R1 to R2

[jefmil50]

Now that I am rated at R1, my wife asked me the other day how do you get to the R2 SMC rating? That question I would like to know also. My wife does give me bowel and bladder care regularly due to my MS, and she is paid by the VA monthly for that. Thanks for any help.

Edited January 30, 2016 by jefmil50 (see edit history)

[jamescripps2]

To get to R-2 you would need to show that you need care on a daily basis and that care would require and be  preformed by a licensed health care professional.

[broncovet]

James said it well, but I will add:

 

Category R2: For this category, the person helping the veteran must be a licensed medical professional or someone working on behalf of a licensed medical professional. In addition, the VA must judge that the veteran would have to be hospitalized, put in a nursing home, or otherwise institutionalized if he did not have this professional-level care at home.

I think the VA wants to grant R2 only when it saves them money putting you into the hospital.  In other words, when in home care is cheaper than the hospital.    

You see, even in the hospital or nursing home, the doctor or nurse does not do everything.  Much of this care is done by nurses aids or sometimes even "candy stripper" volunteers.  

One example of this is feeding.  If you can not move your hands well enough to eat, someone needs to feed you and that someone need not be a doc or a nurse.  But the person doing the feeding is being super vised by the doc or nurse, even tho the doc is nowhere around.  

Edited December 16, 2016 by broncovet (see edit history)

[jefmil50]

Thank you jamescripps2 and broncovet for that information, was kind of what I thought.

[FormerMember]

You will lose R2 if you go into a hospital as you receive care "in kind". To avoid that, it is suggested you get to the high ground of "permanently bedridden" if you end up in the ER or the hospital frequently. I've gotten several Vets R1 and R2 and it requires a few things most do not suffer.

[jamescripps2]

Your wife has chapter 35 benefits. If she uses the educational benefit to go and take a course to become a licensed Certified Nursing Assistant, (CNA) or a licensed LPN, paid for by the chapter 35 benefit she could then become your licensed health care professional. You could then qualify for the R-2 @ about a thousand more bucks per month. This would for sure work for a pre 911 vet already drawing at the R-1 rate. If you are post 911, I don't know if there might be a glitch or offset if she is already getting paid to be your caregiver.

[FormerMember]

Not true, sir. Please read 38 CFR §3.352(b)(3),(4). You do not have to be a licensed caregiver. You merely have to be under the supervision of one. That's a major difference. Of course, nothing prevents you from using Chapter 35 benefits to be a bedpan guru but I would think a spouse would benefit more by getting a four-year bachelor's degree rather than a one-year course in changing incontinence pads and learning how to perform light physical therapy work. 

Please remember to give out accurate information on the site. If you aren't sure, it's best to ask someone rather than make an all-inclusive pronouncement that confuses or misinforms others as to entitlement. Remember, many many Vets read these comments and depend on them for accuracy.

As for R2, the monthly entitlement is $8,506.47 (married). R1 is $7,436.95.