 pages on VA’s Veteran rate site and VA’s survivor rate site
- Sending a weak 21-2680 that lists diagnoses but does not explain bathing, dressing, feeding, transferring, toileting, fall risk, or safety-supervision needs
- Forgetting the medical-expense form when the family’s out-of-pocket care costs are what actually make the person financially eligible
- Using a facility bill that says only “room and board” and does not separate care-related charges
- Missing a VA evidence-request letter and assuming “no news” means the case is moving normally
- Leaving off continuing expenses on a later medical-expense update, even though the 21P-8416 instructions warn that this can cause VA to stop counting that expense from the date of the new form
Best options by need
Do this first: Match the family’s main problem to the safest next step.
| If this is the need | The best next move |
|---|---|
| The family is not ready to file everything | Submit an intent to file now |
| The Veteran or spouse is already in a nursing home | Get VA Form 21-2680 and VA Form 21-0779 completed right away |
| The person is paying for home care or assisted living | Use VA Form 21P-8416, attach itemized care bills, and keep proof of payment |
| The claimant is a surviving spouse and the death may be service-related | Use VA Form 21P-534EZ and ask about DIC too |
| The family needs local, free help | Use a VA-accredited VSO or representative |
| The claim was denied | Read the decision letter and choose the right decision-review option within 1 year |
How long decisions may take and what retroactive pay means
Do this first: Plan for a months-long process and do not assume a quick approval.
VA’s current Aid and Attendance page, Veterans Pension application page, and Survivors Pension page all say the same basic thing about timing: it depends, and VA processes claims in the order received unless priority processing applies. That is why families should be careful with websites that promise a fixed national timeline.
In plain English, these claims often take time because VA may need service records, marriage or death records, care-need evidence, income and asset information, and medical-expense records. Every missing item creates a new delay.
Retroactive pay means VA may owe money for past months once the claim is approved. The intent-to-file page says an intent to file can set a potential effective date if the full claim arrives within 1 year. The Veterans Pension application page also says that if a person starts the online pension application with an identity-verified account, a separate intent-to-file notice is not needed because VA will automatically set the effective date when the online form is started.
After approval, families may receive a lump-sum payment for past months and then regular monthly pension deposits. To check on the case, use the VA claim status tool if the family can go online, or call 1-800-827-1000 if the family needs a phone-based path.
Troubleshooting a denial, delay, wrong notice, or missing paperwork
Do this first: Read the exact reason in the VA letter before sending more papers.
If the claim was denied
The official VA decision-review guide says there are three main review options: a Supplemental Claim, a Higher-Level Review, or a Board Appeal.
- Use a Supplemental Claim if the family has new and relevant evidence, such as a better 21-2680, missing marriage record, corrected facility bill, or additional medical-expense proof. VA says this is filed on VA Form 20-0995.
- Use a Higher-Level Review if VA already had the right evidence but made the wrong call. The Higher-Level Review page says no new evidence can be added, and the request generally must be made within 1 year from the date on the decision letter. VA says this is filed on VA Form 20-0996, and the claimant may request a one-time informal conference.
- Use a Board Appeal if the case needs review by a Veterans Law Judge. If the case reaches the Board, the priority-review page says appeals for people age 75 or older receive Advanced on Docket status automatically.
The most useful evidence after a denial is usually not more of the same. It is usually a clearer medical form, a more itemized care bill, a missing service or family document, or a clean medical-expense report that shows the true out-of-pocket cost of care.
If the claim is delayed
If months pass with little movement, check the claim status tool or call 1-800-827-1000. Then compare what VA says is missing against what the family believes it already sent. A VSO can be very helpful here because delays often come from one missing form, an unreadable upload, or a facility bill that did not explain the care well enough.
If the bill or facility statement is wrong
This is a major real-world problem. Ask the provider for a corrected monthly statement that separates lodging and meals from hands-on care, medication management, dementia supervision, nursing, or other care services. The official assisted-living and in-home worksheets in the pension form instructions are built around that kind of separation. A one-line invoice is often not enough.
If VA says paperwork is missing
Resend the specific missing item with the claimant’s full name and claim number, keep proof of mailing or upload, and include a short explanation if needed. The VA supporting-forms page shows that VA Form 21-4138 can be used to submit a supporting statement when a family needs to explain an unusual care arrangement or financial detail. For medical-expense claims, the 21P-8416 instructions say families should keep receipts and proof of payment for at least 3 years after receiving a decision on the medical-expense claim.
Where to get safe official help
Do this first: Use free accredited help before considering any paid help.
- VA benefits hotline: 1-800-827-1000 (TTY: 711), Monday through Friday, 8:00 a.m. to 9:00 p.m. ET
- Ask a question online: VA Contact Us and Ask VA
- Free claim help: Find a VA-accredited representative or VSO
- Check accreditation directly: VA Office of General Counsel accreditation search
- Find a regional office: VA regional offices
- MyVA411 main information line: 1-800-698-2411 (TTY: 711)
- Scam and fraud help: VA’s identity and benefits scam-protection page says to call 1-833-388-7233 for scams related to VA benefits
- Suspicious debt or overpayment notice: Verify it directly with VA at 1-800-827-1000 or with the Debt Management Center at 1-800-827-0648, as noted on VA’s fraud-prevention page
- Report broader fraud: Federal Trade Commission fraud reporting
For safety, remember these two rules from VA’s official materials: never sign a blank form, and never pay someone to file an initial claim. VA says on its accredited representative page that VSO services are always free, and the VA-accreditation materials explain that attorneys and claims agents may generally charge only after VA has issued an initial decision and the fee rules are met.
FAQ
Is VA Aid and Attendance a separate stand-alone benefit?
No. The official VA Aid and Attendance page says it is money added to a monthly VA pension for qualified Veterans and survivors. The person must first fit the pension or survivors-pension rules.
Does the Veteran need a service-connected disability to get this pension-based benefit?
Not for the pension program itself. The Veterans Pension eligibility page focuses on wartime service, discharge, age or disability, and financial limits, rather than proof that the condition was caused by service.
Can a surviving spouse qualify years after the Veteran died?
Yes, sometimes. The key questions are whether the spouse has remained unmarried after the Veteran’s death, whether the Veteran’s service met the wartime rules, and whether the spouse now meets the financial and care-need rules.
Does Social Security count as income?
Usually yes. But the answer does not stop there. The VA pension rate pages explain that unreimbursed medical expenses may reduce countable income, which is why some families qualify only after their care costs are documented correctly.
Can assisted living, memory care, or home care count?
Often yes, but families need the right proof. The medical-expense form and its instructions show that in-home care, assisted living, adult day care, and similar care can matter when the expenses are unreimbursed and the care is medically needed and documented well.
Should the family file an intent to file first?
If the family is still gathering records, usually yes. VA says on its intent-to-file page that this can protect a potential earlier effective date, and the full claim generally must be filed within 1 year.
How long does approval take, and is there back pay?
VA does not publish one set national turnaround time for these claims. Its official pages say decision time depends on the case. If VA grants the claim, retroactive pay may be due under the effective-date rules, often as a lump sum for past months.
Should a family pay a company to help with the first claim?
No. VA’s official fraud and accreditation materials warn families not to pay someone to file an initial claim. Start with a free accredited VSO or other VA-accredited help instead.
Resumen en español
Haga esto primero: Si la solicitud completa todavía no está lista, presente una intención de presentar una reclamación para proteger una fecha de inicio más temprana. Luego consiga el formulario médico VA Form 21-2680 y reúna los gastos médicos y de cuidado que el seguro no pagó.
La Ayuda y Asistencia de VA no es un cheque separado. Es un aumento de la pensión para Veteranos de tiempo de guerra y para algunos cónyuges sobrevivientes que necesitan ayuda con actividades diarias, viven en un asilo de ancianos por una discapacidad, o cumplen otras reglas médicas. La cantidad real depende de ingresos, patrimonio y gastos médicos no reembolsados.
No pague a nadie para presentar la reclamación inicial. Use ayuda gratuita de un representante acreditado por VA o una organización de servicio para Veteranos. Si llega una carta confusa o una denegación, lea la razón exacta y responda rápido. Muchas veces el problema es un formulario médico débil o facturas de cuidado mal detalladas, no una descalificación permanente.
About This Guide
This guide uses official federal, state, and other high-trust nonprofit and community sources mentioned in the article.
Editorial note: This guide is produced based on our Editorial Standards using official and other high-trust sources, regularly updated and monitored, but not affiliated with any government agency and not a substitute for official agency guidance. Individual eligibility outcomes cannot be guaranteed.
Verification: Last verified April 8, 2026, next review August 2026.
Corrections: Please note that despite our careful verification process, errors may still occur. Email info@grantsforseniors.org with corrections and we respond within 72 hours.
Disclaimer: This article is for informational purposes only. It is not legal, medical, tax, disability-rights, insurance-broker, financial-planning, or government-agency advice. VA pension, Aid and Attendance, Survivors Pension, DIC, income, asset, and medical-expense outcomes depend on the facts of each case, current agency rules, and the evidence submitted.
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