SMC S...Dont make this mistake!

[broncovet]

I went down a rabbit hole to nowhere.  I reasoned, that, if I got SC for sleep apnea secondary to depression, that I would make the "100 plus 60" for statuatory SMC S.  

Big mistake.  If you read the regulation, it says you have to have 100 plus an additional 60 percent seperate from each other.  So, if depression is primary, and sleep apnea is secondary to depression, then its not seperate, and I wont ever get to 100 plus 60, no matter whether service connected for sleep apnea or not.  The "secondary" provides a link that they are NOT seperate.  

I found this out recently.  

You MIGHT be able to get away with this, if you have an uninformed decision maker, but it wont fly on appeal.  

I will be dropping my sleep apnea claim for this reason.   

[Buck52]

broncovet

I thought you already was rated at 100%??? (don't make any difference for what) so if your under the 100%

 A SLEEP-APNEA Rating is only for 30% to 50%  so that's still not enough to climb to the SMC.s

if your not at 100% now ? it will be harder for you to get to the 100%  unless you have another SC Disability in severity to reach at least 80% to 90% now?? depending on your current ratings?

I had a 90% combined rating for hearing loss and they inferred me to TDIU P&T  Which for all intent and purposes is actually a 100%rating  especially when they rate another severe S.C.disability above 60%...for example  my other severe disability 70% PTSD was a statutory rating because of the TDIU P&T Award. (as to which I am thinking about NOD THE 70% PTSD Decision b/c I feel it should have been a 100% rating  but when they added the SMC  I am not sure what to do?

When they checked the criteria for the SMC's   I Met the criteria with the 70%p PTSD Rating. Actually if you look at the ''proper''ratings I would be 170%...thats after you reach the 100% rating.

Maybe I am not understanding this post?

 

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

I could be wrong but that's the way I interpreted the New letter on the 70% PTSD & SMC's they sent me.

[Gastone]

Oh Contrar!

My SA was Secondary to my CAD. 12/15 Quality Review of 07/15 Increase Claim denial, resulted in the SA being Bumped from 50% to 100% Scheduler with SMC S (1) from Tinnitus 10%, CAD 30%, PTSD 70% and PH 0% Secondary to SA.

I'd been IU since 06/14, received the VA 2140 Income letter last year 06/15. Didn't get the 2140 this year, the IU Award was trumped by the 100% Scheduler, no further Income Verification required or considered.

Bronc, DO NOT DROP your SA Secondary Claim! My 2014 PH SC'd 0% as Secondary to my SA, ended up getting me to the 100% Scheduler with SMC S (1).

Semper Fi

[broncovet]

Thank you Gastone.  So, if I understand what you are saying, it did not seem to matter that parts of your "100 plus 60" were secondary, you got SMC S, anyway?

 

Buck, yes, Im at 100% seeking SMC S (housebound).  I have a single 100% for depression, 20% for hearing loss, 10% for tinnitus.  I have had sleep apnea some time, but its non service connected, at present.  If you add another 50% for sleep apnea to this, the combined would bring this to 100 plus 60, for SMC S.   However, my attorney indicated that SC for sleep apnea SECONDARY TO DEPREssION, wont bring me to statuatory SMC s, because the regulation specifically states that they need to be "serpate and distinc" ratings.  In other words, since the apnea would be secondary to depression, that would NOT qualify me for SMC S, because the secondary conditions means they are not seperate and distinct. 

I do think, however, Gastone makes a great point:  VA does not always "catch" they are "seperate and distinct" (when secondary), and sometimes awards it anyway.  It would not be the first mistake VA ever made, and I am still not sure if its a mistake or not.  

I think the "seperate" can be interpreted both ways.  In other words, sleep apnea is different from depression even if it is secondary to depression.  However, at least according to my attorney, the VA "officially" takes the position that when it IS secondary, it is not seperate for SMC S purposes.  

This said, even if VA HAS interpreted this in a Veteran unfriendly way, others may decide it differntly, and award this based on BOD.  If anyone is aware of case law, or a OGC opinion, or fast letter on this, please let me know.  

I mentioned this to Alex, and he said my attorney was correct, but did not cite case law.  

My VBM is not current, so more recent case law could change this.  

[seminoles]

3 hours ago, Gastone said:

Oh Contrar!

My SA was Secondary to my CAD. 12/15 Quality Review of 07/15 Increase Claim denial, resulted in the SA being Bumped from 50% to 100% Scheduler with SMC S (1) from Tinnitus 10%, CAD 30%, PTSD 70% and PH 0% Secondary to SA.

I'd been IU since 06/14, received the VA 2140 Income letter last year 06/15. Didn't get the 2140 this year, the IU Award was trumped by the 100% Scheduler, no further Income Verification required or considered.

Bronc, DO NOT DROP your SA Secondary Claim! My 2014 PH SC'd 0% as Secondary to my SA, ended up getting me to the 100% Scheduler with SMC S (1).

Semper Fi

Good to know Gastone, I think my secondary may bump me to 100% schedular for the primary/secondary combo and then I have an additional 70% so potentially I guess it could mean SMC S. 

[Buck52]

8 hours ago, Gastone said:

Oh Contrar!

My SA was Secondary to my CAD. 12/15 Quality Review of 07/15 Increase Claim denial, resulted in the SA being Bumped from 50% to 100% Scheduler with SMC S (1) from Tinnitus 10%, CAD 30%, PTSD 70% and PH 0% Secondary to SA.

I'd been IU since 06/14, received the VA 2140 Income letter last year 06/15. Didn't get the 2140 this year, the IU Award was trumped by the 100% Scheduler, no further Income Verification required or considered.

Bronc, DO NOT DROP your SA Secondary Claim! My 2014 PH SC'd 0% as Secondary to my SA, ended up getting me to the 100% Scheduler with SMC S (1).

Semper Fi

Wow Gastone  way to go buddy,

you went on a secondary claim with S.A. AT 50% and you filed for increase on your S.A. And was Awarded 100% S.A.  secondary to your  30%CAD?

 And with your already SC Disabilities the tinnitus 10% CAD 30%  & PTSD 70% and when you filed for increase on your secondary S.A. You were at a 50% and they increase your Sleep Apnea to the 100%??

  ..so does the S.A. at the 100% rating Take Jurisdiction (so to-speak) to make it your 100% rating disability as a stand alone rating  and the others are basically secondary ratings...and all these rating made the criteria for the SMC-S Award?  

or is your 100%IU rating your stand alone rating and the VA Considered all your percentages and they met the criteria for the SMC-S

I don't think I ever heard a veteran with  100% Sleep Apnea Secondary... unless that's his only disability and its severe as chronic in nature.

so with your IU even if it's a 90%combined rating    IU is considered a 100% rating

Does this mean you have 2= 100%  The IU and the 100% for S.A.? and then the 10% Tinnitus 30% CAD & 70% PTSD

10% 30% 70% in VA Math is 81.1% rounded off at 80%   so basically your rating added up is 280%?

Anyway Broncovet you should appeal or file your S.A. Claim and hope they don't catch ''separate & distinct''  you never know if you don't file...what's the worse can happen but a denial...be interesting to see what their Reasons and bases will be....? 

I know member ''Andyman'' has tried to get his S.A. service connected to secondary to chronic pain and so for a dry hole.   usually this would be a 50% rating b/c he has a VA dx S.A. & uses a VA C-PAP but no records of sleep disturbance in the marines .

I believe that's why his denial ...just reading some of his post  I may not be correct on this  or if he was ever denied for Secondary S.A. Claim  it seems I read some of his post about that.

They must be really cracking down on SECONDARY S.A. Claims

[Buck52]

I Don't understand these ratings from Gastone?

here is how they did my claims

I was 90%combined for profound hearing loss and could not work b/c of it after trying VOC-Rehab and being in ILP...So they gave me the extra schedular TDIU P&T also a 10%rating for tinnitus   this =to a stand alone 100%rating back in 2002  ok speed up clock 2015 Filed a PTSD Claim and was awared 70% so what the VA did was they took my IU P&T RATING AT 100% added the 70% to the 100%, then looked at the SMC Criteria and they said I met the Criteria for the SMC-S and called it a statutory rating because of the  rating % in the SMC Special table chart.

so They have my rating disabilities as followed 10%tinnitus incurred Vietnam 50% hearing loss incurred Vietnam 60 %increase incurred Vietnam, 90%increase to TDIU P&T incurred Vietnam,all to equal a 100% rating PTSD 70% Incurred Vietnam...they have the effective dates beside the incurred disabilities I just can't remember them off top my head right now  but this is just an example how they have me rated

 10%50% 60% 90%=100% 70% and show the SMC-S-1 at the bottom or just below these ratings.

Now on ebenny's it has the blue round circle as 100%   and  the SMC-S on the disabilities rating sheet.

My compensation increased from the 100%with spouse   to another 347.00 smackers  with the SMC-S  Award.

so even if I did get a secondary S.A. Rating  no more comp for me  unless I lose my arms or both legs or my eye sight with the SMC's..with that I could be getting over 8 grand....but be nice to have the S.A -  S.C.  For the  spouse claim if I die from it.  so I got to think hard about the S.A. Claim secondary to my PTSD

and I pray for the veterans that  are in this condition that they get every penny coming to them the max allowed to them.

Edited August 6, 2016 by Buck52