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SupermanCannedy

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SupermanCannedy last won the day on November 2 2017

SupermanCannedy had the most liked content!

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About SupermanCannedy

  • Birthday 12/26/1960

Profile Information

  • Location
    Austin, TX
  • Interests
    Outdoor activities and anything that gives me a reason to wake up in the morning, including my family, friends and caregiver- who all try to keep my life in order and prevent me from doing stupid things.

Previous Fields

  • Service Connected Disability
    100%
  • Branch of Service
    Marines
  • Hobby
    Swimming, hiking, equine therapy and art.

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  1. Aaaaah, I understand: All Special Monthly Compensation rates are given instead of the standard VA Disability Compensation rates, except for Level K. Level K is given in addition to your standard disability pay. Therefor, you can receive multiples.
  2. I am confused about how you csn get both SMC s and SMC k. It is my understanding that only one SMC is awarded, but I suppose the k could be stacked on top of another SMC? Regardless, increasing the % your existing ratings, will not necessarily increase your compensation because you're already receiving over and above compensation that is awarded by % ….you’re in the SMC charts. If you are at an S and want to go to an L, you’ll need more than a new 21-2680. You’ll need to provide medical evidence that shows the specific ways your condition has declined and can provide a more detailed explanation as to why your need for assistance has increased. Brain scans that can show damage, such as MRI & SPECT, are good. Having the dr assign cognitive, speech and other therapies that assist with decline are helpful. Tests for memory and cognitive dysfunction can also be helpful. Since you’ll need to get all up to date on tests and imaging, you may as well as have your neurologist to look into the possibility that you have a TBI that has gone untreated since your blast. PTSD and TBIs have some symptoms that are similar and some that overlap. It is possible to have both. However, when TBI is left untreated it can become degenerative. Enough time has passed for it to show on imaging and neuropsych testing. So, have the dr look into it and get treatment, if needed....regardless of the outcome of your futurre claims. There are some AMAZING programs that are helpful in the early stages of TBI. If your tests come back showing evidence of TBI residuals, then put in a claim for it because if comes back high enough, it could be combined with your high PTSD rating to get you to the L (100% TBI + the 70% PTSD meets the criteria. I'm not sure how it works if both are less than 100%) OR skip putting in for the TBI claim and take the chance that your results are strong enough to put in a claim for SMC L or L or L ½ .
  3. Usually, a vet needs to have 100% rating to receive special monthly compensation. So, your situation confused me a bit. However, I think I understand how you are getting an SMC without having 100% SC for any one disability….I just remembered that my stepfather is rated at 70% for PTSD with IU. He has no other rating, except for migraines, yet he receives compensation at the 100% rate. So, apparently 70% PTSD + IU = 100% comp. Has anyone else heard of that happening?
  4. Taylor88be8 lost the Caregiver Stipend because it was being paid to his spouse and when she was no longer tending to his needs, that income vanished...It could be paid to another relative living with him. There are several people on my vet caregiver forum who are siblings or parents. However, there is a world of difference in criteria, method and compensation between the Caregiver Stipend and an SMC, but I think that has been established later in this thread, so that’s all good. How the conversation bent toward the possibility of him receiving SMC (t) is puzzling to me as were several statements about the T. I’d like to clarify that, unlike the VA Caregiver stipend, there is no requirement for a veteran to have a spouse or anyone else living with them to receive the T award. In fact, living alone makes the veteran all the more "helpless" and in need on regular a&a. Living alone does not mean they don't recieve a&a from others, but it does make it harder to get all the help they need, which puts them at greater risk of being placed in a nursing home or other care facility. The T was specifically created to ensure that a vet who suffers from such severe TBI would have the funds to hire in-home care, whether they were married or not, so that they could avoid being in a facility. Although the award is large, it is still costs less than the astronomical cost of a facility. A vet in need ot the T would already be receiving regular care a couple times a week, deemed as incompetent, and be assigned a fiduciary. Also, the caregivers who provide in home help do not need to be trained by the VA or any other agency. The results will be better if they hire a home health aid or person with experience as a caregiver, but they can hire whomever they want. Nursing level care is a requirement for R2 and will disqualify a vet for the T. So, don't use terms like "higher level of care" or "high level of supervision" I am going on and on about this because, as a caregiver for Superman Cannedy (who lost his ability to navigate the internet last year), I filed an SMC (t) claim on his behalf and learned a lot along the way. I didn’t know any VSOs, agents or vets who were familiar with it or knew how to develop a strong claim for it. I still haven't come across any other vet or caregiver of one who has recieved it. I had one VSO tell me that if he was so bad off, I should just put him in a home! It was incredibly discouraging. My vet lives alone. I am not his spouse or related in any way, but have taken care of him for years because his family will not. He asked that I become his fiduciary when he was awarded 100% for TBI. Later, he was awarded L ½ and we hired part time help. When his brain degenerated into dementia and I needed more and better qualified help, I filed for the T because a putting him in a care facility was not acceptable. He wanted to stay home and I knew his quality of life would be better there. Developing the claim took “forever” because there was a lot of digging into the details and dry reading. Plus, the drs took awhile to get the paperwork and testing needed. The claim was denied- because the DO who reviewed it incorrectly based his decision on R2 criteria. Even the DO got confused about the T! However, we got that straightened out in the appeal process and it was awarded! I am happy to help others who feel they qualify, but Taylor88be8 does not meet any of the three main criteria, regardless of his marital status. The following is not a copy of the official criteria because…it is written in an over simplified manner which deserves more insight. To be eligible for SMC (t) a veteran must meet these three main requirements: 1. Rated at 100% service connected for TBI (not any other type of disability, such as PTSD, nor a combination of disabilities that combine to 100%) 2. Rated at (or at least eligible for) a&a at the SMC L rate. To qualify for the L rate with TBI, the vet must show the need for regular aid and attendance. Regular does not mean constant or even daily. Two or three times per week is sufficient. Aid and attendance means assistance with custodial care. Custodial care means assistance with more than one activity of daily living (ADL). Here is the list of ADL’s: Bathing, dressing, transferring, eating, toileting, and personal hygiene are ADL’s. Activities like meal preparation and medication management are not ADL’s. If he requires and receives assistance with at least two of the above activities on a regular basis, you are in need of the regular aid and attendance of another person. Most with severe TBIs need assistance in IADLs, but it can be challenging to explain why they also need help with ADLs, but not the same way as a person with physical disabilities. You need the docs to understand it though to accomplish #3. 3. Determination by a Dr (neurologist or psych ...and from the VA preferably) that the veteran is so helpless that "without regular in-home aid and attendance, the veteran would need to be placed in a nursing home or care facility". They need to back that statement up on a 21-2680, which is tricky because the form is designed to focus on the physical, yet you have to prove the cognitive & memory deficits with a lot of yes/no answers. You need a good relationship with a specialist who understands the condition and level of need. They also need to be willing to run tests and imaging, unless you have plenty already (an MRI and a neuropsych eval are a good start), to be able to take the time to fill out the form, AND to back it up with a support letter, addressing how the cognitive, behavioral, and memory problems prevent the vet from living independently. **Does NOT qualify for a "higher level of care" ; aka R2 Surprisingly, a c&p exam is not always necessary. Somewhere in the regs that show the ratings officers how to determine a claim, it states that if the vet has already received a c&p to determine service connected TBI, which is the first and foremost criteria, it will suffice. They may or may not...My vet did not require one during this claim process. I hope this info is helpful and I wish I could give advice on how Taylor88be8 could increase his claim, but TBI claims are the only disability I have any insight into.
  5. I am not sure how it is paid out, but I am on a vet caregiver forum and the tax question has come up often. The VA Caregiver stipend is not taxable income.
  6. There is a possibility that those of you who have helped me will not see the addition to this thread, however.. I have very good news: I got a call from my vet's lawyer to notify us that the SMC T appeal has been awarded!! We didn't even have to go to court! I wrote a statement letter expressing the urgent need to get it out of the county level and within 10 days the file was pulled for review. They read it and approved it right then and there! Apparently, three other signatures are required to sign off for it because it is a higher level award, so it may be awhile before I get notice in the mail. I looked in Ebenfits and it states that the appeal is closed, but there is no more information, but I will keep checking the mailbox and the site. I appreciate the help you gave without judgement. I knew he was eligible and I believed his claim was denied in error, but I just didn't have the strength or stamina to work on it anymore...until you stepped up to give direction and encouragement. A potentially 3-4 year appeal process was completed in a fraction of the time! This is not info I will be sharing with anyone else in real life or online. I wanted to tell you guys because...well, I want to tell someone!...and you've got my six. My vet will be cared for round the clock in his own home instead of a facility and I will get the help I need so that I don't die before him from stress and exhaustion. I am so relieved!! THANK YOU Buck52, John999, Jfrei, R3dneck, Gastone and Broncovet If there is anything I can do to encourage or assist you in your endeavors, please let me know and I will do my best.
  7. You need to get to 100% disability before any additional special monthly compensation is considered. SMC is reserved for veterans that have suffered certain severe disabilities, severely disabled veterans who are housebound, or in need of regular aid and attendance or daily health-care services. Having multiple disabilities that total over 100 is not as much of a factor as you’d think. Some SMCs require that a veteran have 100% in a single disability PLUS 50% or 60% of another single disability in order to be awarded. When the VA makes the decision that a vet is 100%, they are supposed to consider whether the vet is also entitled to SMC benefits. They do not always do it, but should if there is evidence in the claim that indicates the vet qualifies. A vet has to be established with an entitlement to basic Special Monthly Compensation before being considered for higher rates of SMC. The beginning levels are K-S. If you win your claim, but don’t receive a basic level SMC, then file a claim for one. You can then put in a claim for an increase to an L, for example. But, you have to already be awarded a basic SMC to increase from…. You can try to skip to a higher level without being established, but it may be futile. Look at the criteria for each SMC you believe you’re eligible for, with the help of someone who knows and understands them because they are confusing and complicated. You want to file for the correct one and provide the medical proof required to back it up. You mentioned L: There are 3 categories in which you may qualify for SMC L: Aid & Attendance, Permanently Bedridden, and Combination of losses or LOU of extremities & blindness. Let’s just look at what it takes to be eligible for the A&A category of SMC L in a nutshell: The need for regular Aid & Attendance can be due to physical or mental disabilities that require the assistance of another person to help them perform normal functions of daily life. Medical proof is needed to show the vet requires help with ADLs or IADLs, such as dressing/undressing, keeping clean/grooming, feeding, toileting, (or at least prompting or supervision of such activities) and for protection from the hazards of their daily environment. Severe cases of PTSD and/or TBI are the most likely to be eligible for SMC L in regard to mental disability, when they are so afflicted that they become unable to function independently and need a caregiver. There are different levels of A&A in the SMC chart and L is in the middle. Housebound status is another of a type of SMC that entitles a veteran to additional compensation when they are substantially confined to their home because of their service connected disability, and it is reasonably certain that the disability will continue throughout their lifetime. A vet can be unable to leave their home without assistance due to mental or physical disabilities. SMC-s is a basic housebound SMC. It is the most likely SMC you will receive if awarded one and a good one for you to consider putting a claim in for if you are not awarded one. For regular A&A and housebound SMCs, the caretaker does not have to be a medical professional. It can even be a member of the family or a friend helping with everyday tasks. This has been a very quick and broad view with gaps in the details. For more info and to look further into whether you may be eligible to apply, talk to a VSO or an organization that helps with SMC claims. The best of luck to you!!
  8. An SMC L combined with an SMC P1 is considered a "half step". The result is L 1/2. This is what my vet has too. If you are able to pull up your ebenefits info and look further into your claim it will show both L & P1. Kind of a weird way to increase A&A.
  9. SMC t appeal Update: I sent a statement letter to the VA county office where my vet's NOD is sitting with thousands of others. It is to explain the severity of his need and to urge them to pull his out of the pile, so it can be decided by a judge sooner rather than later. I will let you know if it helps get his claim moving along. I really appreciate the advice and support from you all!
  10. Buck, what happened to your uncle is horrible! I am so sorry he had such a terrible experience at the end of his life. It is everyone's worst twilight years nightmare scenario. I appreciate what you and John are saying and you can be certain I will not place my vet in a nursing home. Every elderly person in my family was cared for in the comfort of their own home until the end and, even though his level of care is higher than theirs, it will be the same for our adopted marine. I just need a few extra hands to keep his world bright, full of activities and as stress-free as possible.
  11. John, We have never had to use a lawyer before this claim. We had an awesome VSO who showed me how to put together a solid claim and a cooperative vet who took every test he needed to go through in order to provide evidence. His claim was processed, the c & p was solid and he got 100% P&T + SMC S awarded fairly fast! His claim to increase to a T the first time resulted in an L 1/2. Just over a year later I filed for T again. But, that amazing VSO got promoted beyond my ability to reach her and we moved to a different state where no one seems to have heard of the T. So, I did what I could and the claim was denied. I first used a pro bono lawyer to file the NOD and immediately felt regret because they knew so little about VA law and even less about SMCs. I realized the NOD could sit at the county level for years and I suspected it was done poorly, which would lead to another denial! Time has been ticking, so there will be retro pay in the end. But, if it takes years before it is finally approved and he passes while waiting, it is irrelevant. I took the advice of the folks on this site and found a law firm with experience in VA law. I am very happy with decision and believe it will be worth the % they get to keep. They are working fast to get it out of the county level and before a judge because my vet is at risk of being placed in a memory care or other facility. The claim wasn't denied because he didn't meet the criteria for T; the DO denied it based on criteria for R2, which was an error. We presented evidence from the VA neuro as well as his civilian neuro. There were plenty of other tests and brain scans, etc. It is very clear that he is eligible. However, we will most likely have a civilian brain injury expert do another exam with a follow up letter. We can also submit the MRI, Pet fusion and SPECT scans he received this past year. They show the continued brain atrophy and degeneration caused by the multiple TBIs. His VA neuro started home health services with occupational, speech and physical therapy twice a week each in his home. We could include the initial assessment intake by each therapist. It is unfortunate that Congress didn't allow the VA Caregiver Program to pass for vets of all eras. It was attempted twice, but only passed when it was narrowed down to the caregivers of post 9/11 vets. Receiving the stipend from that program would not have resolved our problem. What would help us both is the ability to hire experienced help. The SMC T doesn't require a veteran to be in need of care 24/7 nor does it require skilled nurses. It is for those who are so helpless that without "regular in home aid & attendance" they would need to be placed in a care facility. He needs assistance, personal care and supervision all through the day and help with the process of going to bed, but he does not need supervision while sleeping....yet. Caregivers do not command the same pay as nurses, however the ones who are experienced and behave professionally can get close to the same hourly pricing. Ideally, we would hire a team of 2-3 caregivers who rotate in regular shifts and can cover for each other when needed. The SMC T will be enough to hire that type of help on a daily basis and I will be grateful for the time it will free up for me. However, I will remain his main caregiver and biggest advocate.
  12. Jfrei, It is my understanding that when a 100% rating is awarded for a TBI claim, the SMC S is automatically applied. That is most likely why you have it. They are not inclined to award the L rating unless you put in a claim for the increase. From what you have written in the various posts the past few months, it does appear you are eligible for SMC L. I don't think you need a lawyer to be successful in getting that award, unless you put in a claim and it is denied. A good VSO will be able to help you with this. It is not an unusual or complicated claim and you seem to have good medical evidence. You just need to put it all together so it is an "easy read" for whichever decision officer's desk it lands on. Google your county VSO office and see who is available and ready to help explain to you what needs to be done and will help you through the steps. I helped my vet make the increase from S to L about 2 years ago and it was much easier than putting in the claim for his TBI! It was also a faster response. I believe it took around 2 months. GO and GET ER DONE!
  13. Jfrei, I agree that you should definitely get connected with someone who knows the SMCs well to increase your S to an L, like James Cripps. For what to do in the VA Caregiver Program, I can tell you that your wife will need to step up. Have her contact other caregivers who have been through the process. Some are new to it and some have done it from the start (2 1/2 years ago it started?) She will find lots of advice and info on the Hidden Heroes site I pointed you to. Take advantage of any opportunity you have to gain knowledge from those with the education or experience to assist you! Buck, I am pleased to say that I was able to increase my vet's SMC from S to L 1/2 using that very inadequate form. No new medical info added, just the form and a back up letter from the neuro so he could explain his reasoning because the form is so limited. It helped that I studied the CFRs, especially 'Entitlement to SMC Based on the Need for A&A' under 38 U.S.C. 1114 (l), all of section H, and anything else I could find that could help with understanding what the DO needed as evidence and to help with responding to the odd and oversimplified wording on the 21-2680. It really helped that we have a good report with the VA neuro and that he actually cares about his patient. I interact during all of the appointments as well because my vet has such a bad memory and is so easily confused he can barely answer the questions asked. The reality is that most people will take that form to their PCP, who will scratch a few words on it here and there, providing no clue to the DO of how helpless they really are. Hopefully, another form will be created with questions that better address the cognitive, memory and behavioral deficits of veterans with TBI or other neurological dysfunctions who are seeking an increase in their A&A. My vet is physically fit because exercise is the one thing that has been constant since he left the USMC. It keeps depression and anxiety at bay. He has all of his limbs, they all function, and he isn't bed ridden. He is housebound because, not only can he no longer drive, he can't even walk anywhere without supervision. He gets lost, can't recall his address, doesn't take his phone and talks with strangers. He has been in a few skirmishes with people, walks in the middle of the road or parking lot and has caused traffic problems, experienced near accidents, etc etc. and then is an emotional wreck, like a child. He is housebound due to memory deficits and mental incompetency. The A&A isn't to provide nursing care, but home health aids or caregivers to assist with his daily needs, provide supervision, and keep him safe from harm. I run his household as well as my own, so my time and energy I have to take care of him is limited, yet his needs increase with time as his brain continues to degenerate. Without hired help, I would collapse...then, he would be (?). I think we will see an increased number of veterans needing care for the neurological diseases that develop in chronic cases of TBI. This war is 16 years in and TBI has been prevalent from the beginning. They eventually set up protocols to treat acute cases, but still have nothing for the devastation that happens in chronic cases. Multiple TBIs, especially when untreated or layered in later years with more TBIs (accidents, fights, etc) can develop over a long period of time into other neurological diseases like Parkinson's, CTE, Alzheimer's and other dementias. Life can even seem "normal" for awhile or as if the TBI was treated and gone. It can take decades before the problems from all those dead brain cells start to really create problems. But, by the time it is realized, the brain is riddled with damage that no one has yet found a way to reverse or slow down. We've met a few vets who have had TBIs for just over a decade that are now presenting mid stage dementia. I wouldn't be surprised if there are a lot more of conditions like these within the next 5 years. The VA needs to be prepared because they are a residual of those service connected TBIs and will require higher levels of A&A and/or long term care. Didn't mean to get so heavy! I thought about erasing those last few lines....but, no.
  14. Jefrei, I agree that the nurse gave you the wrong reasoning for your SMC S. The healthcare side of the VA often interprets the benefits side incorrectly. From what you've stated in other threads, you are rated at 100% P&T for TBI. If your claim was also submitted for those chronic headaches that so often accompany TBI, you have 50% for that alone which leaves you just needing a combo of smaller ratings on other claims to get to the 60%. It is not uncommon for vets with 100% TBI P&T to have SMC S. Less common to have SMC L... very uncommon to have SMC T. It is frustrating that the Caregiver Program and process wasn't better explained to you before the nurse came to do the assessment. It is needs based only and, as others have stated, your disability rating is not factored in. It is supposed to be a uniform system, but it seems that the criteria varies widely. My vet is pre 9/11, so he doesn't qualify for the program. But I have heard a lot about the process and changes within from other caregivers and that's who you and your wife should connect with. I'd like to give you the link to a caregiver site for you wife to look into. It's called Hidden Heroes and is supported by the Elizabeth Dole Foundation. There are many on it who are in the VA Caregiver Program and will be glad to help you both through the steps, regardless of the outcome of your nurse's visit. Lots of caregivers of vets with TBI too and they share info on all aspects of things related to it. It has tons of resources! Here is the link: https://hiddenheroes.org/about/ . She will need to request to join (upper right hand corner of main page.
  15. Hi Jfrei, A 21-2680 is the exam form the specialist fills out to show that you are housebound and have a need for regular Aid & attendance. A person can be housebound due to their mental/cognitive disabilities because of memory problems, the need for supervision in activities, etc. The form really needs to be rewritten to better assess need for those with TBI. It reads as if it is mostly assessing people with physical disabilities. You can download it here and make a copy: https://www.vba.va.gov/pubs/forms/VBA-21-2680-ARE.pdf My advice is: 1. Read it before handing it to a doctor, so that you aren't baffled by some of the questions. For example, of one of the questions is, "Can the veteran feed him/herself"? You may assume they mean put a fork full of food into your mouth and mark that as a yes. However, there is more to feeding than that last step. Do you remember to eat meals or do you need to be prompted? Can you Plan your meals or shop for food on your own? Are you able to prepare a meal or cook? Do you accidently eat food that has gone bad?....Think about how your memory loss, confusion, disorientation with time, and inability to stay focused or make and follow a list effects your ability to feed yourself. Consider that with each question. 2. Set up an appointment with your neurologist to have this exam. If not your neuro, then your psychologist or neuropsych or whichever specialist you feel you have the best rapport/understands you the most. NOT your primary care doc. 3. Ideally, have them write a letter backing up what they said on the form because the form sucks...I mean it doesn't allow much room for explanation. The letter will support that the dr feels you need an increase in A&A because _______- and they can address your cognitive decline, memory loss, confusion, headaches that are debilitating and any physical pain on top of it all. 4. You deliver the form to the dr yourself and when they are done (which may not be at the same appointment), tell them you will pick it up. This should not be a problem for the dr. You then take it from the dr to your VSO or whomever is helping with you claim. 5. If you cannot get a dr to cooperate with you in filling this form out, you can have a civilian neurologist do it. Use your Medicare (if you have SSDI, then you have are eligible for Medicare). 6. Seriously consider getting someone else to help you set this up with the dr and to help you submit your claim. It is a lot for a person with such severe TBI to take on alone. If you have been getting assistance from a VSO, find a new one because you need someone more willing and able to help you with this and your other claims. Best of luck to you!!!
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