WAC-Vet75

Since VA regulations already state against pyramiding, a disability rated at 100% (rated or TDIU) would be separate (or independent) of any other disability rating. You could not get 100% for MS, then get rated separately, for LOU of lower extremities due to MS, but you can be rated separately for each disability MS causes. The reasoning for the combination chart is, because a Veteran can not be rated more than 100% (0 percent efficiency), hence SMC. Once 0% efficiency is established, to combine additional ratings would be penalizing the Veteran. The combined rating chart only goes to 99%, and once that is reached how can they justify reusing it for additional disabilities? Reading the following, it clearly states, "cite disability rated 100% under regular combined evaluation" for the first part of the requirement, yet it only states "cite disability(ies) establishing entitlement", not "cite disability(ies) establishing entitlement under regular combined evaluations". The wording "and additional service-connected disability(ies) of _____, INDEPENDENDLY ratable at 60 percent or more....." clearly states ADDITIONAL, which would prevent pyramiding. Independently ratable at 60%, but it does not state "under regular combined evaluations", may well establish a CUE for Veterans rated 100%, plus, for a few SMC ratings! SPECIAL MONTHLY COMPENSATION UNDER 38 U.S.C. 1114(s) - 38 CFR 3.350(i) TOTAL PLUS 60% OR HOUSEBOUND SMC Code 48 S-1 Entitled to special monthly compensation under 38 U.S.C. 1114, subsection (s) and 38 CFR 3.350(i) on account of (*) rated 100 percent and additional service-connected disability(ies) of (**) , independently ratable at 60 percent or more from (date) . S-2 Entitled to special monthly compensation under 38 U.S.C. 1114, subsection (s) and 38 CFR 3.350(i) on account of (*) rated 100 percent and being housebound from (date) . *Cite disability rated 100 percent under regular combined evaluation. **Cite disability(ies) establishing entitlement. SPECIAL MONTHLY COMPENSATION UNDER 38 U.S.C. 1114(p) - 38 CFR 3.350(f)(3), (f)(4), AND (f)(5) ADDITIONAL INDEPENDENT 50 OR 100 PERCENT DISABILITY OR DISABILITIES OR LOSS OR LOSS OF USE OF THREE EXTREMITIES SMC Code - # P-1 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 (*) and subsection (*) (or) (equal to subsection (*)) on account of (**) with additional disability(ies), (**) independently ratable at 50 percent or more from (date) . P-2 Entitled to special monthly compensation under 38 U.S.C. 1114, subsection (p) and 38 CFR 3.350(f)(4) at the rate intermediate between subsection (*) and subsection (*) (or) (equal to subsection (*)) on account of (**) with additional disability, (**) independently ratable at 100 percent from (date) . P-3 Entitled to special monthly compensation under 38 U.S.C. 1114, subsection (p) and 38 CFR 3.350(f)(5) at the next higher rate or intermediate rate of subsection (*) due to the loss of three extremities from (date) . *Cite applicable subsection(s) of 38 U.S.C. 1114. **Cite entitling disability or disabilities. #Use applicable codes from section VII.

I have another question, and wonder if anyone else has posed this..... 38 U.S.C. § 1114(s) provides that SMC at the (s) rate will be granted if a veteran has a service-connected disability rated as total, and (1) has additional service-connected disability or disabilities independently ratable at 60 percent or more, or (2) is permanently housebound by reason of a service-connected disability or disabilities Looking at the language used, it is stating disability or disabilities INDEPENDENTLY ratable at 60% or more, seems to me not to be a combined rating of 60%, but rather taking the sum of the additional disabilities to be 60%. Is there anything that states the additional 60% is from a combined rating? I've noticed that many times the regulations state "combined rating", whereas this specifically states independently ratable.

The C&P I recently had was for the A&A. The report states 5/200 or worse on eyesight, that functional impairments are permanent, self-care skills unable to perform include:dressing and undressing, bathing, grooming, toileting. I did not receive a C&P for the SLE, I guess since they had already dxd me with it, and it is incurable...the only decision will be the percentage, IF they do grant it service connected. I believe I submitted enough evidence to show that it should be presumptive, but the VA didn't diagnose it until 1 year 1 month AFTER my discharge, and presumption is within 1 year from discharge. Evidence I submitted shows Raynaud's, GERD, rashes, unexplained swelling of lymph nodes, joint pain, etc., all within 2 months of discharge, The VA hospitalization that occurred 1 year 1 month after discharged, showed polyclonal gammopathy, which indicates autoimmune disease, with SLE right up there on the list..... Had the VA performed such tests with my first hospitalization, when it was first reported that I had Raynaud's, my diagnosis would have come within 2 months of discharge! I know.. we are talking VA, and even though I may have supplied evidence to support my contention, the powers that be can still deny the SLE as SC, due to the time frame. I know some of you will understand that having to go through all of this is not only a royal pain, but the constant reminder that I am not the person I "should" be, is very difficult to accept. Each year when the VA would send out that paper for TDIU asking if you are employed, was a cold smack of reality of who I no longer am. Other then an accident, chances are high (ok, certain) that I will die from one of these lovely disabilities, and it's getting more and more difficult to lie to myself (but I give it a great try!). Maybe fighting the VA, is my little way of holding onto the person I once was! Old soldiers never die.... we just find new wars to fight!

Wow, agoraphobia does make you housebound, and they never considered you for SMC S? I do not understand that at all, as the VA is suppose to look for the higher of ratings, and being agoraphobic P&T, should have qualified you for SMC S! I've been in the system since 1976, and they still amaze me with how they rate some people!

Could you direct me to where it states that you need a 100% scheduled rating, plus 60% and not as 38 U.S.C. § 1114(s) states "or" (2) by reason of such veteran’s service-connected disability or disabilities, is permanently housebound? Are there any BVA or COVA decisions that I can search? I am not saying you are incorrect, just that I want to research any denials so that I have a better take on the whole situation. I do not foresee a problem with A&A, as my C&P states 5/200 on visual, and it's well noted that I need assistance due to my MS which is service connected. I could be wrong there, but even the C&P Doc wrote that he considered me "frail" (I REALLY hate that word), and I've had caregivers for the past few years (at my own expense). I spent a decade lying to myself concerning my MS, even though I was SC for it, now having to really face it, and my limitations SUCKS! SLE is Lupus. The VA had diagnosed me with collagen vascular disease back in the 70's, but it wasn't until the 90's that it was shown to be Lupus. Funny thing is, for 2 decades the VA had me convinced that all my symptoms were imagined (in my head, psychiatric)...turns out, thanks to modern medicine (MRI, and newer blood tests), they discovered it was in my head, just not imagined! If, you can direct me to where to research more, I would really appreciate it!!

My PTSD was rated at 70% (not combined), which was used to fulfill the requirement for TDIU. I'm sorry if my original post did not make that clear. I have other disabilities, that combine to an additional 53%. I am waiting on a rating for SLE, and Aid and Attendance. I am going on the contention 38 U.S.C. § 1114(s) states: (s) If the veteran has a service-connected disability rated as total, and (1) has additional service-connected disability or disabilities independently ratable at 60 percent or more, or, <a name="s_2"> (2) by reason of such veteran’s service-connected disability or disabilities, is permanently housebound, then the monthly compensation shall be $2,993. For the purpose of this subsection, the requirement of “permanently housebound” will be considered to have been met when the veteran is substantially confined to such veteran’s house (ward or clinical areas, if institutionalized) or immediate premises due to a service-connected disability or disabilities which it is reasonably certain will remain throughout such veteran’s lifetime. I may be wrong, but the use of the word "or" relieves the need for the additional 60%.

I hope I have a grasp on this, if not, I'm sure someone here will set me straight. I applied for, and was granted TDIU in 1993. Part of my claim was based on the fact that it took me almost 3 years (1990-1993) to be able to leave my house to even attempt to secure employment. I stated that I was not able to leave my home on my own, and when I did leave my home, I needed to be accompanied. I believe this actually satisfied the requirements for housebound, yet SMC (s) was never considered. 38 U.S.C. § 1114(s) provides that SMC at the (s) rate will be granted if a veteran has a service- connected disability rated as total, and (1) has additional service-connected disability or disabilities independently ratable at 60 percent or more, or (2) is permanently housebound by reason of a service-connected disability or disabilities. 38 U.S.C. §§ 5110(a), 1114(s); 38 C.F.R. § 3.400(o) - SMC benefits must be granted when a veteran becomes eligible without need for a separate claim, any effective date must be based on that point in time when the evidence first supported an award of SMC, which may be well before the veteran raised this issue. I was not made aware of any SMC, was never considered for SMC (s), and was granted TDIU, though my disability was the cause of my being housebound. I am presently waiting for a decision (in the rating board now), for SLE, and Aid and Attendance (SMC L). Since my 1993 TDIU decision, I've been granted SC for MS and conditions as a result of the MS. As it stands, I have my 100% TDIU P&T, and a combined rating of 53% (without the SLE). Though I did not meet the requirement for the 100% plus additional 60%, I believe I met the requirement for housebound back when TDIU was granted. My TDIU was based on 70% for "nerves" (PTSD), due to trauma experienced in the military. Am I incorrect in my belief that SMC (s) should have been granted in 1993, and that the VA erred in not considering it?

If you have the sign(s) of stroke, do not allow your Physician to "pooh-pooh" you off. I experienced what I felt was a sign of stroke. One half of the vision in one eye "went funny". I closed my eyes and the strange visual occurrence was still there (so it obvious to me, it was not my eyesight). Unfortunately, I was alone, couldn't drive due to the visual disturbance, and "waited" it out. I explained what happened to my Primary, telling her I believe I had a stroke. I was sent to a fee-basis eye doctor who dx'd me as having an "ocular migraine". Almost a year later, my Neurologist ordered a MRI for my MS. Turns out my "ocular migraine" WAS a small stroke! If you have ANY of the signs of stroke, do not be foolish like me, call 911 if you need to, but get medical help! I was lucky as little damage was caused, but if there is a next time, I am not going to "wait it out" again and I will insist on being checked for a stroke!

I took basic at Ft. McClellan - Jan 1975. I have Lupus, Multiple Sclerosis, and other autoimmune conditions. No one else in my entire family has, or had Lupus, or Multiple Sclerosis. I was fine until basic training, when I started having breathing difficulties. I would really like to know more concerning what transpired at Ft. McClellan!