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Aid & Attendence


Bound4heaven

Question

Greetings to all.

I continue to work with a veteran whom is also 100% for both feet and over 160% on many other issues. He submitted along with a2 appeals a claim for Aid & Attendence. His VA doctor wrote him a letter stating the VA regs verbatium and that this veteran meets the qulaifacations for Aid & Attendence benefit. This veteran also receives a clothing allowence as well. This letter was submitted to the RO as "Objective Edivence"

We took him to his C&P exam in mid August of 2006 for 3 issues and one being the A&A, and we got back the results. He cannot walk without a cane. He can urniate by himself, but cannot wipe fical matter by himself. He is limited to about a block. His sister takes care of him and she also wrote a letter on his behalf and what cares he requires. He only has one good arm, but that is limited to pain from a secondary SCD.

The C&P examiner's results were as follows:

The patients functional capabilities are affected by the service connected conditions as well and the neurological findings. The neurolological syndrome contributes to his functional impairment. The patient has limited use of his right shoulder, however with his left shoulder he was able to do such activities as he helped remove his left orthosis (This is not true My wife took them off, and I sent the RO a letter saying as such) he appears to have adequate function in the left shoulder for him to help do his own cares. This doesnt include the upper extreminity weakness and sensory loss.

Mobility:

The patient was able to come to a stand independently in the clinic. (This is also untrue. He used his cane and I grabed his left arm to help him up. I also sent this issue to the ro) He uses the cane to assist in ambulation. He should be able to walk around his house. Home modifications are being done to allow him to use a downstaires room. He should be able to live independently within that space. He is able to go up the staires to his current bedroom once a day. These functional capabilities don't include any loss of neurological function (what did that last statement mean?)

This Dr Dignosed him at this C&P exam with

1) Myofascial strain of both shoulders

2) Myofascial strain of the back. There is moderate decreased disc height at l5/s1

3) Central neurological syndrome

This vet is currently rated at

100% Loss of both feet

40% Lumbar

40% Right shoulder conditions

30% Myofacial strain in the upper extrimity of upper back

20% Median impengement

50% Varocose Veins

10% Right finger

10% Tennentis

He takes over 20 meds a day.

This C&P Dr said that he couldn't even get a ROM on his lower back due to thye severity of his feet and his inability to bend. This Dr. is way out there. Any thoughts? Thank you and God bless you all.

Bound4Heaven

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Boundforheaven, if he has a Loss of use both feet he should already receive an "L" award. I would get a IMO from another neurologist. This Myofacial pain is a bul---- diagnosis they give to screw you out of what you are entitled. Its similar to the Fibromyalgia. Have you already applied for adapted housing? Submit your doctors statement that he needs assistance with his ADL's

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Greetings,

Thank you for all who responded. He is in the process of adding an addition to his home. He is getting a grant from the VA to pay for it.

His primary doctor wote that he needed protection from harm in his letter to the VARO on his behalf this is vertabitium from the letter.

"I have been asked to send this letter on behalf of the veteran (His name) detailing the aid and attendence requirements provided him by his sister. He requires the aid of another person in order to perform personal functions required in everyday living. These functions include bathing, dressing, attending to the wants of nature, adjusting and applying prosthetic devices (He wears braces at night) , and protecting him from the hazards of his daily environment."

Thats from his personal VA doctor. Ths quack C&P examinier who is a MD made it seem he could do some of his cares by himself in reality he cannot.

I believe his primary VA doctor's opinion and letters from his sister and all progress notes from his med file more then back up the A&A award. In reality the VARO is to take the case in whole in light of all edivence.

What are your opinions on this.

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Boundforheaven- I would think this certainly satisfies the Benefit of Doubt criteria and they should award the A & A.

The letter is from a primary care physician and the letters from his sister should help too.

Maybe I missed something- you are requesting A & A- would it not be better to ask for Special Monthly Comp

and as Dorothy said- the SMC "L" award?

I think this is the higher monetary benefit-but then again- question to all- can a veteran receive a SMC level and also A & A award?

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Greetings,

Thank you Dorothy and Berta for your responses. You both raise good questions in regards to SMC or AA. It was my advice back in May of 2006 for him to request A&A. I knew his sister is his caregiver and does so much for him, so I thought that due to his SC disabilites he should apply. I myself recieve SMC with A&A for my wife. I am unclear on how to proceed in regards to SMC vs A&A. Can you both please help me understand the difference. Thank you and God bless.

Bound4Heaven

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Dorothy sure knows her stuff on this situation!

I am surprised they have not considered him yet for SMC. And you have clarified that avet can receive both.

SMC can be confusing. It is best to read over the levels- as to what Dorothy stated and see how his medical evidence can be shaped to support the highest possible level.

This is the whole shibang-

http://ecfr.gpoaccess.gov/cgi/t/text/text-....1.1.4.2.65.142

This is a claim involing additional retro due to EED for R-1 award -the only one for 2006 at the BVA.

http://www.va.gov/vetapp06/files3/0611685.txt

This claim contains something I have never seen before:

"In addition, we observe that the veteran's PVA

representative, who advocated on the veteran's behalf at the

hearing before the Board, is an expert in the subject matter

pertaining to SMC, as exemplified in the Informal Brief filed

with the Board in July 2005"

"ORDER

An effective date of May 8, 1997, for the grant of special

monthly compensation under 38 U.S.C.A. § 1114®(1) and 38

C.F.R. § 3.350(h), is granted, subject to the laws and

regulations pertaining to the award of monetary benefits"

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