Jump to content
VA Disability Community via Hadit.com

VA Disability Claims Articles

Ask Your VA Claims Question | Current Forum Posts Search | Rules | View All Forums
VA Disability Articles | Chats and Other Events | Donate | Blogs | New Users

  • hohomepage-banner-2024-2.png

  • 27-year-anniversary-leaderboard.png

    advice-disclaimer.jpg

  • donate-be-a-hero.png

  • 0

Trying to figure out if a qualify for SMC S

Rate this question


AF101B

Question

Long time  reader, first time posting. Confused about SMC.  100% SC P&T scheduler. Confused because in my last letter RO sent form 21-526 but no explanation if I should complete.  I still have 2 unrated claims for lumbar spine and sciatica - which are currently rated at 0% service connected.  Been through a C&P for both.  Would I qualify for SMC?

60% CAD - heart -hypertensive  heart disease

50% Sleep Apnea

30% Lft Ventrical - heart

30% Migraines

30% Bilateral Plantar Fasciatas

20% Prostatitas

10% Hips

10% lft shoulder

10% rt shoulder

10% lft knee

10% tinnitus

10% eczama

10% GERD

10% wrist

10% Cervical spine degenerative disease

 

Link to comment
Share on other sites

Recommended Posts

  • 0

I am confused by your info here.

CAD ( artherosclerotic heart disease) is rated under Diagnostic code 7005

Hypertensive heart disease falls under 7007

It seems to me, and I have read this in the rating schedule available here:

http://www.ecfr.gov/cgi-bin/text-idx?SID=3527d6e780f33d2650da34cded5b285e&mc=true&node=sg38.1.4_197.sg5&rgn=div7

that you have 2 ratings when the initial highest rating should have covered both of them.

Is VA actually rating the two heart conditions separately????

Maybe I misunderstood the rating schedule.

Someone else will chime in as well...

SMC is mandated to be considered and then awarded when the cirumstances reflect that it should be.

Did the VA deny SMC consideration in their last award and did they say why?

We have considerable info here on SMC.

 

 

Link to comment
Share on other sites

  • 0

Hi Berta, 

My mistake, I was listing SC percentages from ebenefits.  Sorry for the confusion.  Appreciate your response.

To clarify I do get SMC K

The most current rating letter it list under Issue/Contention states:

CAD with hypertensive heart disease (also claimed as chest pain, shortness of breath and angina) (previously rated as left ventricular hypetrophy (DC7011))

60% assigned and

Explanation:

We have assigned a 60 percent evaluation for your left ventricular hypertrophy.....

A higher evaluation of 100% is not warranted for arteriosclerotic heart disease ....

VA does not state anything about further SMC but did mention DEA Chapt 35 eligibility/granted.

Your overall or combined rating is:

90%   Effective date Apr 1, 2009

100% Effective date Sept 26, 2014

Link to comment
Share on other sites

  • 0
  • Moderator

There are 2 methods to qualify for SMC S:

1.  "Housebound in fact".  This means you have a C and P exam and your doctor states that you are "substantially confined" to the premisis.  Caveat:  Va has a history of denying Vets SMC S, who show up for a C and P exam, reasoning you cant be "substantially confined" to your home if you made it to the docs office.   While this almost never sticks, if the Vet appeals, the VA knows most Vets dont appeal.  

2.  "100 plus 60".  This is a single disability at 100 percent and additional disabilites which combine to at least an additional 60 percent.  This is also called "statuatory" SMC S.  

I have paraphrased the regulations for you.  Better is to check the exact wording to see if it applies to you.  Either of the above suffice, its not necessary to have both.  Bradley vs Peake shows that if you are TDIU, under some circumstances, the IU can be used as the "100%" in number 2.  Bradly vs peake is rather complex.  

Link to comment
Share on other sites

  • 0
  • HadIt.com Elder

I believe they rate the heart disease first & if the veteran files secondary to his #1 Disability   which should be Heart Disease...once a veteran files another claim to be secondary to his SC. Heart Disease   it becomes one rating &usually a high rating...that become his official first rating when combined with the Heart Diesease original rating

they have a SMC Rating table they use to figure out the Veterans other S.C ratings  and if he/she meets the SMC Criteria   then the Statutory rating should be given  usually SMC-S 1  as broncovet mention.

jmo

......Buck

Link to comment
Share on other sites

  • 0
  • HadIt.com Elder

IN my opinion 

This veteran should have recieved SMC-S and possible SMC-k

If they gave him a 60% S.C.rating for heart disease  and had he had all those others S.C. Ratings   & used the IU Extra schedular to warrant the IU & If he had all these other ratings at the time  they should have awared him the SMC

There is the 60%..lets say they gave him the extra schedular IU  AND THAT EQUALS to a 100%paid rating  ...so with his other rating     if they rate him as 100% although he is 60%   with those other ratings he should have been dropped the iu and giving a correct 100% rating plus all the others.

There are  After his 60%      >50%  30% 30% 30% 20%  and 7 =10%  They can only rate a 10% for tinnitus  for both ears.

If he has had this rating for a long time   ..and never  recieved the SMC..maybe a CUE in the works?

When a veteran who has hypertension comes in with an additional diagnosis of coronary artery disease, the coronary artery disease is lumped together with the hypertension. This is because coronary artery disease is considered a natural progression of the hypertension. To avoid pyramiding (the evaluation of the same disability under different diagnoses) these disabilities will be combined to read as one disability: hypertension with coronary artery disease.

Similarly, a case arises where a veteran who is service connected for hypertensive cardiovascular disease has a stroke. After reviewing the hospital report to verify that there was, in fact, a stroke, payment of benefits at the one hundred percent rate would be granted for the stroke (a neurological condition) for a period of six months during the course of the condition. After that, an immediate VA medical examination will be scheduled to determine the current level of disability for the stroke.

Many cases arise when a veteran has, for example, a lower leg or ankle condition, and now complains of back pain. On a VA medical examination the veteran will state that with any prolonged standing or walking he begins to have pain over the lumbar region. The examiner will have the veteran perform tests with his leg/ankle to determine ranges of motion. Next, the examiner will determine range of motion in the back, and note any complaints of pain.

 

 

so looks like to me this veteran should already be getting the SMC's???

Link to comment
Share on other sites

  • 0
  • HadIt.com Elder

Without the 60% rating...all this veteran other ratings calculate up to a 97.256 Rating  to = the 100%   ok now he has another 60%

my opinion is    that qualifies him for The Statutory SMC Rating.

 

..............Buck

Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
×
×
  • Create New...

Important Information

Guidelines and Terms of Use