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SMC Aid and Attendance and Mental Health issues


Jay

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  • HadIt.com Elder

I would say you can get A&A if you have the evidence Dr's Medical rational to state you need A&A because of your S.C PTSD rated at 100%

if not I'm not sure if they will infer you A&A at 70%?...but with the correct medical evidence and what Dr's and Psychiatrist  opine about your condition is what is important, you could go from increase to 100%plus if you meet the criteria For A&A  then SMC-S will be met and they have to infer it then.

The standard criteria for SMC is that you meet the criteria and usually that means you do have  100% Rating and another rating of 60% or more to qualify.

Broncovet is correct with his information to you.

 

.............Buck

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  • Moderator

There is no difference between physical or mental issues when it comes to aid and attendance.  

100% for depression/PTSD is the same pay as 100% if you got two legs blown off.  

It also does not matter for A and A.  You meet the criteria or you dont.  It all boils down to evidence.  

You need to have a doctor state that you need A and A for SC issues.  It does not matter if its physical or mental.  

We dont know what your doctor said.  If you want to post what he said, we may venture a guess. Or, you can read the criteria and find out for yourself:

3.352 Criteria for determining need for aid and attendance and “permanently bedridden.”

(a) Basic criteria for regular aid and attendance and permanently bedridden. The following will be accorded consideration in determining the need for regular aid and attendance (§ 3.351(c)(3): inability of claimant to dress or undress himself (herself), or to keep himself (herself) ordinarily clean and presentable; frequent need of adjustment of any special prosthetic or orthopedic appliances which by reason of the particular disability cannot be done without aid (this will not include the adjustment of appliances which normal persons would be unable to adjust without aid, such as supports, belts, lacing at the back, etc.); inability of claimant to feed himself (herself) through loss of coordination of upper extremities or through extreme weakness; inability to attend to the wants of nature; or incapacity, physical or mental, which requires care or assistance on a regular basis to protect the claimant from hazards or dangers incident to his or her daily environment. “Bedridden” will be a proper basis for the determination. For the purpose of this paragraph “bedridden” will be that condition which, through its essential character, actually requires that the claimant remain in bed. The fact that claimant has voluntarily taken to bed or that a physician has prescribed rest in bed for the greater or lesser part of the day to promote convalescence or cure will not suffice. It is not required that all of the disabling conditions enumerated in this paragraph be found to exist before a favorable rating may be made. The particular personal functions which the veteran is unable to perform should be considered in connection with his or her condition as a whole. It is only necessary that the evidence establish that the veteran is so helpless as to need regular aid and attendance, not that there be a constant need. Determinations that the veteran is so helpless, as to be in need of regular aid and attendance will not be based solely upon an opinion that the claimant's condition is such as would require him or her to be in bed. They must be based on the actual requirement of personal assistance from others.
(b) Basic criteria for the higher level aid and attendance allowance.
(1) A veteran is entitled to the higher level aid and attendance allowance authorized by § 3.350(h) in lieu of the regular aid and attendance allowance when all of the following conditions are met:
(i) The veteran is entitled to the compensation authorized under 38 U.S.C. 1114(o), or the maximum rate of compensation authorized under 38 U.S.C. 1114(p).
(ii) The veteran meets the requirements for entitlement to the regular aid and attendance allowance in paragraph (a) of this section.
(iii) The veteran needs a “higher level of care” (as defined in paragraph (b)(2) of this section) than is required to establish entitlement to the regular aid and attendance allowance, and in the absence of the provision of such higher level of care the veteran would require hospitalization, nursing home care, or other residential institutional care.
(2) Need for a higher level of care shall be considered to be need for personal health-care services provided on a daily basis in the veteran's home by a person who is licensed to provide such services or who provides such services under the regular supervision of a licensed health-care professional. Personal health-care services include (but are not limited to) such services as physical therapy, administration of injections, placement of indwelling catheters, and the changing of sterile dressings, or like functions which require professional health-care training or the regular supervision of a trained health-care professional to perform. A licensed health-care professional includes (but is not limited to) a doctor of medicine or osteopathy, a registered nurse, a licensed practical nurse, or a physical therapist licensed to practice by a State or political subdivision thereof.
(3) The term “under the regular supervision of a licensed health-care professional”, as used in paragraph (b)(2) of this section, means that an unlicensed person performing personal health-care services is following a regimen of personal health-care services prescribed by a health-care professional, and that the health-care professional consults with the unlicensed person providing the health-care services at least once each month to monitor the prescribed regimen. The consultation need not be in person; a telephone call will suffice.
(4) A person performing personal health-care services who is a relative or other member of the veteran's household is not exempted from the requirement that he or she be a licensed health-care professional or be providing such care under the regular supervision of a licensed health-care professional.
(5) The provisions of paragraph (b) of this section are to be strictly construed. The higher level aid-and-attendance allowance is to be granted only when the veteran's need is clearly established and the amount of services required by the veteran on a daily basis is substantial.
(Authority: 38 U.S.C. 501, 1114(r)(2))
(c) Attendance by relative. The performance of the necessary aid and attendance service by a relative of the beneficiary or other member of his or her household will not prevent the granting of the additional allowance.

 

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Thanks to you all.  If I am understanding now you just have to be 100 percent mental and have the right words from the doctors.  If you have these criteria what Smc level would I be at an L?  I don't have 100 percent and another 60 percent condition just 100". Again thanks for your posts.

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  • HadIt.com Elder

If your not 100% , its hard to get that rating....you need to ask for increase on what you have now if its got worse? or if you have another SC contention to file

 The Dr verbage will help you get that and if they say your disability has indeed got worse  then they rate on your symptoms  of how bad they are and rate you...you could get a high enough rating to bring you to the 100% plus SMC.

if your 70%  Now you will need another 90% rating to to qualify for SMC

70% &90% is 97&combined rating in VA Math...that is rounded out to be 100%  then they use a SMC Math table to figure in the SMC to see if it meets the SMC Criteria 

Again medical evidence is the most important and how the Dr's states their opinion.

Edited by Buck52
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  • HadIt.com Elder

If your 100%? then that makes it a little easier  ''so to speak''

  Its getting to the 100% that's hard for a veteran if he don't get that rating the first time, then he has to fight for the 100%  that's just VA way,  if your already at 100%  you can ask for an increase or file for another contention to get service connected ( you can use PRESUMPTION on a contention ) If you qualify? and a rating  then they use the SMC Calculating table to combined the two ratings  to see if you meet the SMC Criteria  

 

so for from what you stated if your 100% rated now you will need an additional 60% rating as broncovet mention above.

Edited by Buck52
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I am 100 percent for mental health reasons already and have two doctors forms saying I need aid and attendance am I understanding you all correctly I have to be 100 percent and 60 percent to qualify? I thought 100 percent was enough for at least a L level. Am I misunderstanding you?

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