SAH/SHA Grant Quick Turnaround to Pending Decision Approval. Good or bad thing?

[mbl22885]

On 08/07/17 I applied for the housing grants and my claim is already at pending decision approval, so I'm not really sure what to make of the quick turnaround.

I am rated 100% P and T with SMC L for PTSD, 40% for Fibromyalgia, 10% for left elbow lateral epicondylitis with painful motion of the forearm,  10% for left elbow lateral epicondylitis with painful motion of the elbow, and 0% for IBS.  (Yep,  as the blue shows, I'm copy and pasting from ebenefits)

When I applied, I included this statement:

"I had a compensation and pension exam for Fibromyalgia (among other issues) with a Dr. X on 08/12/2015. 

Dr. X findings from this exam led to a rating of 40% from the VBA. 40% is the highest value the VA will place on Fibromyalgia, despite as noted in Dr. X exam that my condition exhibits widespread musculoskeletal pain and tender points, with fatigue, sleep disturbance, stiffness, irritable bowel symptoms, depression, and anxiety that are constant, or nearly so, and refractory to therapy. 

As X exam explicitly states, "vet has daily pain in all large muscle groups limiting any exertional

 activiites." These large muscle groups most certainly include those found in the arms and legs. 

Also, as it is noted in the exam and VBA criteria for a 40% rating, the Fibromyalgia must be "refractory to therapy," which essentially means "incurable," so in other words, my Fibromyalgia is permanent."

 

Any opinions on the quick turn around and what the possible reason is? 

 

 

 

 

 

 

Edited September 8, 2017 by mbl22885

[jamescripps2]

I will restate what Berta has said many times, "All things are possible".

38 CFR 3.350 does clearly defines loss of use of a hand or foot.

Loss of use of a hand or a foot will be held to exist when no effective function remains other than that which would be equally well served by an amputation stump at the site of election below elbow or knee with use of a suitable prosthetic appliance. The determination will be made on the basis of the actual remaining function, whether the acts of grasping, manipulation, etc., in the case of the hand, or of balance, propulsion, etc., in the case of the foot, could be accomplished equally well by an amputation stump with prosthesis

2101(a) Grant Fact Sheet VA Pamphlet 26-69-1: Questions on Specially Adapted Housing and Special Housing Adaptations (Online Version) Part 1 - Specially Adapted Housing Eligibility & Statutory Requirements 1. What is the governing law relating to specially adapted housing for disabled veterans or servicemembers? Title 38, United States Code, chapter 21. The original statute was Public Law 702, 80th Congress, dated June 19, 1948. Public Law 109-233, The Veterans Housing Opportunity and Benefits Act of 2006, dated June 15, 2006, and Public Law 110- 289, Economic and Housing Recovery Act of 2008, dated July 30, 2008, amended Public Law 702 and expanded benefit eligibility. 2. Which veterans or servicemembers are basically eligible for the grant? The Specially Adapted Housing Grant is available to veterans or servicemembers who are entitled to compensation for permanent and total service-connected disability due to: a. The loss, or loss of use, of both lower extremities such as to preclude locomotion without the aid of braces, crutches, canes, or a wheelchair. b. Blindness in both eyes having only light perception, plus loss or loss of use of one lower extremity. c. The loss, or loss of use, of one lower extremity together with (1) residuals of organic disease or injury, or (2) the loss or loss of use of one upper extremity. Item (1) and Item (2) above must so affect the functions of balance or propulsion as to preclude locomotion without the aid of braces, crutches, canes, or a wheelchair. d. The loss, or loss of use, of both upper extremities, so as to preclude use of the arms at or above the elbows. e. The permanent and total disability is due to a severe burn injury (as so determined).

[jamescripps2]

SMC L is not awarded for PTSD. An "L" award is Special Monthly Compensation given only for A&A or for loss of use of two extremities. However, It is mandated that the VA consider A&A when any new 100% award is granted. I can understand that PTSD awarded at the 100% rate might also have inferred A&A, which would account for your L rating.

[mbl22885]

19 minutes ago, jamescripps2 said:

I will restate what Berta has said many times, "All things are possible".

38 CFR 3.350 does clearly defines loss of use of a hand or foot.

Loss of use of a hand or a foot will be held to exist when no effective function remains other than that which would be equally well served by an amputation stump at the site of election below elbow or knee with use of a suitable prosthetic appliance. The determination will be made on the basis of the actual remaining function, whether the acts of grasping, manipulation, etc., in the case of the hand, or of balance, propulsion, etc., in the case of the foot, could be accomplished equally well by an amputation stump with prosthesis

2101(a) Grant Fact Sheet VA Pamphlet 26-69-1: Questions on Specially Adapted Housing and Special Housing Adaptations (Online Version) Part 1 - Specially Adapted Housing Eligibility & Statutory Requirements 1. What is the governing law relating to specially adapted housing for disabled veterans or servicemembers? Title 38, United States Code, chapter 21. The original statute was Public Law 702, 80th Congress, dated June 19, 1948. Public Law 109-233, The Veterans Housing Opportunity and Benefits Act of 2006, dated June 15, 2006, and Public Law 110- 289, Economic and Housing Recovery Act of 2008, dated July 30, 2008, amended Public Law 702 and expanded benefit eligibility. 2. Which veterans or servicemembers are basically eligible for the grant? The Specially Adapted Housing Grant is available to veterans or servicemembers who are entitled to compensation for permanent and total service-connected disability due to: a. The loss, or loss of use, of both lower extremities such as to preclude locomotion without the aid of braces, crutches, canes, or a wheelchair. b. Blindness in both eyes having only light perception, plus loss or loss of use of one lower extremity. c. The loss, or loss of use, of one lower extremity together with (1) residuals of organic disease or injury, or (2) the loss or loss of use of one upper extremity. Item (1) and Item (2) above must so affect the functions of balance or propulsion as to preclude locomotion without the aid of braces, crutches, canes, or a wheelchair. d. The loss, or loss of use, of both upper extremities, so as to preclude use of the arms at or above the elbows. e. The permanent and total disability is due to a severe burn injury (as so determined).

I understand, I apologize if I came off as hostile. I'm all the things I'm rated as and I have a 3 and 1 year old I'm trying to be the best I can be for, so frayed doesn't even begin to explain it. I seriously thank you more than anything.

I try to never assume anything, but when I do it's mostly negatively, so even if I do have a take on something like this that borders on positive, I immediately start to chip away at it. My experiences with the VA to this point have taught me that if they have even a microscopic reason to deny, they will.

I'm drained right now, but eventually I'll read and comprehend to the best of my ability what you posted, and then If I have to, I'll apply it. And my claim will be better for it. 

[mbl22885]

2 hours ago, jamescripps2 said:

SMC L is not awarded for PTSD. An "L" award is Special Monthly Compensation given only for A&A or for loss of use of two extremities. However, It is mandated that the VA consider A&A when any new 100% award is granted. I can understand that PTSD awarded at the 100% rate might also have inferred A&A, which would account for your L rating.

You're wrong.

Edited August 20, 2017 by mbl22885

[jamescripps2]

 

The requirements to be eligible for for SMC "L" according to USC 1114(L).

If the veteran, as the result of service-connected disability, has suffered the anatomical loss or loss of use of both feet, or of one hand and one foot, or is blind in both eyes, with 5/200 visual acuity or less, or is permanently bedridden or with such significant disabilities as to be in need of regular aid and attendance, the monthly compensation shall be $3,327

The USC was written by congress and it would take an act of congress to change it or to modify it. If you was awarded an "L" rating for anything else you should keep it to yourself because it is a CUE on the part of the rater and will be severed if discovered. VBA decisions depend on supporting evidence, the laws governing the issues and precedents, no matter how hard you may have fought or will ever fight.

You need to ask your VSO for a copy of your code sheet and see what exactly the "L" was awarded for. Please let us know!

Not trying to discourage you here but you need to be realistic in your expectation. If you don't qualify for the SAH grant under the law enacted by congress governing the grant, it would be an illegal act for the VBA to award it to you. The law, (USC) as congress wrote it is not optional nor is it discretionary for the VA to follow or not.

Not trying to bust your bubble here but you asked a question, like it or not, this is the answer to that question. Do some unbiased research while you wait on the decision. If you come up with legislation that supports the fact that the VBA can award the SAH grant outside what was mandated by congress in USC 1114 please point it out. 

Nobody ever fought the VA harder than I did but I wised up and used the USC, CFR, and M21 as they were written to substantiate my claims. 

 

[mbl22885]

2 hours ago, jamescripps2 said:

 

The requirements to be eligible for for SMC "L" according to USC 1114(L).

If the veteran, as the result of service-connected disability, has suffered the anatomical loss or loss of use of both feet, or of one hand and one foot, or is blind in both eyes, with 5/200 visual acuity or less, or is permanently bedridden or with such significant disabilities as to be in need of regular aid and attendance, the monthly compensation shall be $3,327

The USC was written by congress and it would take an act of congress to change it or to modify it. If you was awarded an "L" rating for anything else you should keep it to yourself because it is a CUE on the part of the rater and will be severed if discovered. VBA decisions depend on supporting evidence, the laws governing the issues and precedents, no matter how hard you may have fought or will ever fight.

You need to ask your VSO for a copy of your code sheet and see what exactly the "L" was awarded for. Please let us know!

Not trying to discourage you here but you need to be realistic in your expectation. If you don't qualify for the SAH grant under the law enacted by congress governing the grant, it would be an illegal act for the VBA to award it to you. The law, (USC) as congress wrote it is not optional nor is it discretionary for the VA to follow or not.

Not trying to bust your bubble here but you asked a question, like it or not, this is the answer to that question. Do some unbiased research while you wait on the decision. If you come up with legislation that supports the fact that the VBA can award the SAH grant outside what was mandated by congress in USC 1114 please point it out. 

Nobody ever fought the VA harder than I did but I wised up and used the USC, CFR, and M21 as they were written to substantiate my claims. 

 

Once again, you're wrong.

Like I have the decision letter. I have a copy of the c and p exam that the approval was based on. 

"Or with such significant disabilities that..." 

Once again, leaglise. The PDF below pulls from multiple sources, including the CFR and M21. 

You should stop giving your opinion as fact.

38 CFR 3.350 has to do with SMC entitlement, not SAH/SHA. 

https://www.law.cornell.edu/cfr/text/38/3.809

(b)Disability. The disability must be due to:

(1) The loss or loss of use of both lower extremities, such as to preclude locomotion without the aid of braces, crutches, canes, or a wheelchair,

(c)Preclude locomotion. This term means the necessity for regular and constant use of a wheelchair, braces, crutches or canes as a normal mode of locomotion although occasional locomotion by other methods may be possible.

"Such as to" doesn't mean "absolutely must." "...although occasional locomotion by other methods may be possible" opens the door to a lot of things. 

And that's just looking at one of the possible criteria. 

 

 

 

SMC at the aid and attendance rate is payable when a veteran.docx.pdf

Edited August 21, 2017 by mbl22885