Trying to figure out if a qualify for SMC S

[AF101B]

Long time  reader, first time posting. Confused about SMC.  100% SC P&T scheduler. Confused because in my last letter RO sent form 21-526 but no explanation if I should complete.  I still have 2 unrated claims for lumbar spine and sciatica - which are currently rated at 0% service connected.  Been through a C&P for both.  Would I qualify for SMC?

60% CAD - heart -hypertensive  heart disease

50% Sleep Apnea

30% Lft Ventrical - heart

30% Migraines

30% Bilateral Plantar Fasciatas

20% Prostatitas

10% Hips

10% lft shoulder

10% rt shoulder

10% lft knee

10% tinnitus

10% eczama

10% GERD

10% wrist

10% Cervical spine degenerative disease

 

[Berta]

"100% Effective date Sept 26, 2014"

"DEA Chapt 35 eligibility/granted. "

I think they should have considered you for SMC S ( HB award)

The HB award does depend on being limited to your dwelling but that can be due to many factors.

They had to grant my husband SMC S posthumously for housebound.I dont think the evidence I had would help you....

maybe others will chime in on how VA determined their housebound status.

My husband had a stroke that the VA caused, and could no longer drive, the VA van had to pick him up for Day Treatment, he could not tell the difference in pocket change money or see what denomination bills were and although he was always showered and put on fresh clothes, one day we went to a local store where he bent over to get a can of soup or something for me and here I thought he had his light blue slacks on but when he bent over I could read "Property of the Veterans Administration" in big black letters on his rear end...(he had put on light blue VA PJs from his recent VA hospitalization, because he couldn't tell they were not his slacks.) He even got lost for a while on the PTSD inhouse program trip and finally they found him, VA said he was not eligible for A & A but awarded SMC HB instead.Further down in that decision, however, they said since he was 100% direct SC plus well over 60% 1151, they awarded him SMC S.  2 different reasons in the same decision.

 

 

 

 

 

 

 

[Buck52]

Me Berta

I was just like this veteran  I  had a combined  rating of 90%...they used the extra schedular for the TDIU P&T...Being paid at the 100% rate and all the benefits like chapter 35,  commissary letter  the property tax exemption  the  whole 9 yards  just the same as a 100% vet.

I had this rating for about 14 years and I recently filed a PTSD Claim  and was awarded a 70% rating...they use the SMC Criteria on me for the SMC S-1 H.B....It was automatic  I never ask for the SMC..

SO I believe they made an error in rating this veteran.  he should already be getting SMC.S H.B.

Can he file a CUE for the wrong ratings?

.JMO

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

[AF101B]

I am currently employed, so VBA may have felt HB was not authorized.  Confusing to me as to why they included form 21-526.  I've already sent in a NOD for effective date Sept 2014.  Wasn't sure about SMC-S criteria since I'm not IU.  Without IU, appears I am entitled to file under 100% plus 60%. Knowing that will help to word the response, and if the CUE applies to filing for SMC - S, I can state that in my letter.

You guys are outstanding- appreciate the support.

[Berta]

If one is employed , they are not housebound.

[AF101B]

SMC S is only for housebound?

[FormerMember]

Let's dissect this. First, the ratings. I do them in colors to show which are related and considered one unique disability.

60% CAD - heart -hypertensive heart disease

50% Sleep Apnea

30% Lft Ventrical - heart

30% Migraines

30% Bilateral Plantar Fasciatas

20% Prostatitas

10% Hips

10% lft shoulder

10% rt shoulder

10% lft knee

10% tinnitus

10% eczama

10% GERD

10% wrist

10% Cervical spine degenerative disease

First, in red, you see 60% and 30% as one disease entity of or having to do with the cardiovascular system. Combined, they equal 70%. That qualifies as a prerequisite for TDIU. Next, the four 10%s in blue are again, all one symptomatology. VA has chosen to rate you as 100% ( combined) but you do not have any one singular 100% disability rated as 100% schedular. Nevertheless, Bradley allows the TDIU to stand in for the 100%. Looking further, the sum of the remaining ratings is well over 60% and do not involve the same systems which makes them all individually different (and thus available) for use as SMC S qualifiers. So the answer is yes- you qualify for SMC S at the earliest date it can be ascertained medically that you had an effective rating of 100% (or TDIU) plus additional disabilities that equaled or exceeded 60%. File it, Dano.

By law, VA is required to maximize your ratings in any form such that you get the highest and best rating. AB v Brown (1995). Thus they are required by law to combine and possibly grant TDIU based on any disease entity that manifests enough to create TDIU. If you're still working, that pokes a hole in the balloon but your ratings are far more than necessary to get the SMC under either interpretation.

 

 

 

 

 

Edited July 3, 2016 by asknod