Homebound

[believe]

My C&P exam records show that the doctor listed me as homebound. Do I have to still apply for homebound or could I be awarded that when a decision is made on my claim without ever applying for it?

[believe]

Im in my 30's if that makes a difference. I surely wouldnt want this backfiring on me though. My next exam is scheduled in 2017. If its possible I could loose my 100% with an rescheduled earlier examination, I think I will be content with what I have. Otherwise, I will contact a lawyer on Monday.

You mean an IMO from VA examiner? I have an IMO from my psychologist that Im permanent but not from the VA examiner.

[Legate]

Believe, despite what some people say, being young (and 30 is very young) may make a difference. It makes sense because deciding that someone that age has a permanent condition means there is little if any likelihood that their condition will improve over the next 40-45 years. That takes a lot of certainty.

Yes, it is always possible, though not too likely, that they could reduce your 100%. I personally cancelled a request for reconsideration for Housebound although I had a good likelihood of winning, since I have a 100% P&T schedular award and my C&P examiner mentioned Housebound and I got supporting documentation from VA psychs attesting to that. The reason for cancelling: I hope to be able to get out more through working hard on my therapy and even if the VA said I would have no future examinations like they did, all that may change when you tack on the Housebound. I might have found myself having to go in for C&Ps every so often for the Housebound, and that examiner could also easily re- evaluate me for PTSD which, if I got a bad examiner, might mean I get a proposal to reduce my 100% award. I don't want to live with that extra possibility hanging over my head. Again, just my 2c worth.

[broncovet]

The VA uses fear tactics hoping you wont appeal because you are afraid the Va will take away what you have. The fact is, that VA can, and does, do reductions independent of whether or not you apply for additional benefits. They are unlikely to "re do" the decision, but they can/do reduce your benefits if you improved. There are protections at 5 years, not just 10 and 20, like most think. You kind of have to read the fine print to find the 5 year protections, but they are there. If you have had a malady for 5 years, with no changes, it is said it has stableized, and the Veteran is afforded protections.

You choose, tho. If you dont want to worry about it, then "settle" for what the Va gives you. Many do.

[carlie]

The VA uses fear tactics hoping you wont appeal because you are afraid the Va will take away what you have. The fact is, that VA can, and does, do reductions independent of whether or not you apply for additional benefits. They are unlikely to "re do" the decision, but they can/do reduce your benefits if you improved. There are protections at 5 years, not just 10 and 20, like most think. You kind of have to read the fine print to find the 5 year protections, but they are there. If you have had a malady for 5 years, with no changes, it is said it has stableized, and the Veteran is afforded protections.

You choose, tho. If you dont want to worry about it, then "settle" for what the Va gives you. Many do.

Here's a pretty good BVA cases for the 5 years - static provision.

http://www.va.gov/vetapp11/Files3/1125607.txt

FINDINGS OF FACT

"2. The Veteran's bipolar disorder has not been medically established to be static,

he is less than 55 years of age, his 100 percent schedular disability rating has been in effect for less than 20 years,

and there is no competent, probative evidence establishing that the Veteran's total impairment

due to service-connected bipolar disorder is permanent."

II. Analysis

"Re-examination will be requested whenever VA determines that there is a need to verify either the continued existence or the current severity of a disability. See 38 C.F.R. § 3.327(a) (2010).

Generally, re-examinations are required if it is likely that a disability has improved, if the evidence indicates that there has been a material change in a disability, or if the current rating may be incorrect. Id.

Following the initial VA examination or other scheduled examination, any reexamination determined to be in order will be scheduled within not less than two years and not more than five years. Id.

No periodic future examinations will be requested where:

1) the disability is established as static,

2) the findings and symptoms are shown by examination to have persisted without material improvement

for a period of 5 years or more,

3) the disability from disease is permanent in character and of such nature that there is no likelihood of improvement,

4) the Veteran is over 55 years of age, except under unusual circumstances,

5) the rating is a prescribed scheduled minimum rating, or

6) a combined disability rating would not be affected if the future examination should result in reduced evaluation

for one or more conditions. See 38 C.F.R. § 3.327(b) (2010).

However, none of the above guidelines are to be construed as limiting VA's authority to request reexaminations,

or periods of hospital observation, at any time in order to ensure that disabilities are accurately rated.

38 C.F.R. § 3.327(a) (2010)."

[believe]

Thanks to all who gave advice. Im sure this thread will help many others deciding about HB and with questions about it.

Maybe the VA doctor did not say permanent because of my age.

Having had this condition for 12 years and the level of severity that my condition is still at .. idk about it improving. That's 1 reason I applied for benefits though because I havent gotten any better over the years working from home. At least now I am able to focus more on therapy. I sure hope I can get better. If I do I will call it a miracle.

I wont continue to pursue my current permanent or HB claim.

[carlie]

Here's a BVA case that is relative for study / research.

THE ISSUES

2. Entitlement to an award of special monthly compensation (SMC) based on a need for aid and attendance or on account of being housebound.

Factual Background

"The file contains a PTSD note dated in May 2006 indicating that the Veteran's depression and anxiety had worsened and that she was virtually housebound, unable to care for herself or do house work. It was noted that she had severe panic attacks when venturing out.

PTSD and panic disorder with agoraphobia were diagnosed. The record stated that the Veteran's request for home health care was supported due to symptoms related to her service connected disability. In a statement from the same VA psychiatrist dated in June 2006, it was (incorrectly) reported that the Veteran was 100 percent service-connected for PTSD and that this was the cause of her being housebound and needing home aid.

REMAND

"A veteran may receive housebound-rate special monthly compensation if he or she has a service-connected disability rated as permanent and total

(but not including total rating based upon unemployability under 38 C.F.R. § 4.17) and

(1) has additional service-connected disability or disabilities independently ratable at 60 percent or more, or

(2) by reason of disability or disabilities, is permanently housebound but does not qualify for special monthly pension at the aid and attendance rate. 38 U.S.C.A. § 1114(s) (West 2002); 38 C.F.R. § 3.350(i) (2011).

A veteran will be determined to be permanently housebound when he or she is substantially confined to the house (or ward or clinical areas, if institutionalized) or immediate premises

due to disability or disabilities which it is reasonably certain will remain throughout his or her lifetime. 38 U.S.C.A. § 1502© (West 2002); 38 C.F.R. § 3.351(d)(2) (2011).

The Veteran's service-connected conditions consist of:

(1) PTSD, rated 100 percent disabling; and

(2) an appendectomy scar, rated 0 percent disabling. In addition, a total rating based on individual unemployability due to service-connected disabilities (TDIU) has been in effect from April 2007.

The Board finds that further development is required before issuance of a final decision on the SMC claim. Initially, the Veteran has indicated that she is in receipt of disability benefits from the Social Security Administration (SSA). As the possibility exists that SSA records could be relevant to the SMC claim, the case must be remanded to request and obtain this additional evidence. See Golz v. Shinseki, 590 F.3d 1317 (Fed. Cir. 2010); Murincsak v. Derwinski, 2 Vet. App. 363 (1992); see also Woods v. Gober, 14 Vet. App. 214 (2000).

Moreover, while this case is in remanded status, to ensure that the record is sufficiently current to decide the issues before the Board, the Veteran should be scheduled to undergo a VA Compensation and Pension examination addressing the matter of whether she meets the criteria for either requisite aid and attendance, or housebound status. In this regard, the Board notes that available evidence pertaining to this topic is now more than 5 years old and may not accurately or fully reflect the Veteran's current status. See e.g., Palczewski v. Nicholson, 21 Vet. App. 174, 181-82 (2007), citing Caluza v. Brown, 7 Vet. App. 498, 505-06 (1998) ("Where the record does not adequately reveal the current state of the claimant's disability . . . the fulfillment of the statutory duty to assist requires a thorough and contemporaneous medical examination.")"