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Smc S Eligible?

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OSC

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I realize there are quite a few threads going on about SMC and I didn't want to hijack any of them with my question...Which is pretty simple (LOL) Am I eligible for SMC based upon my last VA award???

60 Nephropathy w/Hypertension

60 PN Upper Left

40 PN Lower Left

40 PN Lower Right

30 IHD

20 DMII

20 PAD Lower Left

20 PAD Lower Right

10 PN Upper Right

10 Scar L/R Carotid

10 Scar Abdomen

0 Hypertension

0 Surg Rt Ring Finger

100% P&T plus SMC (K-1)

OSC

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I'm not seeing a 100% or TDIU rating. Which exact disease is the P&T based on? Remember, 100% is not the same as TDIU. They pay the same but there is a vast difference in what is protected versus a future rerating. Tell us which disease is the predicate for your Permanent and Total so we can add the balance/type of diseases and injuries to determine SMC-S eligibility. Many forget you cannot add up like disease processes (all those PNs for 60, 40, 40 and 10) if they are related to the DM2.

If you are doing insulin and the doctor has regulated your activities, you should be able to lasso in DM2 for 40%. FYI.

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According to this, you have to have a "single" 100 percent, in order to qualify for Statuatory SMC S (Housebound):

The Housebound benefit is payable under 38 U.S.C. 1114(s) (38 CFR 3.350(i)) to a veteran who has a single, SC disability rated as totally disabling, and

· has an additional SC disability, or combination of disabilities, independently ratable as 60 percent or more disabling, or

· is permanently housebound due to SC disability.

If the veteran is entitled to Housebound benefits by statute (without demonstrating need, under 38 U.S.C. 1114(s)), the additional disability(ies), rated 60 percent or more disabling, must

· be separate and distinct from the single disability, rated totally disabling, and

· involve separate anatomical segments or body systems.

Notes:

· The principles regarding avoidance of pyramiding contained in 38 CFR 4.14 are applicable.

· Within these limits, the fact that the single disability, rated totally disabling, and additional disabilility(ies), independently ratable as 60 percent or more disabling, share a common etiology, does not preclude entitlement.

· Ratings of 100 percent under 38 CFR 4.28, 38 CFR 4.29, and 38 CFR 4.30 of the rating schedule may be used as a basis for entitlement.

· Per Bradley v. Peake, 22 Vet. App. 280 (2008), an individual unemployability rating that is based on a single disability also satisfies the requirement for a total rating under 38 U.S.C. 1114(s).

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I'm not seeing a 100% or TDIU rating. Which exact disease is the P&T based on? Remember, 100% is not the same as TDIU. They pay the same but there is a vast difference in what is protected versus a future rerating. Tell us which disease is the predicate for your Permanent and Total so we can add the balance/type of diseases and injuries to determine SMC-S eligibility. Many forget you cannot add up like disease processes (all those PNs for 60, 40, 40 and 10) if they are related to the DM2.

If you are doing insulin and the doctor has regulated your activities, you should be able to lasso in DM2 for 40%. FYI.

I went over my letter again looking for something that would state what disease they are using for my P&T, but nowhere does it state a specific disease. It also appears that I am one of those who forgets about adding up like processes as all of those PNs are DMII related.

Appreciate you looking at my numbers...I will leave everything alone....I don't want to take the chance of a lowering (I have had one lowering already) of any of my percentages.

Thanks everyone.

OSC

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I agree with you bud, The VA has been messing with me the last few months, since I decided to file for a new FDC, which all was granted, but still got the old merry go round of crap from the VA. Just take it for what it is. Good luck

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I realize there are quite a few threads going on about SMC and I didn't want to hijack any of them with my question...Which is pretty simple (LOL) Am I eligible for SMC based upon my last VA award???

60 Nephropathy w/Hypertension

60 PN Upper Left

40 PN Lower Left

40 PN Lower Right

30 IHD

20 DMII

20 PAD Lower Left

20 PAD Lower Right

10 PN Upper Right

10 Scar L/R Carotid

10 Scar Abdomen

0 Hypertension

0 Surg Rt Ring Finger

100% P&T plus SMC (K-1)

OSC

The 30% IHD, 20% DMII, and 0% Hypertension ratings may be lower than appropriate.

For IHD, METS may not tell the full story. LVEF tests may show a lower result. DMII is often low balled. The VA seems to insist that all the requirements for the next level be met, even though

the law/regs say the majority. 0% Hypertension may get into a with and without medication issue. The VA generally wants to use the with medication values, (because they are lower) and the rest of the medical profession prefers the without meds readings to determine the actual severity.

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