Expert Advice Or Thoughts On Smc?

[jefmil50]

I was trying to figure out what the results of my latest request for increase is? If I already have 100% for LOU of lower extremities bilaterally and LOU of upper right extremity rated {70%} then if another disability gives me 100%, where does all that put me?

So these are my contentions, VBMS (New), left upper extremity weakness due to MS (New), neurogenic bladder with urinary urgency due to multiple sclerosis (also claimed as suprapubic catheter) (Increase), diplopia (Increase). The 100% I stated as another is for the suprapubic catheter which was put in me in July last year after several bouts with uti's and a couple of hospitalizations for the same problem.

Under diagnostic code 7516 Bladder,fistula of: Rate as voiding dysfunction or urinary tract infection, whichever is predominant. Postoperative, suprapubic cystotomy.

So unfortunately this is where I am at in the progression of this disease but I hate to say it "it is what it is". Just wondering where I go to next SMC R1 or "O", I am at SMC M + K now any thoughts?

[Berta]

what SMC rate do you get now?

Have you accessed similar cases at the BVA web site?

[jefmil50]

I am rated at M + k Berta. I have browsed the BVA site a little but have not worded my search correctly to come up with the right results.

[Berta]

Asknod, our member here, is the SMC GURU:

https://asknod.wordpress.com/2013/02/27/special-monthly-compensation-what-is-it/

And has a great explanation of attaining those higher levels here in the SMC forum.

[jefmil50]

Thanks Berta, I have had a discussion from Asknod last year about this smc and his Mr. potato head is awesome but I think he will have to pick this particular scenario differently. I say that because I understand the loss of use of arms and legs but how does loss of use of bladder come into the picture and get added to the smc?

[FormerMember]

LOU of bladder falls into

(h) Special aid and attendance benefit; 38 U.S.C. 1114®—

(1) Maximum compensation cases. A veteran receiving the maximum rate under 38 U.S.C. 1114 (o) or (p) who is in need of regular aid and attendance or a higher level of care is entitled to an additional allowance during periods he or she is not hospitalized at United States Government expense. (See § 3.552(b)(2) as to continuance following admission for hospitalization.) Determination of this need is subject to the criteria of § 3.352. The regular or higher level aid and attendance allowance is payable whether or not the need for regular aid and attendance or a higher level of care was a partial basis for entitlement to the maximum rate under 38 U.S.C. 1114 (o) or (p), or was based on an independent factual determination.

3.352(a) inability to attend to the wants of nature;

The three extremities rule:

(5) Three extremities. Anatomical loss or loss of use, or a combination of anatomical loss and loss of use, of three extremities shall entitle a veteran to the next higher rate without regard to whether that rate is a statutory rate or an intermediate rate. The maximum monthly payment under this provision may not exceed the amount stated in 38 U.S.C. 1114(p).

Technically, there is no stricture of piling 3.350(f) (5) on top of 3.350 (f) (3 or 4) . VA might plead differently but few of us ever get this disabled and try to test the rule. In the past we've always had VSO minders who dissuaded us from even thinking about attempting this.

I'm even working with a gal who's husband is in the TBA zone after the VA weenies dumped him on the floor in the VAMC. She's going to try to put a can opener into SMC T even though he is pre-9/11/2001. Any statute/reg. that is legally at odds with others sets off a wave of disparity in the administration of benefits. SMC is so unique, I doubt anyone has ever examined all the possible permutations or combinations that can present. As such, each is a unique matter of first impression. We pretty much know what VA's take will be but that's immaterial. It's what the Fed. Circus or SCOTUS' take is.