jamescripps2

ok Berta, I'll take a shot at answering your question as I understand it. The answer is just as complicated as the question. If I am wrong, I am sure that asknod or one of the other powers that be will come along and whap me up side of my head! If you are at 100% schedular or IU, an additional 50 % will get you nothing more in the way of money. That extra 50% award is worth fighting for and just becomes a building block that might become useful at a later date. If you have a 100% award and then another separate and distinct 100% award, that will get you an "S" award for housebound by reason of the first 100% plus an additional sixty% = the housebound pay rate. If you are awarded SMC for A&A, that earns you an L award. Now, by law, you can't have a housebound "S" award and A&A at the same time. The A&A pays the greater greater amount of the two, and is the more favorable award of the two, so, the A&A is awarded in place of the "S" award. Now that you have the SMC "L" award, you can use any other unrelated 50% award to advance 1/2 step. In this case to the "L" and1/2. this is called a P-1 award. If you are at the "L" level and you have another separate and distinct schedular 100% P&T award you can advance one whole step. In this case, from "L" to "M". This is called a P-2 award. The advancement using the P-1 or P-2 award can only be used one time for the advancement either to the next half step for the 50% or whole step for the 100% award. Any higher awards require loss or loss of use of two limbs or loss of, or loss of function of internal organs, blindness or any of the malades listed at CFR 3.350. K awards at $103.23 per month also come into play for loss of, and loss of use of an extremity, organ, etc as outlined in CFR 3.350 but can later be lost when they are gobbled up to avoid the pyramiding rule as your issues are used as the predicate for higher awards. Hope this helps!

I am at "M" +1k and have won hundreds of claims for other vets besides my own multiple claims. I have never paid more than a $30.00 copay for a IOM and never recommended that expense for anyone else. Any medical professional can write the opinion and therefore fulfill the requirement of the nexus without emptying the piggy bank so long as the letter is written in proper format. That is the reason to furnish the outline. A vet does not need to be rich enough to pay large sums of money for medical opinions. An obscure little known local doctors opinion just might carry more probative value than a well known frequent flier who is known for writing many IOMs. just my 2 cents, you can look up my AO CONUS win and see how the judge respected my $30 IOMs crippsbvadec.pdf the judge considered my IOMs as overwhelming.

John, type into your web browser usva101.0rg click on nexus letter, print the two page document. Copy the case that I gave you in the above post. http://www.va.gov/vetapp14/Files6/1449192.txt Highlight the text pertaining to the doctors medical opinion in the case, therefore simplifying and saving your doctor's valuable time. Take the copies to a private doctor and pay the co pay using your medicare if you have medicare coverage. If not, expect to pay about 80 to 100 bucks cash for a medical opinion. I have found that about 50% of the doctors will write an opinion if you ask and make it easy on them by furnishing an example,"outline", and another opinion close to what you are contending. Ask the doc if he can concur with what the examiner in the BVA prior decision is saying. If so, ask if he will write you a letter complying to the nexus letter example that you are furnishing him from the usva101.org website. After filing the claim as a FDC, for OSA sit back and wait on the C&P exam. I am expecting a RO decision pretty soon for an increase in diabetes because my VA diabetic doc limited and regulated my activities. So as not to muddy the waters with too many issues, when I get that decision I intend to file on OSA as secondary to Diabetes related to AO exposure, heart disease and the prescribed medications thereof, using the exact evidence that I just handed to you. Good luck to you old friend! P.S. if you really want to hit a home run, get two medical opinions concurring. No problem if you have medicare part B to pick up the tab. Not a big expense if you don't.

John 999, when you decide which came first, the chicken or the egg, try this on for size. http://www.va.gov/vetapp14/Files6/1449192.txt James

Thanks for the reply asknod, and the votes of confidence from Buck and Berta! Information is about the best we have to offer from our own experiences. At the time of the decision both disabilities, heart disease and kidney failure, were available for the rater to use for the bump from "L" to "M" in compliance with 38 CFR 350 (F)(4). It would have been easier for me to show the need for A&A if it could be based upon heart disease rather than the chosen kidney disease. I have been wondering if there was a reason that the rater chose the heart disease over the kidney disease as the predicate for the bump to "M" or was it a random choice? The rater's choice of heart disease is less favorable to me in maximizing my benefits. Maximization of my benefit would have been better accomplished if the kidney disease had been used allowing for the heart disease to become the predicate in the need for A&A. Chronic congestive heart failure, chronic fatigue, A-fib, V-fib, blood thinners, shocks from the implanted defibrillator, chest pain, unconsciousness and other maladies could then be used in the need for the A&A. I ran across this court case this evening supporting my contention for the substitution in order to maximize my benefits and support my claim for A&A. If you remove the word,"housebound", and insert the words,"aid and attendance", it seems to be the answer to my question. In Buie v. Shinseki, the Court subsequently clarified that a TDIU based on more than one disability does not satisfy the requirement under 38 U.S.C. § 1114(s) for housebound benefits that a claimant have a "service-connected disability rated as total." However, VA's duty to maximize benefits requires VA to assess all of a claimant's disabilities, regardless of the order in which they were service-connected, to determine whether any combination of disabilities establishes housebound benefits under 38 U.S.C. § 1114(s). Buie v. Shinseki, 24 Vet. App. 242, 250-51 (2010). I hope this information will help in support of my contention and allow me load the boat with the "O" and R-1 award when the appeal is done. I filed the NOD on May 5, 2016 after being granted the M+K award, retro pay, vehicle grant w/ adaptive equipment and SAH grant. The Nod was for the reason, the VA did not infer the issue of A&A upon the granting of a new 100% P&T decision in compliance with M21-1MR. I have asked the VA to substitute the kidney disease in place of the heart disease and then use the unrelated heart disease as the need for A&A. I should qualify for the "O" because of the two "L"s if granted the A&A. I have chosen the DRO de novo route. If the decision is not favorable, then on to the board. I will be expecting retro pay back to the original date of claim for loss of use of two extremities that was filed on december 27,2011. That's my story and I am sticking to it! PS I am confident, but If you see a flaw in my contention please bring it to my attention so i might can put a bandaid on it. I am not so smug as to not listen to sound advice from anyone.

Probably a question for asknod but all opinions will be appreciated. I have a scheduler 100% P&T award for loss of use of one hand and one foot. That equates to an "L" award. If I am later granted A&A, which is also an L award, will the two separate L awards meet the requirement of two awards between "L" and "N" in order to qualify for the "O" award? My present rating is M+1K because of the bump from L to M for 100% heart disease to include an implanted AICD and congestive heart failure. Also, I have a 100% P&T for kidney disease and many lesser scd conditions, diabetes@ 40%, pn x four limbs @ 40,40,30,10, mood disorder @ 30% etc. I am thinking that the multiple disabilities, when considered as a whole, might be considered as a combination of disabilities so as to constitute helplessness. The 21-2680 was completed by my VA PCP in my favor. The ultimate goal is an "O" award and R-1. I have also asked the VA to substitute the 100% kidney disease as the predicate the bump to "M" instead of using the heart disease as the predicate. That substitution would be more beneficial to me because it would free up the heart disease for use as unrelated, unused, and separate distinct condition to use as the basis for awarding the A&A, therefore maximizing my benefits. Am I headed in the right direction? What am I lacking or overlooking?

I agree with oldman273 I have been trying to get a contractor to bid the job for more than six months now. multiple contractors have looked at the job but turn it down and hit the road when the VA sends them the 28 page contractor certification form. They explain that they are not going to fill out a 28 page form not knowing if they will even get the job. I had the plans drawn up at the cost of $1,000 and we are talking in excess of $100,000 worth of work. I need a new bathroom and laundry room built on to my existing home along with ramps and doorway widening. No small job. I am in the Nashville Tn. area if anyone knows of a willing contractor in the area.

I submitted my NOD along with my request for reconsideration and N/M evidence on the 29th of January, well within the one year deadline. I agree, if the reconsideration produces a favorable decision it will have saved some time. If denied, it will add some time before it will be certified to the board. I am thinking that it is worth a try as it is a pretty well cut and dried claim. Only time will tell. Hopefully, If the claim eventually does go to the BVA some kind of reform will be put into play between now and then to fix the broken system. I hope that time is on my side, but then we never know. I am content, confident and have well learned over time the virtue of patience.

I ran across this in m21-1 Part 3. According to this recently updated information a request for reconsideration is a viable choice at the regional level. Section F. Requests for Reconsideration 1. Requests for Reconsideration Introduction This topic contains information on claims for reconsideration, including · definition of a request for reconsideration · initial steps for handling a request for reconsideration · effective dates for requests for reconsideration of increased evaluation · determining whether to include appeal rights in the decision notice, and · letter to a claimant who provides no evidence, or evidence VA has already considered, in support of a request for reconsideration. Change Date July 15, 2015 a. Definition: Request for Reconsideration For the purpose of this topic, a request for reconsideration is a request from a claimant for the Department of Veterans Affairs (VA) to reconsider one of its decisions that has not yet become final (the one-year appeal period, which begins on the date the claimant was notified of the decision at issue, has not yet expired). A prescribed form is notrequired for a request for reconsideration. A request for reconsideration differs from a claim to reopen in that the decision at issue in a claim to reopen has become final. Reference: For more information about claims to reopen a finally denied claim, see M21-1, Part III, Subpart ii, 2.D. b. Initial Steps for Handling a Request for Reconsideration The table below describes the initial steps for handling a request for reconsideration If the claimant submits ... Then ... evidence VA has never before considered refer the claim to either the rating activity or authorization activity (whichever made the decision at issue) for reconsideration. no evidence but makes reference to available evidence that VA has never before considered assist the claimant in obtaining the evidence. Note: Follow the applicable instructions in this table once VA receives the evidence. Reference: For information about assisting claimants in obtaining evidence to support their claim, see M21-1, Part III, Subpart iii, 1.C.1, 2, and 3. a statement indicating a willingness to report for examination(s) after failing to report to a previously scheduled exam(s) reorder the missed examination(s). · no evidence, or · evidence VA has already considered send the claimant the letter shown in M21-1, Part III, Subpart ii, 2.F.1.e.

Now I have stepped in it for sure!!!!. And it is back to the hamster wheel for me! An excerpt from my NOD. Ultimately, I am in need of A&A due to diabetes, the underlying cause of all of my many service connected disabilities except for chloracne. Justifiably, in order to maximize my benefits and grant A&A, if need be, the diabetes should be reconsidered on an extra-scheduler basis and rated as 100% P&T due to the level of functional impairment it has created in my overall general medical condition, rendering me not only unemployable, but also useless. (38 CFR 4.10)

Wow! I never expected so many people to respond in trying to help me with to my dilemma. I have read the BOD rule a thousand times over a ten year period. I just did not give any weight to the phrase," OR ANY OTHER POINT". That is just what I needed guys. Thanks ever so much. I asked for a DRO denovo review. It has only been five months since the date of the decision in question so the NOD will be timely filed. The RO says the quickest avenue is to reopen the claim. I don't want to do anything that will cause me to loose the considerable amount of four years retro, no matter how long it takes. Do I go with my gut feeling and request a review or reopen as the RO suggest?

Thanks for the post, but I am still looking for the mandate that directs the VA rating authority to give to the veteran, no matter what the discrepancy, a ruling that is most favorable to the veteran. I have an "L" rating for loss of use, The VA then used 100% Heart Disease to get me the boost to "M", Now they want the 21-2680 to show that I need A&A for 100% Kidney disease. That would be hard to do because I am not on Dialysis yet. My contention is, The rater was correct in assigning the loss of use x 2 as an "L" rating. The rater then had a a choice to make as to whether to use the 100% Heart disease or the 100% Kidney Disease for the boost to "M". Had the rater chosen the Kidney Disease, instead of the Heart Disease, for the Boost to "M" That would leave the Heart Disease as an unused 100%award to become a basis for the need for A&A. That scenario would have given the most favorable outcome to the veteran. How can I support my contention, by statute, that the VA is mandated in every incident, to give to the veteran the most advantageous ruling where there is an option to consider? I have another thread open, but here in this thread, I am looking for a matter of law to support my contention. asknod maybe?

I am sure that I have read this either in the 38 C.F.R or the 38 U.S.C. A mandate, that where there is an option, or choice, the VA is to choose the most favorable option in the best interest of the veteran. Where can I find this mandate? I am looking in the C.F.R but I have not found it yet. Thanks

asknod, I had never taken a trip to your website before spending some time there this evening. My comment is with reverence, WOW! Thanks!

For sure, I am going for the "O" and at the same time asking for R-1. The NOD and paperwork have been submitted and I am confident.

Thanks for the input asknod. A call from the RO to my CVSO office today revealed that the case has already earned some attention. The remark was that it may not need to be reopened but indeed reconsidered at the local level. The ro person also remarked that, We may all learn something from this one"! I will keep you in the loop sir, as the claim advances. I am fortunate to be able to discuss such a complicated issue with someone who possesses your insight into SMC related matters. Thanks again.

Thanks for the above post asknod! IMHO the best way to go about going for the "O" award is to ask the RO for a reconsideration of the decision dated Sept. 28, 2015. That decision awarded the M + 1K for loss of use x two extremities with the effective date of . 01/01/2011. My contention is they did not follow the mandated statute to consider A&A as an inferred issue when in the case of a new 100% P&T scheduler award. I am convinced that the RO's failure to consider the A&A, as an inferred issue, constitutes a CUE in that decision. If and when I am awarded the A&A, at the regular rate, and therefore advanced to the "O" rate because of it, that they will need to adjust the retro pay from the date of decision back to the 01/01/ 2011 date. Do you agree, or am I missing something. I did not actually mention the phrase, CUE, on the NOD, hopefully they will CUE themselves. I don't know how much truth there is in it, but I have heard that if the term "CUE" is actually claimed by the veteran the case will automatically be certified to the BVA for a decision. I specifically asked for a DRO reconsideration of the decision, in hopes that it will be adjudicated in a reasonable amount of time at the local RO, whatever that means.... The CVSO, to whom I submitted the NOD, contacted the RO and talked to them about the NOD. They suggested that it would go quicker if the NOD was submitted as a reopened claim instead of a reconsideration. My feeling on the matter is if the claim is adjudicated as a reopened claim, I would loose the retro adjustment going back to 2011. I submitted strong medical statements with the NOD, and the existing medical record strongly supports me, but the VA form 21-0958 from my VA PCP will not be ready for my pick up until January 15. The CVSO is holding the NOD and other submitted paperwork until I can submit the21- 0958. I agree that it should all be submitted at the same time, but I am very leary about branding the NOD as a reopened claim. If required, the retro adjustment would be more than $50,000. I am contemplating, in an attempt to preserve the retro, submitting a 21-4138, along with the 21-0958 and just go ahead and declare, for the record, that indeed a CUE was committed by the RO on the original decision. I am seeking educated advice on these issues? I am not asking for R1 or R2. I can't qualify as I don't have, at this time, a professional or licensed person assisting me. My wife's assistance is fine for now. I can't say about the future. Needing outside aid seems like it would really be an invasion of the privacy that we now enjoy, and I would like to enjoy that as long as we can. asknod, After reading your links, I know for sure how you spent your time in the trenches. For sure, that is learning about navigating the VA system the hard way the hard way. If you, sir, can qualify for a greenhouse, surely, I can come up with SMC "O". I did qualify for "a"house". (SAH) We will break ground in the spring. Thanks for letting me bend your ear!

asknod, sorry, but I needed to drag your boat back into my lake! I thank you sir, for taking the time to help me sort out this complicated issue. I have great respect for your educated opinions related to SMC. You must have spent some amount of time in the trenches to learn, and then, keep up with SMC regulations. On the NOD that I submitted to VA this morning, I am asking for consideration for regular A&A. Am I correct in thinking that there are three levels of A&A. The first being regular A&A, then a higher level at R1 and then an even higher level at R2? This morning I had a service officer tell me that if I was rated under, and being paid at the rate of SMC"L", that I was already getting A&A. I disagreed. I do have three distinct scheduler 100% P&T awards. #1, for heart disease w/ implanted AICD. #2 for Stage III kidney disease. #3 for loss of use of one hand and one foot. I have no awards that involve TDIU. As for VA's microscope, I have spent more than ten years under their microscope, working on complicated issues. This stuff is a breeze compared to putting together my Agent Orange inside CONUS claim. I just need to learn more and do more research in unfamiliar territory. It really makes it easier with someone like yourself to play the devils advocate in the claim. As you well know, once you start down the wrong path with a claim, it is hard to turn things back around. Again, thanks for keeping me straight. I thought that I was finished with the hamster wheel, but I am going for the "O".

This is a question for asknod and anyone else who might wish offer an opinion. I am seeking advice from those who know about SMC before I finish tweaking and submit the NOD. Just to recap from this thread, in December 2011, I filed a claim for loss of use of right hand and right foot. I asked for the vehicle grant /w adaptive equipment and the SAH grant. On 8/26/2015, I received a decision granting all of the above issues. Loss of use of the two extremities was assigned as a 100% grant with an "L" rating. Another preexisting additional 100% P&T granted in an earlier decision, for a unrelated heart disease issue was used as a P-2 bump, one whole step to the "M" level. I also retained an earlier "K" award for ED. My final rating became "M" plus 1- "K". Paid as a veteran with spouse. In addition to the above disabilities and as due to prior decisions over the years, I have another 100% P&T award for stage III kidney disease, 40% for left upper extremity neuropathy, 40% for left lower extremity neuropathy, 30% for Severe Anxiety and Depression, 20% for Diabetes, 10% for a hand and foot fungus and a 0% for chloracne. Not wanting to seem ungrateful, I plan to send in a NOD asking for a DRO reconsideration on the decision based upon the fact that the VA failed to apply the mandated statute under M21-1MR subpart IV, directing the VARO to consider SMC A&A as an inferred claim when any new 100% P&T grant is made. I am asking that the VA consider and award the grant of A&A based upon the evidence of record at the time of the decision showing a clear need for assistance in my every day activities, not solely due to the loss of use but as due to my multiple service connected disabilities. I am also sending a 21-4138 explaining each and every need of assistance in my daily living activities as it relates to grooming, eating, keeping clean and presentable, ambulation and medication management. I also am sending an additional medical opinion explaining my need for A&A. I am asking that if I am indeed granted the A&A that I also be granted the rating under "O", due to two or more separate and distinct ratings between the level of "L" through "N1/2". It is also my contention that my general medical service connected conditions when considered as a whole should dictate the need for the A&A and thus generate an "O" rating as outlined in U.S.C. 1114 (0). My question to hadit is, have I covered all of my bases, and what have I failed to think of or do. Is my NOD viable with a chance for a grant, or just frivolous?

The correct 2015 rate for SMC "K" is $103.23 SMCRatePayment variationK$103.23Usually added to other rate or paid as the rate when percentage is zero.Q$67Paid in place of a rate.The VA housing agent is coming back to see us after the Thanksgiving holiday to take pictures of our new home site. Our present home that I built myself, when I got out of the Army, is situated on thirty five acres. We will choose a second building site to build a new home somewhere on the same acreage.

Ok, at this time I am convinced due to asknods kind effort to explain the issue as a matter of law contained in 3.350. It was there but I just could not put it together. I guess all that remains is to just settle back, enjoy my family and the rest of my life, and just move on. After ten years of doing battle with the VA it is hard to just put your guard down and just stop fighting. Unless, God forbid, I ever need A&A, I am finished with the hamster wheel. By the way, The last of October, 2015, I did get a favorable decision on a claim for hand and foot fungus that was submitted to the RO on October 23, 2005, ten years ago. The last that I had heard of the claim it was remanded back to the RO from the BVA on November 2, 2009, with an expedited status. It was finally rated at 10%. Thanks to everyone here at Hadit for what you do for so many.!

I did find this, and it seems to be the same article that was referred to by broncovet in the post above where I could not open the link. It is an exerpt from the March 23, 2010 Military Order Of The Purple Heart training by the NVSLP III. Higher SMC Levels A. General Information 1. VA will not consider higher SMC levels until a veteran has established entitlement to basic SMC 2. Higher levels of SMC are paid instead of disability compensation under the SRD 3. A veteran can receive SMC(k) in addition to a higher level of SMC, if SMC(k) is based on a different condition than the bases for the higher level of SMC This agrees with what asknod has said above, but, there is no reference to a law, a statue or regulation to support it. Is there an actual legal authority to overrule, negate or otherwise deny the law at 38 C.F.R. 3.350 which allows for the payment of a "K" award in addition to "L" through "N"? I am looking for the legality of the issue. If it is just a matter of VA procedure in the way that the VA interprets the law to deny the "K" awards, it needs to be challenged in court, especially if it, as it seems, conflicts with 38 C.F.R. 3.350 and 38 U.S.C. 1114 "K".

Under no circumstances can one of the ingredients for L also be a predicate for a K as that would be pyramiding. asknod, if you can support that statement as a matter of law, I will be convinced and I am finished. You can't just pull a statement like that out of thin air and expect it to stick!

Thanks for the replies Buck 52, Broncovet and asknod. As I read the regulation on pyramiding I find no reference to anything to do with pyramiding other than two diagnosis being given for the same condition causing an overlap. § 4.14 Avoidance of pyramiding. The evaluation of the same disability under various diagnoses is to be avoided. Disability from injuries to the muscles, nerves, and joints of an extremity may overlap to a great extent, so that special rules are included in the appropriate bodily system for their evaluation. Dyspnea, tachycardia, nervousness, fatigability, etc., may result from many causes; some may be service connected, others, not. Both the use of manifestations not resulting from service-connected disease or injury in establishing the service-connected evaluation, and the evaluation of the same manifestation under different diagnoses are to be avoided. asknod, I know that you are a very knowledgeable veteran when it comes to VA benefits,laws and regulations. Where did you get the information on the ingredients of the SMC and how it disallows the "K" award as an additional award? Is there another regulation on pyramiding that should be as plain as the nose on my face that I am not seeing or am unaware of that could directly, supersede, call into question, negate or otherwise overrule 38CFR 3.350? If there is a legitimate and understandable way for the VA to override and deny the entitlement to multiple "K" awards as additional awards to SMC "L" through "N" surely the regulation could be cited as a matter of law that would give the VA the authority to override 38 CFR 3.350. § 4.14 Avoidance of pyramiding. The evaluation of the same disability under various diagnoses is to be avoided. Disability from injuries to the muscles, nerves, and joints of an extremity may overlap to a great extent, so that special rules are included in the appropriate bodily system for their evaluation. Dyspnea, tachycardia, nervousness, fatigability, etc., may result from many causes; some may be service connected, others, not. Both the use of manifestations not resulting from service-connected disease or injury in establishing the service-connected evaluation, and the evaluation of the same manifestation under different diagnoses are to be avoided. broncovet, I would be very interested in the read by the NVLSP that you posted but I can't open the link. It could be, and I am thinking, that if there is no regulation or law that gives the VA the authority to deny the "K" awards in addition to SMC "L" through "N" as laid forth 38 C.F.R. 3.350 it needs to be challenged. I am of the opinion that just because that is the way the VA has always handled it don't mean that it is proper procedure according to the laws and regulations that govern the issue. It could come down to a difference of interpretation of the law. Recognizing and witnessing all of the knowledge and talent that follow this forum,I am hoping that with your help, we should be able to bring the issue to an equatable conclusion supported by applicable regulation. I really don't want to challenge the VA on the issue by climbing back into the hamster wheel again, but I can if need be.

Previously I was service connected for, 100% p&t for AICD implant. 100% p&t for class III kidney disease, 50% neuropathy right upper extremity, 40% neuropathy left upper extremity, 40% neuropathy right lower extremity,40% neuropathy, 30% for severe anxiety and depression, 20% type II diabetes 0% for chloracne, 0% for ED. I was rated and being paid as a 100% veteran with spouse. I had an "S" award and one "K" award. On a new rating decision dated August 2015, I was awarded Loss of use of upper right extremity and loss of use of right lower extremity. They combined the two loss of use awards at 50% each for a total of 100% for both. The loss of use of two extremities generated an "L" rating. I was given a ( P-1) bump to the next higher rating of "M" on account of the independent 100% rating for the implanted AICD. The "K" award for ED was continued. My question, A "K" award for loss of use of a hand and another for a foot was not mentioned in the decision. From what I read at 38 CFR 3.350 The "K" award is payable in addition to the basic rates. Should my correct rating be at the level of "M", veteran with with spouse, plus one "K" for the ED? Or should my rating be an "M", veteran with spouse, rating with three "K" awards, two for loss of hand and foot and another for ED? I know that a veteran can have a maximum of three "K" awards. From what I read at 38CFR 3.350 a "K" award is payable in addition to the basic rate of "L" through "N" provided the total does not exceed the monthly rate set forth in 38 U.S.C 1114 (o). The only thing that I can think of where I might be missing the point is if using the "K" award in addition to the "M" might be considered by the va as pyramiding? What am I not seeing when I read the first paragraph at 38 C.F.R. 3.350? I was also awarded the automobile grant w/ adaptive equipment and the SAH grant.