ptsd Am I Eligible Or Smc (S) Now?

[nwlivewire]

First time poster and have a question about SMC (S)

I have been told both "YES!" and "NO!" as to my eligibility to apply.

Can you please help me by providing your answer? And,how you came to logically/legally arrived at your answer?

My situation is as follows:

Army PDRL discharge - APR 2012 - 70% - IDES process (VA/Army both at once)

ARMY RATED ISSUES:(ARMY USED VASRD %)

1. LOWER BACK = 40%

2. R. SHOULDER = 30%

3. NECK = 20%

40 + 30 + 20 = 70%

VA FINALIZED IDES CLAIM - JUN 2012 - RETRO TO APR 2012 = 100% P&T

VA RATED ISSUES

1. PTSD = 70%

2. BLADDER = 60%

3. LOWER BACK = 40%

4. R. SHOULDER = 30%

5. NECK = 20%

6. TINNITUS = 10%

AT THAT TIME, VA "DEFERRED" 3 ISSUES FOR FURTHER ASSESSMENT, BUT ALLOWED THIS 100% P&T RATING/ISSUES TO PROCEED

70 + 60 + 40 +30+ 20 + 10 = 100%

SEPTEMBER 2013, VA FURTHER AWARDS RATINGS FOR THREE "DEFERRED" ISSUES - AND, RETRO'S THEM BACK TO DATE OF ORIGINAL CLAIM ABOVE - APR 2012

(THESE ISSUES WERE PART OF THE ORIGINAL CLAIM, but it took the VA another 15 months to decide and then rate them)

THESE VA RATED ISSUES ARE:

1. ASTHMA = 30%

2. R. KNEE = 10%

3. L. ANKLE = 10%

********************

So am I eligible to apply for SMC (S)??????

Or any other code???

Thank-you very much for your time!

V/R,

nwlivewire

[Philip Rogers]

<<During the past 10 yrs I've added 20, 10, 10, 10 and 10 but because of the combined ratings table they continue to deny, even though once you're 100%, they can't use the ratings table, as it's similar to double jeoprody(sp)>>

This was what I was referring to, PR, when I said I disagreed with you. The 4.25 table is employed to add everything up. If you have one single schedular rating, and then start adding more, the only vehicle with which to add them is the table. Thus, assuming you have a 100% schedular and the additional ones above, I see 100% plus 48 (50)%. [20 +10 = 28 +10 = 35 + 10= 42 + 10 = 48 which rounds up to 50%]. I expect VA would deny as it's less than the additional 60% needed. I do see VA use the disparate body systems rule as the vehicle to deny frequently. That's what they do. They're rude, argumentative, adversarial and generally always get things wrong. When you get into 3.350 (or 38 USC 1114) law , there has to be a metric to measure what's needed to attain S or the bump you get from an additional 50 or 100% rating that pushes you up one notch from L to M or M 1/2 et cetera.

Winning strictly on being "substantially housebound'' often boils down to a doctor making the appropriate pronouncement on the 21-2680 much like a nexus. It may require some reasoned logic. My attempt to get it in 2009 was denied. They used the argument that some of my problems were not service connected and thus not eligible for consideration. They conveniently overlooked my C&P exam saying "must avoid sun". I expect I'll win it but to do so means never throwing in the towel. I'm glad Mrs. Spotz sees fit to carry the flag forward. I hope you do as well. Each victory, however small, sets the stage for the next Veteran.

One last note. If you do not get S when you feel entitled to it, file for it. I did. Don't ever expect VA to arrive out of breath and say "Whoa, dude. You left some money on the table. Thank goodness we figured it out. Here's the check." When I win my S, I'll come back and tell you wonderful folks all about it. I hope it doesn't take another 20 years as my 100%P&T took.

Win or Die

a

Yes, but it should be simple addition, once you're rated 100% scheduler. The ratings table is used to combine ratings based on the whole person theory vs. the disabled person residuals. Once you're 100% you have no residuals but they still use the table against you. jmo

pr

[jfrei]

On May 30, 2014 at 0:31 PM, asknod said:

Correction. You only need a TDIU rating to qualify for the 100% requirement of SMC S. This was decided long ago in Bradley and Buie. One single disability at 60% or above can be the predicate for your P&T. Once that is satisfied, you begin adding up (from scratch) the other disabilities from largest to smallest using the 4.25 table. If the disabilities are separate and not of one etiology, then you qualify if you go over 60%. Special monthly compensation (S) is not hard to comprehend. If you have separate and distinct disabilities that affect different parts of your body, and they equal or exceed an additional 60%, then you qualify-period.

 

Using what you have listed, add them like this. 70% (PTSD) +60% (bladder)= 88% + 40%(lower back) = 93% + 30%(rt. shoulder)= 95% which is now enough to equal 100% . That's 100% total, not 100% schedular. You still have 30% for asthma, 20% for neck and 10% each for tinnitus, right knee and right ankle. Begin again. 30% + 20% = 44% + 10% = 50% + 10% = 55% + 10% = 60%.

 

Now, if the etiology of the right shoulder, lower back, neck, rt. knee and left ankle is one common cause -say from a parachute accident, you'd have a problem. One single disease such as the PTSD (or the bladder), needs to be held to be a stand alone reason for unemployability or TDIU. This becomes the fulcrum for the P&T rating. Once you attain that as Mr. Buie did, the rest of the ailments are viewed as separate body issues that are unrelated to the PTSD. The bladder alone (at 60%) would qualify you for SMC S all by itself. Don't get caught up in the math of adding 8 or nine ratings up. One, and only one, disease or injury is usually the culprit (and thus the path) for unemployability. Get that if you have not already. Armed with it, the SMC is awarded based simply on your other ratings for different body systems that add up to or exceed 60%.

 

If you attain an additional 100% above the original one granting you P&T, you also will get a bump up from SMC L to SMC M when you reach the higher, more debilitating part of life in the future. The bump carries through to SMC N.

 

I see far too many Vets attempt to string together a pearl necklace of ratings to do this. Focus on the one that is going to kill you or make you unemployable and get the 100% schedular or TDIU for it. After two years, go for the P&T unless it is never going to improve. In that case, go for the P&T immediately. Once you have the P&T, with your other ailments, VA will see it and award you the SMC S. You may have to remind them to do so but most raters would spot that long list of ratings and add it up themselves. With VA, assume nothing (of course).

Best of Luck.

a

Hey Nod I was granted SMC S but they said my 100% isn't P and T? Should I just ask to reopen it, my doctors have all said its just a matter of limiting the damage of my TBI residuals but that it's 99 % permanent after 10 years later.