ptsd Smc (T) For Tbi

[SupermanCannedy]

Oh, Ok~? I thought this thread was about SMC t for TBI? I'm a newbie. Thank you for the link. I'll hop over it!

[SupermanCannedy]

Berta,

....The link you gave brought me right back to the forum I originally posted on (SMC t for TBI)

Maybe there is a more current thread? I'll search for others.

Perry

[jfrei]

Hey Crazyhorse I'm on the same boat currently 100 IU PT and jwas at an increase for  my TBI and PTSD and an intial for a chronic adjustment disorder have copies of all my C&Ps so now it's the waiting game 

Edited September 6, 2017 by jfrei

[jfrei]

On 12/25/2014 at 12:51 PM, asknod said:

If you read that FAST letter, you see one flaw that may queer the deal. It says you must qualify for SMC "L" to be eligible for SMC "T" which is basically R2 with a new name. You list your disabilities but fail to mention loss of or loss of use of an extremity.

 

General rating and development rules apply to claims for SMC (T). In addition, before considering entitlement to SMC at the (T) rate, Rating Veterans Service Representatives(RVSRs) and Decision Review Officers (DROs) must establish entitlement to A&A benefits at the (L) rate. Procedures governing award of SMC (L) for A&A are outlined in the Adjudication Procedures Manual M21-1MR Part IV, Subpart ii, Chapter 2, Topic H, Block 44.

 

§ 3.350

 

(b) Ratings under 38 U.S.C. 1114(l). The special monthly compensation provided by 38 U.S.C. 1114(l) is payable for anatomical loss or loss of use of both feet, one hand and one foot, blindness in both eyes with visual acuity of 5/200 or less or being permanently bedridden or so helpless as to be in need of regular aid and attendance.

(1) Extremities. The criteria for loss and loss of use of an extremity contained in paragraph (a)(2) of this section are applicable.

(2) Eyes, bilateral. 5/200 visual acuity or less bilaterally qualifies for entitlement under 38 U.S.C. 1114(l). However, evaluation of 5/200 based on acuity in excess of that degree but less than 10/200 (§ 4.83 of this chapter), does not qualify. Concentric contraction of the field of vision beyond 5 degrees in both eyes is the equivalent of 5/200 visual acuity.

(3) Need for aid and attendance. The criteria for determining that a veteran is so helpless as to be in need of regular aid and attendance are contained in §3.352(a).

(4) Permanently bedridden. The criteria for rating are contained in § 3.352(a). Where possible, determinations should be on the basis of permanently bedridden rather than for need of aid and attendance (except where 38 U.S.C. 1114® is involved) to avoid reduction during hospitalization where aid and attendance is provided in kind.

 

 

Here is the definition under (a)(2) for hand foot loss:

(2) Foot and hand.

(i) Loss of use of a hand or a foot will be held to exist when no effective function remains other than that which would be equally well served by an amputation stump at the site of election below elbow or knee with use of a suitable prosthetic appliance. The determination will be made on the basis of the actual remaining function, whether the acts of grasping, manipulation, etc., in the case of the hand, or of balance, propulsion, etc., in the case of the foot, could be accomplished equally well by an amputation stump with prosthesis; for example:

(a) Extremely unfavorable complete ankylosis of the knee, or complete ankylosis of two major joints of an extremity, or shortening of the lower extremity of 31/2 inches or more, will constitute loss of use of the hand or foot involved.

(b) Complete paralysis of the external popliteal nerve (common peroneal) and consequent foot drop, accompanied by characteristic organic changes including trophic and circulatory disturbances and other concomitants confirmatory of complete paralysis of this nerve, will be taken as loss of use of the foot.

 

My guys have run into this at the Seattle RO. Raters there use their bellies for a porthole which tells us where their head is located:

 

It is not a formal requirement that the veteran be rated 100% for his or her service-connected TBI. The statute and regulation relating to regular A&A (SMC(l)) do not mention a 100% schedular requirement . The VA Adjudication Procedures Manual Rewrite (M21-1MR) states:

A single disability rated 100 percent under a schedular evaluation is generally a prerequisite to a determination of need for regular A&A. Any lesser disability would be incompatible with the requirements of 38 C.F.R. § 3.352(a).

 

VA is big on promising us all manner of largesse. When it comes time to cut the check, we find the Thursday rule in small print that says it only applies if you were born on a Thursday and can prove it. SMC T is being rationed out very sparsely. So far, it has been rough for the ones I helped. They are missing one of the ingredients or don't make the 100% schedular test. All three I did are on appeal to DC. One was a DRO review and he basically reiterated the "Sorry. You have all your hands and feet. Missed it by that much."

 

You also mention needing the A&A about two days a week. VA will eviscerate you on that alone if you do not require it on a daily basis as described in § 3.352(b)(5):

(5) The provisions of paragraph (b) of this section are to be strictly construed. The higher level aid-and-attendance allowance is to be granted only when the veteran's need is clearly established and the amount of services required by the veteran on a daily basis is substantial.

 

Merry Christmas

Thanks just found this in my research for For my next latter step on the SMC scale. I have a current claim open for an increase they are looking to see if I qualify which I do in fact I qualify for T if I’m granted to L first. I hope I make it that long hate how unpredictable sTBI could show up out of nowhere “like my migraines which have been increased to 50% but still awaiting the Botox for any relief will be better then sticking my head in a vice and squeezing...

[Buck52]

lOOK AT CFR 38 4.16 That rates the TBI  VET. CORRECTION HERE IS WHAT I MEANT

⦁  '' Important: ''
⦁  ''  The single disability rated as totally disabling must be the sole or partial cause of the need for A&A. ''
''38 CFR 4.16 applies only to IU determinations.  It does not permit decision makers to apply ⦁    38 CFR 4.16 guidelines on what constitutes a single disability to A&A determinations.''
⦁  ''  To establish entitlement to SMC at the (t) rate, the need for A&A must be due to traumatic brain injury (TBI) or multiple disabilities due to TBI that combine to a 100-percent evaluation.''
 

For A&A.  If you get the A&A   and they find other condition that the TBI is related to or caused by  you may go on up to SMC (t)   

Remember  TBI VETS are Rated differently than the general vet with other type disability's and what they were caused by...

TBI Veterans have special regulations and criteria to meet..so you can't compare the general rating disbilitys to the CFR'S  As the same you would with veterans with non TBI.

Edited August 21, 2018 by Buck52

[jfrei]

But I would still need to get a. 21-2680 filled out ahead by my doctors instead of Waiting. The two months their telling me I should know an answer by which means their are just going to schedule me for another exam in two months and then wait another few months for their decision. The dog and pony show is easy to see when you call them on their Bullshit, or I’ll just walk into the RO ask what their looking for request a VES exam and get it done. I’m fed up with the VA delays the woman on the Whitehouse line was like I have vets waiting decades for what you’ve gotten do you want me to send in an inquiry asking why are you finally Getting around to what i request in April of last year, I politely said I’ll get back to you and hung up....