[Special Monthly Compensation]

Good evening!

I have a question regarding special monthly compensation.  I'm currently rated as S1 and my appeal has been added to the docket in DC.  I need to see what my chances are getting bumped to L, L1/2 or M?

My current service connected disabilities

1. PTSD-100%

2.  Asthma-60% on appeal seeking 100%

3.  Endometrosis-50%

4. Migraines-50%

5.  Eczema-10%

6. Rt knee-10%

7. Lt knee-10%

8.  Leaking heart valve-0%

9.  Bells Palsy-0%

10.  Pregnancy Complications-0%

 

Any help or suggestions would be helpful

Thank you!!

 

[Special Monthly Compensation, Please help]

There is no "statutory" Aid and Attendance, like there is a "statutory" housebound.  SMC S housebound is not a "building block" for higher levels of SMC.  You need to meet this criteria, for SMC L:  

§ 3.352 Criteria for determining need for aid and attendance and “permanently bedridden.”

(a) Basic criteria for regular aid and attendance and permanently bedridden. The following will be accorded consideration in determining the need for regular aid and attendance (§ 3.351(c)(3): inability of claimant to dress or undress himself (herself), or to keep himself (herself) ordinarily clean and presentable; frequent need of adjustment of any special prosthetic or orthopedic appliances which by reason of the particular disability cannot be done without aid (this will not include the adjustment of appliances which normal persons would be unable to adjust without aid, such as supports, belts, lacing at the back, etc.); inability of claimant to feed himself (herself) through loss of coordination of upper extremities or through extreme weakness; inability to attend to the wants of nature; or incapacity, physical or mental, which requires care or assistance on a regular basis to protect the claimant from hazards or dangers incident to his or her daily environment. “Bedridden” will be a proper basis for the determination. For the purpose of this paragraph “bedridden” will be that condition which, through its essential character, actually requires that the claimant remain in bed. The fact that claimant has voluntarily taken to bed or that a physician has prescribed rest in bed for the greater or lesser part of the day to promote convalescence or cure will not suffice. It is not required that all of the disabling conditions enumerated in this paragraph be found to exist before a favorable rating may be made. The particular personal functions which the veteran is unable to perform should be considered in connection with his or her condition as a whole. It is only necessary that the evidence establish that the veteran is so helpless as to need regular aid and attendance, not that there be a constant need. Determinations that the veteran is so helpless, as to be in need of regular aid and attendance will not be based solely upon an opinion that the claimant's condition is such as would require him or her to be in bed. They must be based on the actual requirement of personal assistance from others.

....

(c) Attendance by relative. The performance of the necessary aid and attendance service by a relative of the beneficiary or other member of his or her household will not prevent the granting of the additional allowance.

end of regulation quote.

 

However, there are about 60 kinds of SMC, as this article explains:

Eligibility

Special Monthly Compensation (SMC) is very difficult to understand – even experts in veterans benefits can find it confusing. So you are not alone if you find the SMC program difficult to figure out. This article introduces the SMC program. However, it cannot explain every detail. For additional questions, see the Vets101 article on Getting Local Help to find a qualified representative.

There are about 60 levels of SMC divided into 9 letter categories: -K, -L, -M, -N, -O, -P, -R, -S, and -T. If you get SMC, the VA will tell you which of these categories of SMC you qualify for. Some of the letter categories also have in-between levels, which are shown by a “½” symbol after the letter. Here we’ll introduce the basic eligibility requirements for the main categories of SMC benefits.

Many of the eligibility requirements use specific technical language that may be difficult to understand. You may need to talk to an expert to figure out exactly what level you qualify for.

Eligibility for Specific Levels of SMC

To receive an SMC (k) award you must have one of the following:

• Anatomical loss (or loss of use) of:
  • One hand
  • One foot
  • Both buttocks (where the applicable bilateral muscle group prevents the individual from maintaining unaided upright posture, rising and stooping actions)
  • One or more creative organs used for reproduction (absence of testicles, ovaries, or the creative organ, ¼ loss of tissue of a single breast or both breasts in combination) due to trauma while in the service, or as a residual of service-connected disabilities
  • One eye (loss of use includes specific levels of blindness)
• Complete organic aphonia (constant loss of voice due to disease)
• Deafness of both ears that includes absence of air and bone conduction

To receive an SMC (l) award you must have one of the following:

• Anatomical loss (or loss of use) of:
  • Both feet
  • One hand and one foot
• Blindness in both eyes with visual acuity of 5/200 or less
• Permanently bedridden
• Regular need for aid and attendance

To receive an SMC (m) award you must have one of the following:

• Anatomical loss (or loss of use) of:
  • Both hands
  • Both legs at the region of the knee
  • One arm at the region of the elbow with one leg at the region of the knee
• Blindness in both eyes, having only light perception
• Blindness in both eyes resulting in the need for regular aid and attendance

To receive an SMC (n) award you must have one of the following:

• Anatomical loss (or loss of use) of both arms at the region of the elbow
• Anatomical loss of both legs so near the hip that it prevents the use of a prosthetic appliance
• Anatomical loss of one arm so near the shoulder that it prevents the use of a prosthetic appliance, along with the anatomical loss of one leg so near the hip that it prevents the use of a prosthetic appliance
• The anatomical loss of both eyes, or blindness in both eyes that includes loss of light perception

To receive an SMC (o) award you must have one of the following:

• Anatomical loss of both arms so near the shoulder that it prevents the use of a prosthetic appliance
• Bilateral deafness (both ears) rated at least 60% disabling, along with service-connected blindness with visual acuity of 20/2000 or less in both eyes
• Complete deafness in one ear or bilateral deafness rated at least 40% disabling, along with service-connected blindness in both eyes that includes loss of light perception
• Paraplegia-paralysis of both lower extremities, along with bowel and bladder incontinence
• Helplessness due to a combination of loss (or loss of use) of two extremities with deafness and blindness, or a combination of multiple injuries causing severe and total disability

To receive an SMC (p) award you must have one of the following:

• Anatomical loss (or loss of use) of a leg at or below the knee, along with the anatomical loss (or loss of use) of the other leg at a level above the knee
• The anatomical loss (or loss of use) of a leg below the knee, along with the anatomical loss (or loss of use) of an arm above the elbow
• The anatomical loss (or loss of use) of one leg above the knee and the anatomical loss (or loss of use) of one hand
• Blindness in both eyes, meeting the requirements listed for SMC (l), (m) or (n)

To receive an SMC (r) award you must:

• Be receiving the maximum SMC (o) benefits and require:
  • Aid and attendance, or
  • Aid and attendance of another person without which you would require hospitalization, nursing home care or other residential type care

To receive an SMC (s) (Housebound) award, you must either:

• Meet all of the following:
  • You have a service-connected disability rated at 100%
  • You have a qualifying, additional service-connected disability (or disabilities) that is completely separate from the first disability and is independently rated at 60%
  • You are approved for VA disability compensation

OR

• Be housebound:
  • Your disabilities must directly cause you to be substantially confined to your home and the immediate premises or, if you are in an institution, to the ward or clinical areas
  • Also, it must be reasonably certain that your disability or disabilities and confinement will continue for the rest of your life

To receive an SMC (t) award you must:

• Need regular Aid and Attendance (A&A) for the residuals of (results of) Traumatic Brain Injury (TBI)
• Not be eligible for a higher level of A&A under SMC (r)(2)
• Need hospitalization, nursing home care, or other residential institutional care without in-home A&A

Eligibility for Aid and Attendance

Usually, you may qualify for regular Aid and Attendance (A&A) benefits based on any of the following circumstances:

• You need the regular help of another person to perform everyday living activities, adjust prosthetic devices, or protect yourself from the hazards of your daily environment. Even if you are able to perform some of those functions, you may still be able to qualify for A&A, because the VA will consider the particular personal functions that you are unable to perform in connection with your condition as a whole.
• You are bedridden because your disability (or disabilities) requires you stay in bed, not because of any treatment you have had, such as surgery; OR
• You are a patient in a nursing home because of a mental or physical incapacity; OR
• You are blind, or so nearly blind as to have corrected visual acuity of 5/200 or less, in both eyes, or have concentric contraction of the visual field to 5 degrees or less.

For more information on disabling conditions that the VA considers for A&A, read the glossary entry for Disabling Conditions Relevant to Aid & Attendance.

When you apply for A&A, your evidence must show that you actually need personal assistance from others. But you don’t need to show that you need it all the time, just that you need it regularly.

Certain spouses may also qualify for A&A benefits. If you are a veteran with a 30% or greater combined VA service-connected disability rating, and your spouse needs the aid and attendance of another person, you may be entitled to get a spouse-related A&A payment.

Usually, if you get VA disability compensation and you qualify for A&A benefits, the VA will pay you at the SMC-L rate instead of your normal monthly disability compensation. There are exceptions to this, which can sometimes get you even more compensation. These exceptions can be read in the glossary entry for Exceptions to the SMC-L Rate for Aid & Assistance. If the VA finds you eligible for SMC-L, your monthly compensation from the VA will come on or about the first day of each month and will not be subject to federal or state taxes.

Source:  for further reading:

https://www.vets101.org/a/58/d1.aspx

 

thank you so much!! 

[Special Monthly Compensation, Please help]

Wow!! That's very confusing. Thank you sooo much! Just when I thought I understood everything....I think I understand that I do not qualify for SMC L based on the qualifications for L. I guess I'm asking like is it possible to get S and K? (As long as it doesn't exceed L, rt?) I thought I seen somewhere that a 0% service connected disability is normally paid like K. So even though I don't qualify for L adding S and 3 Ks(3 0% ratings) would actually equal L (payment wise)

 

Now I know my husbands claim is extremely difficult. Is it normal to rate Lupus and all the side effects such as kidney failure under lupus? I guess I'm just a bit confused? And when we applied for Aid & Attendance for my husband we used the correct forms etc. I'm just baffled they denied it. He's down more than half the month so I'm not sure what they meant by he's not in need of regular aid and attendance. The appeal process here is 3 to 5 years, is there a way to speed up the process since its for aid and attendance? 

 

 

 

[Special Monthly Compensation, Please help]

Good Evening Everyone!

Okay I have a few questions regarding my Disability claim as well as my husband.  First let me start off by listing all my  service connected disabilities:

1.) PTSD-100%

2.) 60% Asthma

3.) 50% Migraines

4.) 50% Endometrosis with IBS

5.) 10% Eczema

6.) 10% Rt. Knee

7.) 10% Left Knee

8.) 0% scar left breast

9.) 0% hernia

10.) 0% rt breast scar

 

I'm currently rated 100% SMC S and I'm paid at the housebound rate.  I'm a little confused.  Another veteran told me I should be rated L or L1/2 because I was getting paid the housebound rate prior to Migraines and Asthma being increased from 10% to now 50% and 60%.  Is this true?  I read on one forum (can't remember where) that I should receive the letter S and 3 K's which ultimately equals L.  Just confused.

 

Also, my husband was medically retired due to Lupus.  He's currently rated at 100% for Lupus and 100% for Depression.  I recently applied for Aid & Attendance because with two kids and my own disabilities (no family within 2 1/2) its extremely hard.  When he has flares he can't do anything.  He has flares anywhere from 2 to 3 times a month lasting anywhere from5 to 7 days.  His civilian dr filled out the Aid & Attendance form and explained how bad he needed this benefit.  Well of course the VA denied it.  They stated Aid & Attendance is for someone in regular need of assistance.  They also stated since he can walk with a cane 25 ft he doesn't need it as well.  I'm really at the end of my rope with the VA.  To add insult to injury, when I filed a claim for his kidenys (he has stage 3 kidney failure) they said that falls under Lupus.  I understand if I opened a claim regarding back, joint or neck pain, but Kidney failure!  We have a two young kids and we will make due, but I can't make it to my MST meetings unless I have someone here with my husband. Sorry, folks I had to vent.  Please help

 

 

[Please Help! Am I Rated Correctly?]

Hello veterans!

This is my first time actually asking a question on this forum, but I've looked through this forum previously. First and foremost I would like to thank all of my sisters and brothers who served....thank you for your service.

I'm currently rated 100% P&T SMC S and I would like to see if I'm rated correctly. I do have a C&P coming up next month for asthma. When I was initially rated in 2005, I rarely had to take any medication for asthma. Over the last few years it's gotten worse to where now I'm on Dulera, turdoza inhalers and two two nasal sprays. I've been on steroids at least 4 times since December. It's gotten so bad I had to call 911 because I couldn't breath. With that being said, my current rating for asthma is 10%. Will I qualify for a higher rating for asthma? I have also listed my other disabilities

PTSD 100% P&T

Migraines 50%

Endometriosis with irritable bowel 50%

Asthma 10%

Rt knee 10%

Left knee 10%

Eczema 10%

Leaking heart valve 0%