Smc R1

[Guest morgan]

I go completely brain dead when trying to understand the SMC ratings! I've been trying to understand how the levels increase to the maximum rate for (O) or (P). No matter how many times I read about this, I can't understand it.

I'd appreciate anyone's help in explaining how a veteran can get to the maximum rate for (o) or (p)as mentioned here:

(h) Special aid and attendance benefit; 38 U.S.C. 1114® -- (1) Maximum compensation cases. A veteran receiving the maximum rate under 38 U.S.C. 1114 (o) or (p) who is in need of regular aid and attendance or a higher level of care is entitled to an additional allowance during periods he or she is not hospitalized at United States Government expense.

He's rated (VA math) at 260%, including two separate and distinct 100% schedular ratings. He was awarded A&A three years ago and has several secondary conditions not rated. He's at the SMC M compensation level now. I believe he should be getting SMC R1.

Thanks.

[Pete53]

Morgan:

There are several Hadit Members who can help on this issue. However, its way above anything I feel confident about but I wish you the best cause you are helping a Veteran.

[Berta]

Morgan- SMC is in my opinion-the most confusing aspect of VA case law- particularily when it gets into high levels of SMC such as P or R-1-

The VBM adds little to what you posted as to the regs-

They say the vet must be at SMC (o) and also entitled to SMC L to be eligible for SMC R-1.

They give this example:

Vet has loss of use of both feet,rated at 100% (DC 5110)

and PTSD rated at 100%.The veteran is also considered due to his PTSD as a danger to himself.

The veteran is entitled to 38 USC 1114 -SMC L award.

Because this vet meets requirements for regular aid and attendance also-per those ratings-

this is why he is eligible for the L award.

However since he meets requirements for both L and N award -with no condition considered twice-he is entitled to the O award.

Since he meets the O award and is already SMC for A & A under L-he also is eligible for the SMC R-1 award ( $6,164 per month)

Page 370 2007 Edition VBM

say what? It IS confusing-

This BVA case explains R-1 a little better:

http://www.va.gov/vetapp07/files3/0726436.txt

I asked for R-1 for my husband in my SMC CUE claim.

loss of use of 2 hands (by medical documentation)( 100% -Sec 1151 and DMII AO disability)M award plus SC 100% PTSD-then

loss of use of normal foot use- up to 1114 P rate-(med documentation)( Sec 1151 and DMII)

then he also met requirements for basic aid and attendance-by medical documentation from his shrink)

so that take him up to SMC R-1

I am NO expert in this stuff at all-

But I found that R-1 claims at the BVA website were a big help.

The VBM contains many combos that can generate SMC levels higher than the basic rates-and they give many more examples -unfortunately I am not allowed =per NVLSP-to copy here too much from the VBM.

But others will chime in too

[MrPain7]

Morgan:

If you have lost or loss of use of both upper extremities or both lower extremities

or one upper and one lower extremity you recieve the (L) award for loss of use,

and if you have other ratings combined or single every 50% will increase your rate

L-1/2 100% a whole letter to (M) and so on until you reach the O/P status and then it changes the rating higher

then O/P require A&A or constant medical assistant of some kind...

also you will recieve the (k) award for each loss of use up to 3 times(both feet and one hand)ect...

If you have one separate rating at 100% and one separate or combined rating equal to 60% you would be entitled to the (s) award

[Rich T]

The need for A&A R1 has to been over and above (separate from) the original rating of 100%, if the combines ratings are N1/2 + k or more, except for the loss of use for bowel and bladder. The SMC is so flexible, they can try to make it say practically whatever they want.