Attn: Veldrina

[Philip Rogers]

Hi Veldrina - I'm looking for how the VA decides SMC(s) claims/awards. As near as I can tell the VA is not supposed to use the combined ratings chart when totaling the additional 60% for a SMC(s) claim. Can you tell me how they handle these claims, specifically regarding the 100%+60% claims?? If so, can you link me to any official documents(M-21, fast letters, OGC decisions, etc.) telling the RO's how to handle the claims?? Thanks!!!

pr

Oooops - wrong forum title- any moderator, please move to SMC Forum. Thanks!

Edited February 24, 2011 by Philip Rogers

[Veldrina]

We now have an SMC calculator that takes some of the guesswork out for us. The 100% plus additional 60% is for housebound. There is SMC for other levels of disability, such as anatomical loss or loss of use, and aid & attendance if u need a higher level of care or are so helpless u need the assistane of an aide to do acivities of daily living,. As for links, i only found this: http://www.vba.va.gov/bln/21/Rates/comp02.htm The explanation under CFR 3.305 is apparently an intranet thing, but i think u might be able to find it on hadit. I would have to copy & pate it from work. I will try to do so tomorrow.

Hi Veldrina - I'm looking for how the VA decides SMC(s) claims/awards. As near as I can tell the VA is not supposed to use the combined ratings chart when totaling the additional 60% for a SMC(s) claim. Can you tell me how they handle these claims, specifically regarding the 100%+60% claims?? If so, can you link me to any official documents(M-21, fast letters, OGC decisions, etc.) telling the RO's how to handle the claims?? Thanks!!!

pr

Oooops - wrong forum title- any moderator, please move to SMC Forum. Thanks!

[WAC-Vet75]

Veldrina.... I believe you misunderstood what PR was asking. For SMC housebound under the 100% plus 60%.... After one reaches 100%, either under the rating schedule, or extra schedular, the additional 60% is not a "combined evaluation", but rather an independent 60%, ADDING disabilities as oppose to using the combined rating chart. According to VA training module 4F 12-06 "Special monthly compensation is also payable if the veteran has one single service-connected condition rated 100% disabling plus other, separate service-connected condition(s) independently ratable at 60% or more in combination, or if veteran is permanently housebound, or is in need of regular aid and attendance." It does not state "combined evaluation", nor does it state "which combine". USC 1114 states ....."additional service-connected disability or disabilities independently ratable at 60 percent or more". PR is asking is, after the 100% rating, can the additional rating of 60% be found by using 30% + 20% +10%, instead of making a combine evaluation 30%+20%=44% 44%+10%=50%?

[Philip Rogers]

Veldrina - WAC-Vet75 correctly explained my question. The claimant has a single 100% rating and was denied SMC(s) for HB/A&A. They now have 100%+20%+10%+10%+10%+10%, which I feel should qualify them for an SMC(s) award and am just trying to confirm I'm correct. It concerns me that the VA now has an SMC calculator. Could you perhaps run that total on the calculator and see what it brings?? All our research shows that once a claimant is 100% the additional disabilities are combined using standard math addition, not using the combined ratings chart. You might want to try 100%+30%+20%+10% also. If the calculator totals 50% for SMC then there could be a programming error. Again, thank you for your assistance!!!!

pr

[Pete53]

I have SMC S rating and VA has sent a nurse twice a week and an aide 3 times a week to help me. The nurse takes vitals, reviews my medication and makes sure I have set up meds correctly for the week. The nurse also counsels suggesting strategies for the week and checks my feet and inquires about my current health and any problems.

The aide helps me wash feet up to knees and applies lotions prescribed by Doc. Checks for any skin conditions or sores does light cleaning. The VA pays for this when I checked my records they are paid over 1,000 a month.

They have been doing this for over 2 years prescribed by my Doc originally cause I was overwhelmed with keeping track and complying with my medications. At the current time I have over 40 active prescriptions from VA and a couple of over the counter vitamins and fish oil recommended by my VA Doc.

My question is should I ask VA for a higher rating than S I am 100% for Panic Disorder with agoraphobia and 30% for pes planus. I really have a poor understanding of higher ratings over 100%.

If I am busting a thread and not wanted I will delete this post.

Pete

The more I learn about the VA the less I know.

[john999]

Pete

If you need assistance with daily life activities then you should ask for a higher level of SMC. It sounds to me like you do. You need help with your meds and your nurse or attendant does cleaning and washes you. I think you should ask for more! Without the nurse's help you might have big trouble with your feet so this to me shows a need for care and assistance with daily living. I really feel for you with the foot situation. One bad sore that is not identified early and you have big problems. This is why you need the extra care and compensation.