diabetes Reason For Decision To Smc-P(L 1/2)

[Dolphin25]

Can someone tell me whether I have the SMC P rate or the SMC L 1/2 rate, as this is what is stated in my decision...and what would be the next rate available should I prevail on appeal??

I have been rated for numerous conditions since 1999 including Aid and Attendance at the L rate but was recently rated a higher percentage, so I now have a 100% P&T for PTSD and a 60% rate for incontinence plus the other conditions for my back, legs and diabetes all rated at 40%. What they did in effect was increase my monthly compensation rate $69 more dollars per month and that is for the increase from L rate to L 1/2 rate. I just don't understand the

P rate and how they have it stated....

1. Entitlement to special monthly compensation based on aid and attendance.

Entitled to SMC-P(L 1/2) on account of entitlement to the statutory rate payable under 38 U.S.C. 1114(l) with an additional disability or combination of disabilities, bladder incontinence, degenerative joint disease, lumbar spine, left lower extremity radiculopathy, left upper extremity radiculopathy, diabetes mellitus, degenerative joint disease of cervical spine due to back injury, hepatitis C, right upper extremity radiculopathy, degenerative joint disease, thoracic spine, and radiculopathy with diabetic peripheral neuropathy, right lower exgtremity independently ratable at 50 percent or more from October 29, 2010.

What would be the best way to go in order to obtain a higher level of Aid and Attendance???

[Berta]

They took you a half step up from L to L 1/2.This BVA case might help you determine if you should NOD the decision if you believe your medical evidences warrants a higher rating.

This BVA claim and others there available under a search, while they are lengthy reads, do show how VA determines L, L 1/2, M, N,O and P awards.

“In addition to the above awards of service connection for individual disabilities, the Veteran has been granted SMC under 38 U.S.C.A. § 1114(p) at an intermediate rate between 38 U.S.C.A. § 1114(m) and § 1114(n). 38 C.F.R. § 3.350(f)(3) (2010). She now contends that she is entitled to a higher level of SMC based upon the loss of use of both lower extremities or the need for aid and attendance.”

ORDER

Entitlement to special monthly compensation under 38 U.S.C.A. § 1114(o) is granted.

Entitlement to increased special monthly compensation based upon the need for regular aid and attendance under 38 U.S.C.A. § 1114®(1) is granted."

http://www.va.gov/vetapp/wraper_bva.asp?file=/vetapp11/Files2/1119042.txt

This veteran's medical evidence warranted the intermediate rates between M and N but the evidence also determined she was eligible instead for R-1.

If you feel your medical evidence warranted a higher rating than L 1/2, by all means NOD the decision and tell them why it is wrong based on the medical record.

[Dolphin25]

Thank you Berta..if you could help me understand something...all along I have been seeking an increase in Aid and Attendance simply for what it implies that I need someone inside my

home to help me in all phases of living and taking care of myself...so I ask for an increase but then I read about an increase in SMC..am I requesting the wrong thing?? Are they both considered the same, SMC and AA???

I know I should have a higher rating than L 1/2 but I am unable to get the RO to read the file where it documents a loss of use of my lower legs and loss of use of an upper extremity. I mean the Dr.s have clearly stated on the findings, plus I have two doctors who have stated that if I don't get an increase in AA then I will be forced to enter into some kind of nursing home or living facility, something I just refuse to give into. I had a dream if I went into one I would end up dying, pretty vivid dream.

I had applied back in 2009 for an increase and was denied by the RO so I filed an appeal in Feb 2012, now somehow in 2010 the RO states I have a claim pending for about 12 different claims and one of them being an increase in AA again...I don't remember filing that claim but I do remember complaining in a letter to the RO about when they denied me for the claim I filed in 2009 why they didn't hear me on those issues that the C&P Dr's stated were wrong with me at that time, one being incontinence in which I already had a 10% rating. What happened was I filed in 2009 for a higher level of AA and in April 2010 I was denied..and then I filed for a hearing by the DRO and eventually I filed my appeals for AA in 2-2012. In October 2010 they state a claim was filed for all of those issues I wrote to them about in my letter. So how does this affect my Appeal?? I have an appeal for an increase in AA and now have this current decision in which I was granted the half step to an L 1/2 rate. What happens if I file an appeal and the BVA ends up getting two claims for the same thing. I one going to cancel the other one out, are they going to say since I was awarded the increase it is now a moot point?? So many damn questions and no answers.

It's so confusing to me I can't even write about a decent timeline on all of this.

They gave me retro pay from the Oct 2010 date for the 1/2 step, but shouldn't they have gone back to the date I first filed for a higher level of AA in 2009, even though that case was denied and is now on Appeal?? How screwy is this..??

Any help is appreciated and thanks for the case..I had read that one before an yes it is a good one...

Edited July 16, 2012 by Dolphin25

[Berta]

“They gave me retro pay from the Oct 2010 date for the 1/2 step, but shouldn't they have gone back to the date I first filed for a higher level of AA in 2009, even though that case was denied and is now on Appeal? “

That concerns me too.

I am no expert on A & A and it is a confusing criteria.

Have you considered trying to obtain a vet rep who can make a 'house call' to help you with this claim.

Some vet orgs and (I know the NYS stat and county vet reps used to to this and possibly still do) will come to your home if you cannot get to their office, to go over claims issues like this.

Then again with the backlog these days maybe they cannot take the time that would involve for a house call.It is worth a try however.

I wonder if the L ½ should be appealed. It depends on their rationale in the decision.If you feel your evidence warrants a higher SMC rating , then NOD this with the medical evidence that would warrant the higher levels, as I assume they enclosed the criteria for all SMCs in the decision.

I hope others with experience on SMC at high levels with chime in here.

Based on what you posted here I would also NOD the Effective date,if I were you.

Also I do not understand this part of their decision that you posted.:

“Entitled to SMC-P(L 1/2) on account of entitlement to the statutory rate payable under 38 U.S.C. 1114(l) ….etc”

I cant understand why the “P” is in there and this could be questioned in the NOD.