Aid and attendance exam final Dx statement

[jfrei]

So here the last page where she lists dx not sure if it hurts me I’m hoping for SMC L? I know I could go for T but I’m taking one step up at a time I’m SMC S now...IMG_3723results.pdf

100% P and T residuals of traumatic brain injury with cognitive disorder, short term memory losses/lapses, difficulty sleeping, problem solving with PTSD (to include cerebral contusion with diffuse axonal injury to bilateral frontal and temporal lobes)

Edited September 28, 2018 by jfrei

[broncovet]

The only thing I see on this exam is that the VA is probably going to insist you have a fiduciary to handle your finances, as you are not competent to do so, according to this report.  

It does not address the criteria for Aid and Attendance, at least the portion you posted does not.  Here is the criteria for A and A:

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§ 3.352 Criteria for determining need for aid and attendance and “permanently bedridden.”

(a)Basic criteria for regular aid and attendance and permanently bedridden. The following will be accorded consideration in determining the need for regular aid and attendance ( § 3.351(c)(3): inability of claimant to dress or undress himself (herself), or to keep himself (herself) ordinarily clean and presentable; frequent need of adjustment of any special prosthetic or orthopedic appliances which by reason of the particular disability cannot be done without aid (this will not include the adjustment of appliances which normal persons would be unable to adjust without aid, such as supports, belts, lacing at the back, etc.); inability of claimant to feed himself (herself) through loss of coordination of upper extremities or through extreme weakness;

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inability to attend to the wants of nature;

r incapacity, physical or mental, which requires care or assistance on a regular basis to protect the claimant from hazards or dangers incident to his or her daily environment. “Bedridden” will be a proper basis for the determination. For the purpose of this paragraph “bedridden” will be that condition which, through its essential character, actually requires that the claimant remain in bed. The fact that claimant has voluntarily taken to bed or that a physician has prescribed rest in bed for the greater or lesser part of the day to promote convalescence or cure will not suffice. It is not required that all of the disabling conditions enumerated in this paragraph be found to exist before a favorable rating may be made. The particular personal functions which the veteran is unable to perform should be considered in connection with his or her condition as a whole. It is only necessary that the evidence establish that the veteran is so helpless as to need regular aid and attendance, not that there be a constant need. Determinations that the veteran is so helpless, as to be in need of regular aid and attendance will not be based solely upon an opinion that the claimant's condition is such as would require him or her to be in bed. They must be based on the actual requirement of personal assistance from others.

(b)Basic criteria for the higher level aid and attendance allowance.

(1) A veteran is entitled to the higher level aid and attendance allowance authorized by § 3.350(h) in lieu of the regular aid and attendance allowance when all of the following conditions are met:

(i) The veteran is entitled to the compensation authorized under 38 U.S.C. 1114(o), or the maximum rate of compensation authorized under 38 U.S.C. 1114(p).

(ii) The veteran meets the requirements for entitlement to the regular aid and attendance allowance in paragraph (a) of this section.

(iii) The veteran needs a “higher level of care” (as defined in paragraph (b)(2) of this section) than is required to establish entitlement to the regular aid and attendance allowance, and in the absence of the provision of such higher level of care the veteran would require hospitalization, nursing home care, or other residential institutional care.

Your examiner did not say if you can feed yourself, dress yourself or attend to the wants of nature.  He just said you cant handle your finances.  

[jfrei]

Sorry I didn’t post all 14 pages of evidence she cited and when she talked about my wife scheduling my appointments and cooking for me as I’ve been known to leave the oven running the whole night due to my memory issues. I have moderate short term memory issues and am to complacent to guard myself from daily hazard so my wife tells me not to do things so I don’t get hurt. Here’s s my recent MRI attached to the C and P as well this was from 5 months ago 12 years post sTBI..

IMG_3724mri.pdf

[broncovet]

This, also, does not specifically state whether or not you meet the criteria, above, Jfrei.  What counts is not what I think, or what you think, its what the doctor documents.  In what you posted so far, there is no documentation of symptoms consistent with an award of Aid and Attendance (SMC L).  

Is your wife handling your finances for you currently?  

[jfrei]

I was told it’s in the final stages awaiting the VA authorizes signature. The “he requires care or assistance on a regular basis to protect the claimant from hazards or dangers and daily environment due to my moderate short term memory and impulsive behavior” is how it’s worded isn’t that the only requirement and the fact it’s due solely from my sTBI and secondaries due to my TBI. How would that not be at the least L if not SMC t? I am told it’s been flagged for a hardship and should be completed by the 11th so guess I’ll know..

Edited September 26, 2018 by jfrei

[Buck52]

jfrei

I would think that if you meet the criteria for the SMC L  should be no problem getting what you deserve  if your Dr  examines you and your MRI's  &Dr states that your symptoms  is likely as not due to your TBI & Secondary conditions (name them)

''The “he requires care or assistance on a regular basis to protect the claimant from hazards or dangers and daily environment due to my moderate short term memory and impulsive behavior”

This could be a temp rating and they will evaluate you at a later date  but you should get the SMC L

You should request they rate your total TBI and its conditions to the legal fullest amount allowed  by law.  to included and and all Mandatory  SMC Previsions.

 

[jfrei]

It’s already been made total back on Nov 2016 they just got to SMC claim after I filed for an increase in it in 2017. It’s been a long fight but I know others have fought way longer then 8 years to finally get what I got already in those years. I’m sure your right Buck I’m just tired of them always finding a reason to delay things. Luckily they also said it was flagged for a hardship so hoping this last suspense date is the final one they have a current MRI and my tbi neuropsych that made me P and T done by the Va hospital entered into this exam.

 

(If you are granted the aid and attendance it will be included with your SMC. However, SMC codes can be complex. It could potentially create a new SMC code that includes both the aid and attendance and the SMC.) was the RO reply

Edited September 28, 2018 by jfrei