SupermanCannedy

We filed the original claim through the RO in Austin. The rep was unfamiliar with the SMC-t, but so were all of the other VSOs I spoke with. I presented all of the documentation that I could gather, based on the information we had access to, and she filed it. She was very unenthusiastic and told me two times that I should place him in a VA care facility. When the claim was denied, she was "done". The denial letter states the reasons for denial as physical ones and noted other things that are required as criteria for r2....that's not the SMC we filed for. After asking for help from several VSOs in the area and one tried to explain the different choices I could make in the appeals process, but I couldn't get an apt to see them in person for awhile. I agreed to have the lawyers draw up the NOD because they could get me in to see them. Maybe that isn't even the step that we should have taken. So, go back to the RO?...don't be as concerned about finding a VSO who understands the SMC t, but rather one who is good at navigating us through the appeals process?

Has anyone on this site put in a claim for SMC-t? Do you know of anyone who has been awarded it? I am the sister of a pre 9/11 veteran who has been rated at 100% for TBI P&T. I am his full time caregiver and have been appointed his fiduciary. I also have helped him with his claims...and have done well, until this one. I do my best to give him a high quality of life, but need to hire because his body is fit, but his memory and cognitive skills are in constant decline. He is a textbook case for SMC T because, in addition to the first 2 requirements, his VA neurologist has also filled out the forms to state that "Without regular in home care the veteran would need to be placed in institutional care". That is a major requirement for an SMC T. We submitted the claim for an SMC T 2015 and they granted him A&A at the L 1/2 rating, which we didn't realize is also required to qualify for SMC t...actually SMC L or higher. We submitted the SMC t claim again April 2016 and they denied it based on R2 criteria. After not knowing what to do about that and not getting any help from the local VSOs (they aren't familiar with this SMC T) a pro bono attorney offered assistance, so we took it. The decision board came back with a "We got your new claim...we can give you an answer within 30 days or you can have up to a year to submit more evidence." I have NO IDEA what that really means or what to do...So, I submitted for the extra time. Now, I need some guidance. Should I have people we know write up some buddy letters to explain how much help the vet needs in his daily life? Should I hire one of those VA lawyer firms that take 20% of whatever award is granted? Do any of you know of anyone who has worked on an SMC t? The last report I read was from Dec of last year when the congressional coding was recommended to be changed in order to make the criteria more clear and the "open". The charts show that as of 2011, when the Fast Letter first went out, only 120 or so veterans have been awarded this SMC. So, that's why I am hitting brick walls! We appreciate any help. Thank you!!

CJax, It is not too late to pursue a claim for TBI! If your husband received a concision or several (as in my case) during his time in service that resulted in a chronic brain injury, his symptoms will require treatment from the VA healthcare side and compensation from the benefit side. When they look into a claim for TBI, they consider what symptoms the vet has, such as: chronic headaches, sensitivity to light, memory loss, depression, impulsive and/or inappropriate behavior, confusion and decline of executive brain functions. It depends on which area of the brain was impacted, how hard and how often. Military Records: You need to be able to prove that your husband sustained his TBI his time in service in order for the VA to assume responsibility for his care. We went back through my military records from 1980-1985 to search for ER reports and other write ups to help me and found 5 recorded incidents when I received a concussion or the possibility of one. This provided specific dates, times, a certain level of trauma and other information that later became important. Does he have scars from the incident that caused his brain injury? Take a photo, especially if there is any mention of suturing in his medical report. Post Military Medical and other Records: Did he have accidents due to poor balance, impulsive behavior, or similar? Car or bike accidents? Is he treated for headaches, depression, or anxiety? Has he required counselling for mood or relationships? Is he able to work? If any of these happened after he was out of the service, find the paperwork that documents it because these may be linked to his TBI. In cases of falling, fighting or vehicle accidents, the new injuries add layers to the old and worsen his condition. Tests: The VA had done tests for mood, cognitive ability and memory test, but I was being treated for each problem individually, not for TBI. I didn't even know I could claim what they were treating me for...or that it had a name. The health side of the VA doesn't report anything to the benefit side unless they are directed to, unless they find something that needs urgent attention. That finally happened with me after an evaluation from a VA neuro psychologist. Go with your vet to his dr appointments (and I mean, ALL of them) and be his advocate. Ask the questions he may not. Explain symptoms that he may not bring up. Get to know his doctors, meds, and the VA health system. Ask for the various kinds of tests that can evaluate his mental acuity. The better you understand these things, the more you can ease his anxiety and the smoother the process will progress. *For example, I'm not sure what was going on with the "injection of radio active dye test". What exactly was it and what was it suppose to accomplish? An MRI may be able to show brain shrinkage, but no dye is injected. A CT scan is one where they use the dye. It may be able to show damage to the brain through imaging. however, a CT scan is not needed as evidence for your claim. You can discuss it more with the doc and help your vet decide if it is needed or not. Find a good Veterans Service Officer (VSO)- You need someone who is knowledgeable about the system and paperwork, who cared about your vet and good at communicating with you and others who you may need to be directed to. After a couple of "standard" reps, we found an excellent one who always responds quickly and keeps things moving. They will know what questions to ask, which forms to fill out and where they need to be sent. Be An Advocate: Although a good VSO is invaluable in certain ways, they are limited to what they can do. Your vet needs someone to be by his side through the process, because it is too confusing and frustrating for a person with TBI to organize all of the things needed. Be prepared to make appointments, make phone calls, fill out forms and type emails when necessary. Keep records and follow up on everything. My caregiver had a lot to learn about the VA system. But, she did learn...because she had to, for my sake! (She is writing this for me now because I can't use a computer well). I encourage you to work on this, in the hope that the had been out of the military for over 20 years and had only started treatment with the VA about two years before I met my caregiver, who volunteered to help me sift through all of the chaos. At the time I only had a 10% rating for a spinal injury, had 3 visits to the PICU, was not working and nearly back on the street again, and about to be kicked out of the Voc Rehab program (because I didn't understand what I was supposed to do and couldn't do the classes they put me in). She started helping me with school first. Then went to a dr appt with me, then helped me find a good VSO....and then really got to work! After a lot of appointments, letters and phone calls, within about a year and a half, I was awarded 100% TBI + housebound total and permanent. My life is vastly improved! I understand how I am different and what my limitations are. I have been able to receive treatment I never had access to before, like going to the Martinez, CA TBI clinic for treatment. All of my medical needs are addressed promptly and I am in the best physical condition I have been in years! My life has stability and I feel safer and more secure. Doing this will not only help your husband, but it will help you too. Go for it!

I have 100% TBI + SMC S and am in the process of being assigned a fiduciary because I can't handle my own finances. When I left the Martinez TBI clinic after a month of assessments and tests, the head psych said that without my cargiver assisting me on a daily basis, I would need assisted living and said he'd help me get A&A. However, the staff stated that since I served during peacetime and am not missing any limbs, I was not eligible. They are used to the A&A given as a pension and not at all familiar with SMC T, which is given as compensaion and has different eligibility standards. Although the fast letter for it was created in 2013, it is still so new that most people haven't heard of it. In Jan my VSO told me about the SMC T raitng and said I should be eligible because my poor short term memory and cognitive decline require that I have supervision for meds, meals, scheduling and everything I do outside my apartment. I fit the eligibility profile well, but now that I'm out of the TBI clinic (which is 2 hours away) getting the dr to fill out the form 21-2680 has been impossible! It is also recommended that the dr write up a detailed report stating that I will need to be in assisted living without daily in home care. I've sent an email with speicifc information and the form 5 weeks ago....And he has not done anything! Each week the dr's assistant states the dr is "Very busy, but working on it". My caregiver sent another email, this time through MyHealthevet because the dr supposedly HAS to respond within 3 days. Nothing. Today we went to a patient advocate, who is unfamiliar with the SMC T rating and this form of A&A, but put a note in the system to the dr and his assistant that we are anxiously waiting for the papers to be completed. So, at least there is something on record. Any ideas on what else we can do to get the doc moving? We've never had such a hard time communicating with a doctor! Crazy Horse, you are the only vet we've come across who has even started the process for an A&A for TBI claim. How long has it been and what has happened since you submitted the 21-2680?

Crazy Horse, I have 100% TBI + SMC S. I am in the process of being assigned a fiduciary as well because my math skills are non existant. Found out I may be eligible for SMC T because my poor short term memory and low executive brain funtions keep require that I have supervision for meds, meals, scheduling and everything I do outside my apartment. My caregiver has read all she can about it and I fit the eligibility profile well, but getting my psych to fill out the form 21-2680 has been near impossible! It is recommended that he also write up a report stating that I will need to be in assisted living if i don't receive daily in home care. He has had the form and written request for 5 weeks. I won't submit a claim without this very important evidence. My VA records will support everything they need to look into afterward. So, I would also like to know...Any vet out there been rated with the SMC T?

Berta, ....The link you gave brought me right back to the forum I originally posted on (SMC t for TBI) Maybe there is a more current thread? I'll search for others. Perry

Oh, Ok~? I thought this thread was about SMC t for TBI? I'm a newbie. Thank you for the link. I'll hop over it!

I am in the process of applying for SMC t, after being told by the had psych at the Martinez TBI clinic that there is nothing the VA can do to improve my severe TBI and it would be best for me to be placed in assisted living. (My volunteer caregiver is actually typing all of this up for me because there is no way I could articulate my thoughts well on the subject or navigate my way through this forum). The doctor said he'd help me to obtain A&A, but it turns out I am not eligible for the standard type because I did not serve during war time. My head injuries are from multiple concussions received while boxing for the USMC. After nearly giving up, we were pointed to the SMC t and we read the fast letter very carefully. Since I need daily care in just about every IADL category and have already been rated at 100% with housebound compensation, I should be eligible to receive this. The problem is getting the ball rolling by having the psych fill out the form 21-2680! We've also asked him to write up a report, since I stayed in the Martinez TBI clinic for a month of assessments and testing. We need these, and an IADL test. as evidence of my need. We can't file for SMC t successfully without it. Since working with the VA we have never had such a hard time getting a doctor to communicate or fulfill a request! If didn't live two hours away, I'd have my caregiver drop me off every day and sit by the main desk until he handed them back! The doctor's assistant calls weekly to check up on my condition, but always says the doctor hasn't completed the paperwork I requested. Does anyone know how to light a fire under the doctor? Also, has anyone on this forum been through the process successfully? I have to believe there are some who have been awarded this, even though it is "new" and hard to get, because I need to know it will be possible for me to continue my care at home. I don't do well in institutions of any kind and will wither away or get kicked into the street if they put me in assisted living care.