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Letter From Va Doctor Vet Needs 24Hr Attendant Care

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Last year I filed for a higher or enhanced level of Aid and Attendance and was denied...I am now in my 60 day notification to file for a DRO or Appeal decision and just recently filed for an extension of the 60 days certified mail return receipt requested. I don't know if I am interpreting the statute correctly or not...here in the Statute it states....

"Title 38, United States Code, section 1114®(2), provides for the payment of a specified monthly aid-and-attendance allowance to a veteran if, in addition to needing regular aid and attendance, the veteran: (1) needs a higher level of care; and, (2) would require hospitalization, nursing-home care, or other residential institutional care in the absence of the higher level of care. The statute further requires that need for a higher level of care be considered to be "need for personal health-care services provided on a daily basis in the veteran's home" by a person licensed to provide such services or a person regularly supervised by a licensed health-care professional.

My doctor wrote a letter to the Regional Office stating...in part..."Due to his chronic medical problems patient requires assistance with his activities living and needs twenty-four hour attendant care. If he did not have twenty-four hour attendant care, he would require long term care placement."

Now according to Title 38 1114®(2) I think I meet the needs that in addition to needing regular aid and attendance (which I have had for 10 years now) I meet the number (1) needs a higher level of care and (2) would require hospitalization, nursing-home or other residential institutional care in the absence of the higher level of care...In other words if I don't get the requested higher level of care I am requesting then I will need long term placement with 24 hour attendant care...am I interpreting this correctly with the letter my Dr. has provided?? Even though I have not been rated for loss of use of my legs they did state in my C&P exam that I have loss of use in lower extremities and weakness in my upper extremeties, long with incontinence in which I was given a rating for that and now my doctor is setting me up for catheters. In my denial I am pretty sure they made a few CUE although I haven't zeroed in on them yet.

Am I interpreting the Statute correctly and will this letter from my Doctor be enough to warrant a higher level of Aid and Attendance???

I know from many things that I have read that the VA would rather a veteran stay in his home instead of in-patient care, for one it would be less expensive on the VA and two I would feel much more comfortable in my own surroundings but I know I have got to have help from others as I cannot make it much longer on my own, daily living is such a struggle for me that I wonder why I even put up with it daily. They did finally give me an electric wheel chair although I need help getting in and out of it so again it is useless unless I have help.

Does anyone have any thoughts about what I am requesting??

Also, should I request a DRO or go straight for the Appeal??

Thank you all...

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Do you presently receive R-1 level SMC or the SMC P award ?

Can you scan and attach here the actual reasons the VA denied the higher level of R-2?

(Cover personal stuff like name and c file number)

The VA will probably want proof from the attendant as to what he or she needs to help you with.

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"Even though I have not been rated for loss of use of my legs they did state in my C&P exam that I have loss of use in lower extremities and weakness in my upper extremeties"

Unless these are absorbed into the level of SMC you get now, then if service connected -they could warrant additional SC K awards.

The BVA web site -using their decision search feature -is often a good way to see how the VA determines the higher levels of SMC.

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