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Should I Be At Smc L 1/2?

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ollie100

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• .Benefits Special Monthly Compensation Benefits

You are receiving the following compensations


SMC (L-1) Effective Date : 12/06/2011 Entitled to special monthly compensation under 38 U.S.C. 1114, subsection (l) and 38 CFR 3.350(b) on account of being so helpless as to be in need of regular aid and attendance while not hospitalized at U.S. government expense from 12/06/2011.Rating Date : 01/26/2013

SMC (P-1) Effective Date : 12/06/2011 Entitled to special monthly compensation under 38 U.S.C. 1114, subsection (p) and 38 CFR 3.350(f)(3) at the rate intermediate between subsection (l) and subsection (m) on account of schizophrenia, paranoid type with depression with additional disability, tardive dyskinesia, independently ratable at 50 percent or more from 12/06/2011. .



..My wife was looking thru ebenefits and noticed this feature.. .Should I be getting paid at SMC L or L 1/2. .....Im confused....Im getting paid at the SMC L level......Im rated at 100% P&T and the A&A is probably for all of my disabilities.....Thank you for your responses and your service!!!!!
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On 7/11/2015 at 5:13 PM, asknod said:

<<<<<<<<<< 38 CFR 3.350(f)(3) at the rate intermediate between subsection (l) and subsection (m) on account of schizophrenia, paranoid type with depression with additional disability, tardive dyskinesia, independently ratable at 50 percent or more from 12/06/2011.>>>>>>>>>>>

 

The answer is simple. If you are rated 50% over and above a 100% schedular (but notTDIU), 38 CFR 3.350 (f) (3) kicks in.:

(3) Additional independent 50 percent disabilities. In addition to the statutory rates payable under 38 U.S.C. 1114 (l) through (n) and the intermediate or next higher rate provisions outlined above, additional single permanent disability or combinations of permanent disabilities independently ratable at 50 percent or more will afford entitlement to the next higher intermediate rate or if already entitled to an intermediate rate to the next higher statutory rate under 38 U.S.C. 1114, but not above the (o) rate. In the application of this subparagraph the disability or disabilities independently ratable at 50 percent or more must be separate and distinct and involve different anatomical segments or bodily systems from the conditions establishing entitlement under 38 U.S.C. 1114 (l) through (n) or the intermediate rate provisions outlined above. The graduated ratings for arrested tuberculosis will not be utilized in this connection, but the permanent residuals of tuberculosis may be utilized.

 

Your ratings indicate you are 50% or more above 100% so they automatically go up 1/2 step from L to L 1/2. If you have two dissimilar ratings for 100% they would give you the full step from L to M. I'm in the process of doing this now at the BVA on appeal. I have one 100% schedular for HCV and fought a long CUE battle to get SMC S back to 94. When VA caved in at the CAVC after I filed my Extraordinary Writ in January, they granted 60% for the Agent Orange disease ( Porphyria). This entitled me to what you are talking about (3.350(f)(3) My 2008 C&P clearly said "totally disabled" due to Porphyria alone. If I prevail on it, then I qualify for the full bump from L to M (3.350(f)(4) after I get my driver's license for a wheelchair. Build it before you get there. If you even suspect you are entitled to a full schedular rating for any one of your diseases, do it now so the wifesan won't have to fight this when you are toast. Most VSO reps would not be aware of this. Hell, my VLJ at the travel board hearing had to look it up. It's not very well known. Funny how VA forgets to mention these things, huh?

 

 

I think my husband's ratings will qualify for the bump up from L to M also...Please tell me who can help me submit this the right way. My husband died Dec 6, 2015 (of long term coronary artery disease) before we could get his claim filed for kidney failure. He was already rated in 2007 at 100% for his heart, 40% for diabetes and 10% for neuropathy in one leg and 10% in the other one - total and permanant.  Then in 2011 he had kidney failure and started dialysis (peritoneal at home with exchanges 5 times a day).  He declined from there in his ability to do things for himself and I took care of him for the past 4+ years. We tried numerous times to get him rated for kidney failure and each person we asked told us he couldn't go any higher than 100% and so they couldn't help us. We were just trying to get it rated and didn't know about Special Compensation or Aid and Attendance or Housebound till a year ago. When we learned that we requested his C-file, but by the time his C-file was received and reviewed, he had passed away just before the review was completed so no claim was filed before his death. However, Don's GP doctor at VA petitioned back in 2011 for VA to pay for his treatment, supplies, labs etc with the private company we had chosen. We didn't even know she did that till much later. But they've been paying for it all - all this time. So that means there is a record of his condition being approved for payment at least, with the VA and any records in their possession at the time of death are applicable. That's what their own statement says. So I'm trying to get what was due him as accrued benefits on my DIC application. I am supplementing my budget monthly with the life insurance money but it will run out in about 10-12 months so it's vital I get this as right as I can the first time. I'm close to being ready now to submit it all but sure could use some suggestions and answers to some questions if anyone knows please. Also, when he made his first claim for disability he was already unable to work due to his heart and was on SS Disability for that. We informed VA of that, but they said they couldn't get the details of the decision and we couldn't find our copy to give them. So they rated his heart at 30% I think it was when he should have gotten IU for being totally unemployable. Is that something I should fight for or let go?  That's a considerable amount of retroactive money, but maybe it's lost now.  Questions I have: 1. is there a form to be filled out for Housebound and Aid and Attendance? I have some statements from his private GP doctor and one from a head nurse at the nephrology clinic that monitored him twice a month and a couple other statements (one from a friend and one from my  adult daughter) stating what they each can testify to that I did to care for him and my own statement. I also had his nephrologist fill our the renal failure form. Any others needed?  2. How far back does anyone think they may go for the dialysis?  3. Will they decide my DIC separately from the accrued benefits so it's faster to get that started?  4. Should I mark 'Fast Tracking' on my DIC form?  Or will it just delay it longer to have it put into the slower processing group. And if I mark that I don't intend to send additional information will that mean they won't ask me for anything even if they need it and just deny the claim?  5. It doesn't say anywhere on the DIC form about it being over 8 years since he was rated 100% which will increase the amount of DIC...but there's no mention of that anywhere...will they overlook that and then I have to petition for the increased amount?  Or should I make note of it somewhere?  Thank you to any and all who can help.

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I am 100% IU and 90% over all. My back rating just went up to 20% from 10%. This was due to thoracolumbar spine degeneration, disc bulging, partial compression fractures T4, 5,and8. CFR 4.40, 4.45 and 4.59. This was just given June 1st 2017. i am now scheduled for T2 to L2 titanium boron rod fusion next week july 20th 2017. Kyphosis. Range 50 to 70 degrees. My question, What is available and how do i file for SMC....L,S...? i also am aware a reconsideration for back is warranted as well. possibly a new claim? not sure. i am rated 50% for depression/anxiety....i dont see this improving but worsening. i will be trying to control as best as possible. Panic attacks while my back is stitched up 12" or more is a fear. Does anyone have any advice? i trust this site tfrough your experiences. possibly being where im at now...Sua sponte RLTW

Edited by abnrgr88
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  • Moderator

Persistant and abnrgr88    

Please repost your questions in a "new topic" and you will get more answers.  When you ask a question in someone elses topic, it gets confusing and this is a very old topic and it may go unanswered.  

Your questions are good questions, we just need a lot of eyes to look at them for a great answer.  Asknod may even answer.  

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On 7/14/2017 at 11:55 AM, abnrgr88 said:

I am 100% IU and 90% over all. My back rating just went up to 20% from 10%. This was due to thoracolumbar spine degeneration, disc bulging, partial compression fractures T4, 5,and8. CFR 4.40, 4.45 and 4.59. This was just given June 1st 2017. i am now scheduled for T2 to L2 titanium boron rod fusion next week (unrelated to 20%) july 20th 2017. Kyphosis. Range 50 to 70 degrees. My question, What is available and how do i file for SMC....L,S...? i also am aware a reconsideration for back is warranted as well. possibly a new claim? not sure. i am rated 50% for depression/anxiety....i dont see this improving but worsening. i will be trying to control as best as possible. Panic attacks while my back is stitched up 12" or more is a fear. Does anyone have any advice? i trust this site tfrough your experiences. possibly being where im at now...Sua sponte RLTW

 

Edited by abnrgr88
needed clarity
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I am with you Broncovet....one of the posters here recently, Persistant,  had a DIC claim in 2016, and they are asking about accrued benefits now.

I never saw the 2016 post because it was not in DIC forum.

The widow ( using Persistant handle) stated in 2016:

We tried numerous times to get him rated for kidney failure and each person we asked told us he couldn't go any higher than 100% and so they couldn't help us. We were just trying to get it rated and didn't know about Special Compensation or Aid and Attendance or Housebound till a year ago. When we learned that we requested his C-file, but by the time his C-file was received and reviewed, he had passed away just before the review was completed so no claim was filed before his death."

If no claim was pending at time of the veteran's death, then there is no basis for an accrued claim.

Unless this was a Nehmer AO IHD situation, and a past decision held a rating ( or should have held a rating- Footnote One Nehmer as explained in the Agent Orange forum)

In any event I have spent time today and yesterday and actually many days when my time is limited here- to get back to older posts and search for more info - because the threads are hijacked....

I wont do that anymore.

Persistant, the info you need is in the DIC forum or search under Accrued here under the search feature.

And then search under Footone One Nehmer  in the Agent Orange Forum if the death due to 100% IHD was an Agent Orange award.

Better yet here is what you need to understand:

https://www.hillandponton.com/va-benefits-for-qualified-survivors-accrued-benefits-and-substitution-basics/

One cannot substitute themselves for a deceased claimant if the veteran did not have a claim pending at time of death.One cannot claim accrued if one year has passed after the veteran';s death.

Unless it is a Nehmer claim and falls under these guidelines :

https://community.hadit.com/topic/66483-footnote-one-nehmer-a0/

Accrued discussions are available under a search here (in the DIC forum) and there are multiple discussions on Nehmer 2010 and Footnote One in the Agent Orange forum.

If I have time and see your response in one of those forums I will reply to it.

I think you are misinterpreting the 8 year rule for DIC, as well.

All of the DIC regulations are here in the DIC forum.And at the Main VA web site.

The 8 year rule is here:

http://www.benefits.va.gov/compensation/resources_comp03.asp

 

and there are 156 other posts regarding Footnote One, and many regarding accrued claims.

 

Edited by Berta
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