A change in SMC S (Housebound)?

[deemac76]

Greetings Vets!! I'm rated 100% P&T for MH and other physicals disabilities and haven't worked in 8 years. I was on IU before and after being deemed unable to be retrained via voc rehab and also a ssd approval, I was increased to P&T. I just recently was informed about smc (s) from another vet with similar issues and not working as well. I checked over my award letter and it basically stated that I didn't qualify for statutory entitlement but that was all. I asked my VSO about it and he stated even though I'm not working and I only get out for appointments that I wouldn't get smc (s) due to the way the VA looks at the entitlement. He gave me the link to 38 CFR 3.350 (i)(2) and he said this what the VA goes by, but I also looked up M21-1MR, Part 4, Subpart 2, Chapter 2, Section H (10)(B) and (F) and it states that HB "in fact" is determined if a Vet can't earn a income. So basically which VA reg determines the entitlement? I think my SC'd rating in itself should being considered originally (Panic Disorder w/Agoraphobia) but it wasn't. How would one proceed with trying to see if I should be getting this compensation? A CUE or a normal claim for it? 

[john999]

There are two ways to get HB.  If you have a total disability plus at least 60% for an extra and different disability you can get statutory HB.  The other way is to actually be unable to leave your home.   A DX of Panic

disorder w/Agoraphobia would meet that criteria IMO.  In my own case I had TDIU P&T effective 8/2001 and about 8 years later I got an extra 60% for an AO condition.  I filed a claim for HB and the VA called a CUE on themselves and granted HB.   If you have scheduler 100% the VA is supposed to consider you for HB.  The VA's  new trick is to say they considered you  for the benefit and then denied it.  I would file a claim for HB due to the fact I am substantially confined to my home because of the Agoraphobia.
 

[deemac76]

16 minutes ago, john999 said:

There are two ways to get HB.  If you have a total disability plus at least 60% for an extra and different disability you can get statutory HB.  The other way is to actually be unable to leave your home.   A DX of Panic

disorder w/Agoraphobia would meet that criteria IMO.  In my own case I had TDIU P&T effective 8/2001 and about 8 years later I got an extra 60% for an AO condition.  I filed a claim for HB and the VA called a CUE on themselves and granted HB.   If you have scheduler 100% the VA is supposed to consider you for HB.  The VA's  new trick is to say they considered you  for the benefit and then denied it.  I would file a claim for HB due to the fact I am substantially confined to my home because of the Agoraphobia.
 

Yeah john999 that's what I thought when I heard about SMC HB a month or so ago. When I got my rating back in 2012 I was glad it was over because what I went thru to get it and wasn't informed that me being housebound has some other type of compensation. Not being greedy or nothing but it's difficult not being able to get out and enjoy yourself without being in fear of being out. My VSO looked at me like you're here then they won't give you HB, but I told him look up Agoraphobia and tell me what it means to you. So at this point I don't know what to do, the consensus seems to be don't rock the boat. I think my medical records speaks for itself and I should be fine. I'm being treated for severe migraines and a nexus have been established between them and my anxiety disorder. I wonder if I have to file a claim I might as well put in that in too secondary to my MH. Based on my records getting the highest rating looks pretty good and that would give me statutory HB anyway along with my other SC'd ratings. Thanks for your reply.

[Buck52]

I agree with john999

John, Elder broncovet Member & Forum Maintainer 

Mention also that anytime a Veteran receives a TDIU P&T Award  The rater is suppose to invite the HB-S  As a statutory rating.(lot of times they either forget or just to lazy to give it to the Veteran) jmo

They never inferred mine H.B. -S   for me back then...Maybe  this was not a regulation back in 2002?

Anyway I did like you I had other S.C. Disability at 70% separate from my TDIU P&T Award  and they did infer the H.B. -S  as a statutory rating.

 

 Just to throw this part in,

Also the SMC K is a non rating disability  but its S.C. at 0% but pays an additional 103 per month mixed in with all the other disability' payments.

[deemac76]

1 hour ago, Buck52 said:

I agree with john999

John, Elder broncovet Member & Forum Maintainer 

Mention also that anytime a Veteran receives a TDIU P&T Award  The rater is suppose to invite the HB-S  As a statutory rating.(lot of times they either forget or just to lazy to give it to the Veteran) jmo

They never inferred mine H.B. -S   for me back then...Maybe  this was not a regulation back in 2002?

Anyway I did like you I had other S.C. Disability at 70% separate from my TDIU P&T Award  and they did infer the H.B. -S  as a statutory rating.

 

 Just to throw this part in,

Also the SMC K is a non rating disability  but its S.C. at 0% but pays an additional 103 per month mixed in with all the other disability' payments.

Buck52 I think based on my award letter, the VA looked at SMC since I was being rated at 100% but only on a statutory level cause they mentioned it but not the HB "in fact" based on severity and/or condition since they didn't mention it I would guess. Since I have been researching cases and VA laws on SMC HB I've seen all different variations of how it is entitled of than the statutory way. The VA says "substantially confined" whereas Congress says "unable to earn a income". I've look over the M21-1 and it seems they've been updated it and I noticed this today. 

A housebound in fact determination requires a Veteran’s inability to leave his /her place of residence and immediate premises in order to earn any income.  However, it does not require a total inability to leave the place of residence and immediate premises for all circumstances.  Leaving home for medical purposes cannot, by itself, serve as the basis for finding that a Veteran is not substantially confined for purposes of SMC housebound benefits.  The limitations must be the result of the Veteran’s SC disabilities.   Non-medical indicators of housebound status may include but are not limited to inability to walk substantial distances leaving the home with assistance only occasionally for appointments grocery shopping, or church, or inability to mow one’s lawn.

[Buck52]

 Yes they  updated it some times  in 2016?

..as I understand the M 21-1

 there suppose to infer it  when you can't leave home for work....notice the word ''WORK''  House Bound Infact

Also if this sentence is in your award letter '' Disability is Permanent  in Nature''

It don't mean you can't leave home for appointments or buy groceries ect,,ect,,

but yes SMC is based off the severity of the disability or disability's...this is why the SMC has a special rating table  for S -Q  to R.T1

There are no claims for SMC  b/c  it's always Inferred by severity of the disability or by a statutory rating.

The IU rating and get the SMC -S is a new one on me for SMC- S H.B.

Edited August 28, 2017 by Buck52

[deemac76]

2 minutes ago, Buck52 said:

Well there suppose to infer it  when you can't leave home for work....notice the word ''WORK''  House Bound Infact

It don't mean you can't leave home for appointments or buy groceries ect,,ect,,

but yes SMC is based off the severity of the disability or disability's...this is why the SMC has a special rating table  for S -Q  to R.T1

Yeah that's the way I see it as well. With all that being said should I file a cue for it or file a claim for it since my award date was 2012 but effective date 2010? Being that I'm 100% P&T will it be like a normal claims process? (i.e. C&P) or since it's a special entitlement they would just look at the rating decision? Thanks again Buck52!!