Smc (T) For Tbi

[crazyhorse3022]

Jus curious if vets are aware of the new smc t rating for tbi n residuals. It seems like some arent. I just learned about it. I'm awaiting a decision by the va. I've read requirements for t rating. Seem justifiable but I know the va doesn't want to pay vets at that rate. It's 7900 a month. Funny my psychiatrist from the va told me the va doesn't want to pay the t rate. Amazing. I've seen him.for 7 yrs. He's a decent dude tho. He did my 21-2680.

[SupermanCannedy]

How is your SMC-T Nod going, Crazyhorse 3022?

I had my VA neurologist write up the 21-2680. He made it very clear that without regular in home care I would need to be placed in a care facility. Still, the board came back with a denial. It was based on the physical needs and professional nursing care requirements for r2. Of course, I don't have any of the physical problems or needs for a nurse...if I did, I would have filed for that! Now, we are trying to figure out how to do the appeal correctly. 

[jfrei]

I don’t even know what a 21-2680 is? I know what it is but where or how do you get your primary doctor to even look at this. He filled out SSA paperwork for me so I’m sure this wouldn’t be an issue if I only have to just ask...

Edited October 27, 2017 by jfrei

[SupermanCannedy]

Hi Jfrei, 

A 21-2680 is the exam form the specialist fills out to show that you are housebound and have a need for regular Aid & attendance. A person can be housebound due to their mental/cognitive disabilities because of memory problems, the need for supervision in activities, etc. The form really needs to be rewritten to better assess need for those with TBI. It reads as if it is mostly assessing people with physical disabilities. 

You can download it here and make a copy: https://www.vba.va.gov/pubs/forms/VBA-21-2680-ARE.pdf

My advice is:

1. Read it before handing it to a doctor, so that you aren't baffled by some of the questions. For example, of one of the questions is, "Can the veteran feed him/herself"? You may assume they mean put a fork full of food into your mouth and mark that as a yes. However, there is more to feeding than that last step. Do you remember to eat meals or do you need to be prompted? Can you Plan your meals or shop for food on your own? Are you able to prepare a meal or cook? Do you accidently eat food that has gone bad?....Think about how your memory loss, confusion, disorientation with time, and inability to stay focused or make and follow a list effects your ability to feed yourself. Consider that with each question.

2. Set up an appointment with your neurologist to have this exam. If not your neuro, then your psychologist or neuropsych or whichever specialist you feel you have the best rapport/understands you the most. NOT your primary care doc. 

3. Ideally, have them write a letter backing up what they said on the form because the form sucks...I mean it doesn't allow much room for explanation. The letter will support that the dr feels you need an increase in A&A because _______- and they can address your cognitive decline, memory loss, confusion, headaches that are debilitating and any physical pain on top of it all. 

4. You deliver the form to the dr yourself and when they are done (which may not be at the same appointment), tell them you will pick it up. This should not be a problem for the dr. You then take it from the dr to your VSO or whomever is helping with you claim. 

5. If you cannot get a dr to cooperate with you in filling this form out, you can have a civilian neurologist do it. Use your Medicare (if you have SSDI, then you have are eligible for Medicare). 

6. Seriously consider getting someone else to help you set this up with the dr and to help you submit your claim. It is a lot for a person with such severe TBI to take on alone. If you have been getting assistance from a VSO, find a new one because you need someone more willing and able to help you with this and your other claims.

Best of luck to you!!!  

[jfrei]

Sadly I have no VSO or attorney anymore I had an attorney for years but once he got his cut and found no more money coming in for him he decided to let me go. Maybe Ill email him ask him about the SMC L to get it backdated to May when they increased my TBI. But if he says no I have to google where to get a VSO at the RO.

[jfrei]

On 10/29/2017 at 4:24 AM, SupermanCannedy said:

Hi Jfrei, 

A 21-2680 is the exam form the specialist fills out to show that you are housebound and have a need for regular Aid & attendance. A person can be housebound due to their mental/cognitive disabilities because of memory problems, the need for supervision in activities, etc. The form really needs to be rewritten to better assess need for those with TBI. It reads as if it is mostly assessing people with physical disabilities. 

You can download it here and make a copy: https://www.vba.va.gov/pubs/forms/VBA-21-2680-ARE.pdf

My advice is:

1. Read it before handing it to a doctor, so that you aren't baffled by some of the questions. For example, of one of the questions is, "Can the veteran feed him/herself"? You may assume they mean put a fork full of food into your mouth and mark that as a yes. However, there is more to feeding than that last step. Do you remember to eat meals or do you need to be prompted? Can you Plan your meals or shop for food on your own? Are you able to prepare a meal or cook? Do you accidently eat food that has gone bad?....Think about how your memory loss, confusion, disorientation with time, and inability to stay focused or make and follow a list effects your ability to feed yourself. Consider that with each question.

2. Set up an appointment with your neurologist to have this exam. If not your neuro, then your psychologist or neuropsych or whichever specialist you feel you have the best rapport/understands you the most. NOT your primary care doc. 

3. Ideally, have them write a letter backing up what they said on the form because the form sucks...I mean it doesn't allow much room for explanation. The letter will support that the dr feels you need an increase in A&A because _______- and they can address your cognitive decline, memory loss, confusion, headaches that are debilitating and any physical pain on top of it all. 

4. You deliver the form to the dr yourself and when they are done (which may not be at the same appointment), tell them you will pick it up. This should not be a problem for the dr. You then take it from the dr to your VSO or whomever is helping with you claim. 

5. If you cannot get a dr to cooperate with you in filling this form out, you can have a civilian neurologist do it. Use your Medicare (if you have SSDI, then you have are eligible for Medicare). 

6. Seriously consider getting someone else to help you set this up with the dr and to help you submit your claim. It is a lot for a person with such severe TBI to take on alone. If you have been getting assistance from a VSO, find a new one because you need someone more willing and able to help you with this and your other claims.

Best of luck to you!!!  

I just read this in detail and now I’m searching for a Doc? Should I ask my Psychiatrist my neurologist has retired 2 months ago i am waiting for a new one since June....