diabetes C&p Exam Question

[Shaky Vet]

I am hoping you can help me. I had my C&P exam today for Parkinsons . The nurse called me later in the day, leaving a message, asking for my retirement date. I am now collecting SSI as of Dec 09 when I turned 65. Before this I was on SDI (disability) for a back injury. For a presumptive disease such as Parkinsons is my "retirement date" relevant? I currently am 40% SC for diabetes and neuropathy. I have a claim in for estemic (sp) heart disease also and have never been asked this question. I am worried it may effect my results and I really need the aid and assistance portion of the benefits.

[Pete53]

It is my understanding that retirement date really does not affect VA except that it establishes that you are not working and could lead to TDIU. I would say your retirement date should be when you went on SSD at least that is what I tell people who ask me.

Good Luck

[carlie]

I am worried it may effect my results and I really need the aid and assistance portion of the benefits.

Department of Veterans Affairs

or being so nearly helpless as to re- quire the regular aid and attendance of another person. The criteria set forth in paragraph © of this section will be applied in determining whether such need exists.

© Aid and attendance; criteria. The veteran, spouse, surviving spouse or parent will be considered in need of regular aid and attendance if he or she:

(1) Is blind or so nearly blind as to have corrected visual acuity of 5/200 or less, in both eyes, or concentric con- traction of the visual field to 5 degrees or less; or

(2) Is a patient in a nursing home be- cause of mental or physical incapacity; or

(3) Establishes a factual need for aid and attendance under the criteria set forth in § 3.352(a).

(Authority: 38 U.S.C. 1502(b))

(d) Housebound, or permanent and total plus 60 percent; disability pension. The rate of pension payable to a veteran who is entitled to pension under 38 U.S.C. 1521 and who is not in need of regular aid and attendance shall be as prescribed in 38 U.S.C. 1521(e) if, in ad- dition to having a single permanent disability rated 100 percent disabling under the Schedule for Rating Disabil- ities (not including ratings based upon unemployability under §4.17 of this chapter) the veteran:

(1) Has additional disability or dis- abilities independently ratable at 60 percent or more, separate and distinct from the permanent disability rated as 100 percent disabling and involving dif- ferent anatomical segments or bodily systems, or

(2) Is ‘‘permanently housebound’’ by reason of disability or disabilities. This requirement is met when the veteran is substantially confined to his or her dwelling and the immediate premises or, if institutionalized, to the ward or clinical area, and it is reasonably cer- tain that the disability or disabilities and resultant confinement will con- tinue throughout his or her lifetime.

(Authority: 38 U.S.C. 1502©, 1521(e))

(e) Housebound; dependency and in- demnity compensation. The monthly rate of dependency and indemnity com- pensation payable to a surviving

§ 3.352

spouse who does not qualify for in- creased dependency and indemnity compensation under 38 U.S.C. 1311© based on need for regular aid and at- tendance shall be increased by the amount specified in 38 U.S.C. 1311(d) if the surviving spouse is permanently housebound by reason of disability. The ‘‘permanently housebound’’ re- quirement is met when the surviving spouse is substantially confined to his or her home (ward or clinical areas, if institutionalized) or immediate prem- ises by reason of disability or disabil- ities which it is reasonably certain will remain throughout the surviving spouse’s lifetime.

(Authority: 38 U.S.C. 1311(d))

(f) Housebound; improved pension; death. The annual rate of death pension payable to a surviving spouse who does not qualify for an annual rate of death pension payable under §3.23(a)(6) based on need for aid and attendance shall be as set forth in §3.23(a)(7) if the sur- viving spouse is permanently house- bound by reason of disability. The ‘‘permanently housebound’’ require- ment is met when the surviving spouse is substantially confined to his or her home (ward or clinical areas, if institu- tionalized) or immediate premises by reason of disability or disabilities which it is reasonably certain will re- main throughout the surviving spouse’s lifetime.

(Authority: 38 U.S.C. 1541(e)) [44 FR 45939, Aug. 6, 1979]

§3.352 Criteria for determining need for aid and attendance and ‘‘perma- nently bedridden.’’

(a) Basic criteria for regular aid and at- tendance and permanently bedridden. The following will be accorded consid- eration in determining the need for regular aid and attendance (§ 3.351©(3): inability of claimant to dress or un- dress himself (herself), or to keep him- self (herself) ordinarily clean and pre- sentable; frequent need of adjustment of any special prosthetic or orthopedic appliances which by reason of the par- ticular disability cannot be done with- out aid (this will not include the ad- justment of appliances which normal

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persons would be unable to adjust with- out aid, such as supports, belts, lacing at the back, etc.); inability of claimant to feed himself (herself) through loss of coordination of upper extremities or through extreme weakness; inability to attend to the wants of nature; or inca- pacity, physical or mental, which re- quires care or assistance on a regular basis to protect the claimant from haz- ards or dangers incident to his or her daily environment. ‘‘Bedridden’’ will be a proper basis for the determination. For the purpose of this paragraph ‘‘bedridden’’ will be that condition which, through its essential character, actually requires that the claimant re- main in bed. The fact that claimant has voluntarily taken to bed or that a physician has prescribed rest in bed for the greater or lesser part of the day to promote convalescence or cure will not suffice. It is not required that all of the disabling conditions enumerated in this paragraph be found to exist before a favorable rating may be made. The particular personal functions which the veteran is unable to perform should be considered in connection with his or her condition as a whole. It is only nec- essary that the evidence establish that the veteran is so helpless as to need regular aid and attendance, not that there be a constant need. Determina- tions that the veteran is so helpless, as to be in need of regular aid and attend- ance will not be based solely upon an opinion that the claimant’s condition is such as would require him or her to be in bed. They must be based on the actual requirement of personal assist- ance from others.

(b) Basic criteria for the higher level aid and attendance allowance. (1) A veteran is entitled to the higher level aid and attendance allowance authorized by §3.350(h) in lieu of the regular aid and attendance allowance when all of the following conditions are met:

(i) The veteran is entitled to the compensation authorized under 38 U.S.C. 1114(o), or the maximum rate of compensation authorized under 38 U.S.C. 1114(p).

(ii) The veteran meets the require- ments for entitlement to the regular aid and attendance allowance in para- graph (a) of this section.

38 CFR Ch. I (7–1–09 Edition)

(iii) The veteran needs a ‘‘higher level of care’’ (as defined in paragraph (b)(2) of this section) than is required to establish entitlement to the regular aid and attendance allowance, and in the absence of the provision of such higher level of care the veteran would require hospitalization, nursing home care, or other residential institutional care.

(2) Need for a higher level of care shall be considered to be need for per- sonal health-care services provided on a daily basis in the veteran’s home by a person who is licensed to provide such services or who provides such services under the regular supervision of a licensed health-care professional. Personal health-care services include (but are not limited to) such services as physical therapy, administration of injections, placement of indwelling catheters, and the changing of sterile dressings, or like functions which re- quire professional health-care training or the regular supervision of a trained health-care professional to perform. A licensed health-care professional in- cludes (but is not limited to) a doctor of medicine or osteopathy, a registered nurse, a licensed practical nurse, or a physical therapist licensed to practice by a State or political subdivision thereof.

(3) The term ‘‘under the regular su- pervision of a licensed health-care pro- fessional’’, as used in paragraph (b)(2) of this section, means that an unli- censed person performing personal health-care services is following a regi- men of personal health-care services prescribed by a health-care profes- sional, and that the health-care profes- sional consults with the unlicensed person providing the health-care serv- ices at least once each month to mon- itor the prescribed regimen. The con- sultation need not be in person; a tele- phone call will suffice.

(4) A person performing personal health-care services who is a relative or other member of the veteran’s household is not exempted from the re- quirement that he or she be a licensed health-care professional or be pro- viding such care under the regular su- pervision of a licensed health-care pro- fessional.

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Department of Veterans Affairs

(5) The provisions of paragraph (b) of this section are to be strictly con- strued. The higher level aid-and-at- tendance allowance is to be granted only when the veteran’s need is clearly established and the amount of services required by the veteran on a daily basis is substantial.

(Authority: 38 U.S.C. 501, 1114®(2))

© Attendance by relative. The per- formance of the necessary aid and at- tendance service by a relative of the beneficiary or other member of his or her household will not prevent the granting of the additional allowance.

[41 FR 29680, July 19, 1976, as amended at 44 FR 22720, Apr. 17, 1979; 60 FR 27409, May 24, 1995]