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Appealing Denial for SMC T based on SMC R2 criteria
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SupermanCannedy
Has anyone on this site put in a claim for SMC-t? Do you know of anyone who has been awarded it? I am the sister of a pre 9/11 veteran who has been rated at 100% for TBI P&T. I am his full time caregiver and have been appointed his fiduciary. I also have helped him with his claims...and have done well, until this one. I do my best to give him a high quality of life, but need to hire because his body is fit, but his memory and cognitive skills are in constant decline.
He is a textbook case for SMC T because, in addition to the first 2 requirements, his VA neurologist has also filled out the forms to state that "Without regular in home care the veteran would need to be placed in institutional care". That is a major requirement for an SMC T. We submitted the claim for an SMC T 2015 and they granted him A&A at the L 1/2 rating, which we didn't realize is also required to qualify for SMC t...actually SMC L or higher. We submitted the SMC t claim again April 2016 and they denied it based on R2 criteria. After not knowing what to do about that and not getting any help from the local VSOs (they aren't familiar with this SMC T) a pro bono attorney offered assistance, so we took it.
The decision board came back with a "We got your new claim...we can give you an answer within 30 days or you can have up to a year to submit more evidence." I have NO IDEA what that really means or what to do...So, I submitted for the extra time. Now, I need some guidance.
Should I have people we know write up some buddy letters to explain how much help the vet needs in his daily life? Should I hire one of those VA lawyer firms that take 20% of whatever award is granted? Do any of you know of anyone who has worked on an SMC t? The last report I read was from Dec of last year when the congressional coding was recommended to be changed in order to make the criteria more clear and the "open". The charts show that as of 2011, when the Fast Letter first went out, only 120 or so veterans have been awarded this SMC. So, that's why I am hitting brick walls!
We appreciate any help. Thank you!!
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SupermanCannedy
You guys are great!! R3dneck and Gastone, I will get working on posting the redacted denial letter. Hopefully, the error will be very clear. broncovet- check, check, double check: His TBI di
SupermanCannedy
Thank you!! I wonder if you can't get a claim for the skull fracture because the VA considers it to be part of the evidence that you have TBI, so rating it would be redundant? My vet's brain has globa
SupermanCannedy
Jfrei, It is my understanding that when a 100% rating is awarded for a TBI claim, the SMC S is automatically applied. That is most likely why you have it. They are not inclined to award the L ra
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