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Expert Advice Or Thoughts On Smc?

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Thanks for that great answer to my question, so I guess I am heading in that direction of uncertainty and by myself. Yes it just me and my wife/caregiver, she is my awesome caregiver paid by the VA for bladder care, taking this journey by ourselves with the guidance from the people on this forum.

My next question is if I have to be admitted to the VA hospital and I am rated at the R1 level, how and when does the rating get adjusted?

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Thanks, Asknod for your help explaining this SMC. To answer jefmils most recent (how and when) question, SMC is supposed to be "inferred" so no application should be necessary. However, I do not reccommend you count on the VA going through your records and saying, "Gee, we better increase this Vet's SMC as it looks like he deserves a higher level". You may wait a long long time for that to happen. Instead, if you think you are eligible for a higher level of SMC, send in a request for increase, and it may not hurt to use the new "intent to file". Your effective date of the increase, if VA does award a higher level of SMC, would still likely be the later of the date you file or the date the doc said you had the increase. If in doubt, apply.

It sounds like you are likely eligible for "Aid and attendance", if you are not already getting that. Someone can chime in, but I think there are 2

"Aid and attendance's"

1. An additional rate of SMC paid to you, above and beyond "housebound".

2. I think you can, in some circumstances, get VA to pay your provider of A and A for you. And, I think this can even be a relative who cares for you, since you may well need assistance with the "wants of nature" at hours when your A and A caregiver has gone home. I seem to recall the later A and A is ONLY for Iraq era Vets, somehow Vietnam Vets dont get this one.

The "How", is you file an intent to file.

The "When" (for you) is whenever you think an increase is warranted.

The "When" (for VA) is whenever they get around to it, and, if you dont like the effective date, appeal it.

The VA likely wants to break Vets claims into "pieces", since this allows them to delay you more.

For example, you get denied service connection, so you appeal. The BVA awards, and the RO implements this at 0%.

Next, you appeal the percentage. So, BVA says you get a higher percentage, and you get awarded benefits. However, the VA decides to save money and award them with an effective date 5 years after you applied. So, you appeal the effective date.

See how they delay you? That is 3 appeals where one should do. But you are not done yet. Now you can jump on the SMC hamster wheel AGAIN, pretty much like the above, so they can ring you around the rosie for 3 times there, also.

With an average BVA appeal taking about 4 years, this means the VA can hold off paying you for 4 years times 6 appeals or 24 years. Asknods took about 20 years, but he is not done yet, I dont think. Mine has taken a "mere" 13 years, so I am still a newbie, and can look forward to another 8 years or more of appeals.

I would like to see VA executives paid on the "Veterans benefit" time frame, and see how they like that. If there pay is short 100 bucks, then they will expect that to be corrected in 2 weeks for next payday...all while making Vets wait 20 years for their money.

Edited by broncovet
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According to the thread, he's already at M with a bump up from SMC L from the 3.350 F (4) which was already Aid and Attendance, Mr. L. I think he needs to be looking at R1 and that is whole different ballgame. VA defends that like Seattle in the red zone on 4th and goal.

You could throw SMC O against the wall to see if it stuck:

(2) Paraplegia. Paralysis of both lower extremities together with loss of anal and bladder sphincter control will entitle to the maximum rate under 38 U.S.C. 1114(o), through the combination of loss of use of both legs and helplessness. The requirement of loss of anal and bladder sphincter control is met even though incontinence has been overcome under a strict regimen of rehabilitation of bowel and bladder training and other auxiliary measures.

One thing most do not understand is that R1 is given if you qualify but do not use a "licensed" caregiver. R2 is paid for a licensed one if required. and boy howdy will VA weigh in on the need for a licensed one to keep you out.

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Yes, Im sure you are correct about the A and A, but are there not "2" A and A's? The first one you mentioned, gets paid to the Vet, and the second one to the caregiver, which, I understand can be paid to a family member.

The second A and A, is probably done by VA to save money. Think about it. You have a caregiver come in for 8 hours a day, 5 days a week (most often less than that) to do things like change bandages, sometimes bathing, etc, if/when assistance is required. Well what about the rest of the time?

Often a family member needs to be there to help 24/7, sometimes to feed, sometimes to help them walk (to prevent falling) etc. I think this may be the second A and A, often paid to a family member, not to the Vet. I seem to recall some legislation on this, but it seems like this is ONLY for Iraq era Vets and not Vietnam Vets. That is kinda crazy as the older Nam Vets are probably more likely to need A and A rather than younger, often healthier, Iraq Vets.

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"That is kinda crazy as the older Nam Vets are probably more likely to need A and A rather than younger, often healthier, Iraq Vets."

Precisely so! That's why the benefit is limited. Cost, don't you know!

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SMC S is "Aid and Attendance 1". Aid and Attendance 2 is SMC L. R1 and R2 are another set of metrics for those in the SMC O and P bracket. SMC "T" is the $2900 a month caregiver stipend for an unlicensed caregiver of a post 9/11/2001 Vet. Animal Farm for Vets. Some pigs are more equal than other pigs.

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