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.   

[john999]

I was TDIU for a mental health disorder since 2001.  Around 2008 I got SC'ed for DMII.  I have filed for a couple of things as secondary to the DMII.  I filed for CAD secondary to DMII in 2009 I think.  I was eventually awarded 60% just for the CAD.  I still had not reached a scheduler 100% and probably never will , but I was able to get "S" based on the TDIU plus  the 60% for CAD.  I did file a CUE claim to get it.   The VA should have awarded me the "S" as soon as I got the 60% due to Bradly vs Peake.   I did get the backpay for the statutory "S".   Any TDIU vet can get it, but the VA is trying to avoid paying it all this jive.  The 60% must be separate from the original TDIU rating.  This is the main key.  You cannot have TDIU and  100% at the same time.  I bet the VA is cracking down on S.A. claims because they see a tidal  wave of claims coming at them.  I have S.A.  and I am surprised to see someone get it SC'ed secondary to CAD.  Gastone:  Which doctor wrote you an IME connecting your SA to your CAD?  I want to possibly meet this doctor.   I am 60% CAD and after this DX I was DX'ed with OSA about four years ago.  I have so many SC conditions but I never am able to get to actual 100% and I don't care anymore, but I would take it I could get it.  I think the VA will keep refining the requirements for "S" until nobody qualifies.

[Buck52]

Roger that Gastone!  I had figured that out over night  LOL...  & way to go buddy.

what's weird to me is I still have the TDIU P&T Rating but they made it as of nature & also getting a statutory award for SMC-S because the 70% PTSD met the SMC Criteria as I understand it? I think b/c its a separate distinct disability? but its not secondary..So with Gastones information  if I would have go a 100% PTSD Rating   they would have dropped the TDIU P&T...But on second thought maybe its a good thing they didn't drop it   for P & T Purposes....I still got the SMC-S.

 but as John999 pointed out veterans can't have 2-100% as a stand alone rating, even tho Gastone was IU at 100% but with the Sleep Apnea 100% Award they took the IU away, but still used the percentages (I think) to be able to get the SMC-S Award

They have a weird SMC rating table they use

john 999 you should be able to get your S.A. Claim to the 100% secondary to CAD if you can find a Sleep specialist to nexus your OSA has chronic and use a bi-Pap or C-Pap...Check your Sleep Clinic or private Notes.

JMO

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

[Gastone]

Buck

I think Ask NOD covered the IU & SMC Rating before. As I recall, when a Vet gets an IU Award, even if it's based on a 50 or 60% SC, if his other SC's ever total by themselves 60%, he's eligible for SMC S (1).

New IU Claims require the Vet to list which SC is causing his IU. Back in 11 or 12, you could just list all your SC's, no requirement to be SC specific. I'm not sure if it was the BVA or CAVC that ruled which ever SC is the primary cause of the Vet's IU, for SMC purposes, it was considered as a separate 100% SC Rating.

I had my NOD ready to file, when I got the 12/15 QCR Award.

Semper Fi

[ArNG11]

I am very curious on how this will be interpreted in my claim.  The VA has yet to provide me a copy of the last decision which gained me the 100% IU (really 90% plus IU) even after FOIA requests. The VA was nice enough to pay the retro but no decision letter to accompany it.  I have an NOD in the pipeline as I know there is only a one year appeal period, but I find this quite funny.

My conclusion is that my Mental Health ratings were used to attain the IU, however, it is impossible to know without an award letter.  Also besides no decision letter, there was no appeals paperwork or anything. This is very convenient and very nice of them, my Muskogee VA Regional Office.

I am in a similar boat to Gastone's predicament as I have the 70% mental health rating.  That rating in itself should open the door to a few things since this causes the unemployability, and there are multiple other claims on appeal that will raise my combined rating.  When my appeals go through is when I will really know how this will go though.  I am banking on my back disability getting to 60% on it's own though, if my appeals go my way.  My situation is a big gamble though and there are no guarantees.  

I gather from the regulation that I will be eligible for SMC as well, time will tell though.  Who knows more time on the hamster wheel.

[Buck52]

Roger that Gastone.

Beings I only got a 70% for the PTSD  I will have to use the IU as my stand alone disability  so that means I have 5 more years  sending in the employment questionnaire.

A Veteran needs to check his  rating status occasionally  make sure what they added? or took away without us knowing it.

 

Mr A  you should try to get copy of your award letter it should be up on ebenny's?

you really need a copy of it  if you have other claims pending  even NOD.

IF they rated you IU using the extra schedular formula at 90% and you get at least 60% for your Back and with your other disabilities no matter how small ( they can only rate in 10% increments) on the level of the disability ...and  your Back  % would be considered a different disability..so my thinking is after they  add up the smaller % that would bring you the 100% and then use your Back ratings for the SMC's S-1 & Possible K AND L-1 1/2  depending on your Back  disability and other complications from it??

you could get a 100% rating on your S.C.Back problem  and if so you should be getting some statutory ratings for SMC.

jmo

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

[john999]

AskNod  says that even if your many individual disabilities add up to 100% you are not considered 100% scheduler.  I am stuck at 90% unless I get another rating of at least 50% because I think I am at 93% rounded down to 90%.   I have 3-4 more years of sending in Employment questionnaire because when I hit 70 or therebouts no more paperwork for IU.  In five years I will have 20 years of being IU.  I would like to be rated as 100% before then if possible.  I had the Inspire device implanted in my chest and throat instead of using the C-Pap.  I think it works OK plus I get oxygen every night.  My OSA was pretty horrible and life threatening.   I have been playing with the VA for 45 years just to get what I got.   What a long strange trip it has been.    For Vietnam vets agent orange related disease will probably get us all in the end.   I went to a psychologist at the VA to treat my insomnia.   He asked if I had been DX'ed with PTSD.   Of course, but I am already rated for it. 

My question is this:  What conditions cause OSA?  Is it related to being obese or some other set of conditions?  The conditions I have are all so intertwined with VA disabilities it is hard to separate them out as to being VA or non-VA.