tdiu My Smc Math - Am I Close & Is There A "correct" Order?

[GlassRose1500]

p.s. asknod - very sorry to hear about your PCT diagnosis. Come live in Ohio - I believe our lakeside city has the fewest sunny days in the nation - or we're a close second.

[FormerMember]

It can't be worse that Seattle. We don't tan. We rust. I do a phlebotomy every month to reduce the effects. The tradeoff is pernicious anemia and danger of another myocardial infarct. I, too, wish I had my life back building homes. Helping Vets is an acceptable, rewarding second career. Ohio is too cold. The cryoglobulinemia tears me up and I can't go out in weather below 38 F. We have a net avg. of 55 year round. I'm not big on religion but I'll have a word with the Big Guy and ask him to intercede in your case. Apparently he heard me in SEA in 1970. I called him 'Howard" back then as in "Howard be thy name."

I do agree with your sentiments that I do not want anything I'm not entitled to. I'm almost finished on the CYA project for my wife. I wouldn't want to leave her to the devices of a VFW chowderhead with a POA. SMC is underawarded and misunderstood. It's a minefield of ands and ors. No two can agree on what Congress intended. English was my major.

Best of Luck.

a

[GlassRose1500]

@asknod Hmmm, yes, our temperatures would be a problem for you from October through parts of March - though not today. It's raining...

Thanks for your analysis AND your kind words - I'll let you know how it goes. It does seem to be going a little faster than it should, by rights. It was submitted on Nov 21st, picked up for review mid-December, and a few days ago it went into gathering evidence. My VBA said it's already with a DRO (he called what for him is his home office). I am not going to hope for anything less than 2 years, because that's the going duration, but when I learned that it had been picked up by human hands so quickly I panicked a bit and tried to get a grip on the SMC component. But really I think I'm better off just presenting my case. They honestly have been pretty good to me thus far.

My apologies (to all) for getting frustrated last night.

[GlassRose1500]

An update, asknod - and I hope it finds you well. I have been decidedly unwell to the point I gave up caring about all this. Some recent developments raised my curiousity, and I found enough energy to fill you in. As always, I welcome your thoughts (as well as any of the other amazingly empathetic and knowledgeable veterans on this forum).

My NOD late in 2014 included disagreement with ratings for SC Knee and Migraine conditions, and also asked that the SMC evaluation be performed, as per a bunch of regulations which I won't rehash here.

The DRO carved out SMC as a NEW claim, saying 1) it was not interwined with the other issues, and 2) since SMC had not been adjudicated, the DRO had no jurisdiction. I wrote a very compelling response with lots of case law, which my VSO and the Local VA Rep discouraged me from sending, saying that it was compelling enough it WOULD work and the new claim would be reunited with the NOD, but that that would work counter to my interests, as the NEW claim was already in preparation for decision, and my NOD and records clearly made the case (in their opinion) for A&A. The trade off was that I'd have to likely ask for a reconsideration of the effective date, and that the whole thing might get reconfigured if the DRO elected to increase the ratings for knees and migraines.

That was a few months ago. The NEW claim (SMC only) went back to gathering evidence recently, and I am scheduled for four C&Ps this month. The C&P request form from the VA to the C&P office (which they very kindly offered when I asked what the exams were for) asks for the examiner to weigh in on Depression (I've had a few incidents since the original rating, but have not asked for nor do I believe I warrant an increase for MDD, despite these events), Incontenance issues related to medications and sedentary lifestyle (wheelchair bound fm SC disabilities), Loss of use of LE & Buttocks from Spine and Knee issues, Re-eval of Spine and Knee issues for rating purposes, and A&A and Housebound related to any of the above. No exam for migraines (though this is extraordinarily well documented so maybe they'll use those records).

My VSO feels my case has been handled with incredible speed and that the questions being asked seem to imply a positive SMC outlook. If he had to guess based on medical records and what he and the local VA fellow can see, he'd say the following - I'm not even going to try to figure out what this might mean, in terms of SMC.

1. 100% SC MDD
2. 40% SC Lumbar IVDS, etc.
3. 20% SC LRE Sciatica
4. 20% SC LLE Sciatica
5. 70% SC Migraine
6. R Knee 20% (5828)+10%(5828 associated pain)+10% (5003 limitation of movement)
7. L Knee 10%+10%+10% (as above)
8. LOU Creative Organ
9. LOU LEs
10. LOU Buttocks bilateral
11. Fecal Incontenance due to SC related Sedentary and Meds
12. A&A, Housebound in Fact

Edited April 6, 2015 by GlassRose1500

[broncovet]

Maybe IM the one not getting it here, but there are TWO roads to SMC (S). One is Statuatory, the other is "housebound in fact': Statuatory Housebound is the now famous "100 plus 60" criteria. However, there is also "housebound in fact". This is the one requiring a C and P exam, where you doc states (or does not state) you are housebound.

While I realize you are referring to A and A, A and A is a step up from housebound. To get A and A (in fact) you dont need to worry about the 100 plus 60, just your docs C and P exam, assuming he says you meet the criteria for A and A.

Lay evidence (that is, you own statement) probably wont suffice. You need a doc to weigh in on whether you meet A and A criteria or not UNLESS you can qualify for "statuatory" housebound.

[GlassRose1500]

Thanks for the reply :)

I have from my PCP the form that says I require A&A and am housebound in fact. Also one of the C&P is for A&A. I would, under this scenario, qualify for statutory housebound as well. My VSO is not able to assess what the SMC results might be, in terms of how things would get bundled and stacked. I confess despite the copious reading I've done, I cannot hazard a guess either.

Edited April 6, 2015 by GlassRose1500