Special Monthly Compensation.

[old fellow 67]

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Just a short topic on one of the widely talked about topics. Aid and Attendance and SMC, Special Monthly Compensation. I am at the point now of submitting my 2nd Aid and Attendance. My claim is approved for the loss of both lower extremities, with one SMC L award. Everyone knows the CFR,  that leads us to the SMC levels, but here I want to say what happened to me. My Primary care Doctor Retired and at that time my Aid and Attendance was filled out for my darn Diabetes which ended up in a mess. My new Primary care Nurse Practitioner has no idea on how to fill out the form, she said to fill it out myself. Here is the concern. I have seen a lot of the 21- 2680 ( Aid and Attendance ) forms filled out and yet not many of the Yes or NO questions were filled out for explanation of why? the 2nd page of the 21-2680 by each question states to use more paper if needed. I have talk to many vets who have not seen the added paper,  21-4168 ( Statement of Support of Claim) used. I feel to express my disabilities and qualify for the stated reasons for the Aid and attendance is what should be filled out. I will fill out the extra piece of paper to clarify my disability if needed.  I feel the questions ask are important and if I don't  answer the questions then the attempt to have the 2nd L approved gets less and less possible. I would  rather use an extra piece of paper then squeeze words in an area that is not illegible. Any questions or concerns on my topic of using the 21-4168 for additional statements in support of claim?

[old fellow 67]

40 minutes ago, broncovet said:

Good point.  IF you are "unable to dress yourself" because medications cause you to be groggy, etc., then so state.  (Note if you were able to dress yourself previously, that is  before you started taking x medication.) 

Also, look up the side effects of your different meds.  If one for Prozac, for example, is grogginess, then that will add credibility.  PPPPP.  Proper Preperation Prevents Poor Performance.  

broncovet

Your comment is well taken. Normally in a question on medications causing such issues as not getting dressed with out help, normally is just stated as " Veteran is not able to dress them self due to Medications for PTSD which cases weakness and doggy effects. If the question ask for information about how long has this Medication caused the problem then it would be OK to state further statements. There is a point that must be thought of seriously. There must be no statements on an area that has already been granted such as my diabetic Nephropathy. I am already being paid for that disability.

What would your thought be on using an outside Doctor to sign the Aid and Attendance form?

[Navy04]

Sorry to hear of your health issues. Truly wish you the best, and God Bless

[broncovet]

Yes, an "outside doctor" should be able to fill out the form, its not necessary that it be filled out by a NP who does not know what they are doing.  We sometimes call this an "IME" (Independent Medical Exam), and it serves just fine "as evidence".  

However, your IME doc needs to supply VA with the information VA needs, and not all non va docs know the format for this.  Your IME needs to document:

1.  That the examiner "reviewed your records".  Leaving this off can result in a denial.

2.  The IME examiner needs to be experienced and or trained in your issue.  That is, a PHD in History, can not make a valid opinion as to the cause of your hearing loss, for examplel.  Its best to have a CV of the doctor, showing his expetise in your issue.  Things like "Board certified audiologist" is very good.  Or, "Phd in Audiology awarded by MIT university" , etc.  For this evidence to be valid, the examiner is acting as an "expert witness" highly skilled in the diagnosis and treatment of your condition.  

3.  The examiner needs to be very specific:  "The Veterans hearing loss is at least as likely as not due to excessive noise exposure in service".  

It can not be:  The Veterans hearing loss "may" have been caused by military service.  Dont use the word,

"could be caused by military service"  May, might, could be, could possibly be, are all "Deal breakers".    The VA denies an IMO/IME with these words they call "speculative".  

4.  The examiner needs to explain "why" he reached such a conclusion.  Example:   The Veterans inability to dress himself is at least as likely as not due to xxx drug prescibed for treatment of his PTSD.  According to the PDR (Physicians desk reference) xxx drug has the side effect of dizziness, and memory loss, and this makes the Veteran unable to dress himself. etc etc.  

5.  The examiner should so state his expertise:  Again, (the doc) is a "board certified" in the treatment of elderly, and graduated magna xxx Laude from Harvard University with a PHD in Audiology.  etc, etc.  The doc needs to establish that "his opinion" is probative as he is an "expert" in Audiology.  

[Buck52]

Great Advise form brocovet......He Nailed it.

[old fellow 67]

broncovet

Thanks again for your comments. I am sure most know that Aid and Attendance is not a claim, it is a( SMC ) Special Monthly Compensation. The hole process is different and yet the background of what you need and how important it is, can be the same as a claim.  The Special Monthly Compensation, comes in when you are AWARDED YOU CLAIM. The Special Monthly Compensation process is what many may need to go through if they do not have a GOOD Primary care Doctor.  Follow the advice and read them slowly, you do not want to toss your opportunity away. You may also have another disability that can slide in and full full the gray area of your  SMC , but don't count on it. Just remember what  Broncovet  has mentioned. Topics like this can get twisted easily.  I do not want to get too far off topic as it is very easy to do. I have helped Veterans since 1999, one thought is that I ask vets for comments to help myself as well as share comments to others. Old Nam Vet.