Just learned my BVA appeal from r-1 to r-2 was approved, retroactive from 4 Aug 2023 to 12 Aug 2011. VFW help was tepid at best, even not showing up for the video BVA hearing. I did all the creative stuff before and after that. R-2 requires skilled, licensed professional care at home and I've refused all such care. Apparently what won the decision was the scope of SC issues (over 500%), DNR & terminally ill, the spouse having been "oriented" as to home PT and other care, and a compassionate judge.
I stressed throughout that regulations say a vet must be in need of advanced home care or face nursing home placement - NEED vs. actual-the plain meaning of the word is quite clear. Also stressed duty to assist and the fact that a vet need not apply for SMC because VA should have automatically considered it. Stressed that an exam by a nurse practitioner back in 2011 where she checked off the block for nursing home care should have triggered another 21-2680 exam by a VA physician, as only VA physicians' decisions are acceptable for R-2. INTERESTING: VA doesn't even list that 2012 exam for aid and attendance as one of the pieces of evidence.
Perhaps helpful was an early decision by VHA to consider me "catastrophically disabled." While doing nothing for benefits or care, it makes apparent the overall situation.
While the new rating is retro for 11 years, I've been R-1 all that time so compensation will be for the difference between the two ratings. Okay by me, of course
Redacted-SMC R2r Narrative Decision copy.pdf