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SMC (R1) EXAM: IS SMC (R1) A PHYSICAL EXAM OR VERBAL?

Question

All,

Does anyone know if the SMC (R1) exam is a physical exam (ROM DEGREES) or is it an INTERVIEW or combined?

The thing that is confusing me is that according to the VA, this SMC (R1) exam is scheduled for 4 hours?

I was told that a form 21-2680 is going to be used by the VA medical provider?

I would like to prepare myself for the type of examination (verbal or physical or both).

CP

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The examiner will be asking you question off the 21-2680 about House Bound or Aid an Attendance  to see what you qualify for ? the correct  SMC's

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Well I am a R1 veteran, my rating was given to me by a VA rater. I wrote to the va secretary and was called by the rater and he determined at te time I should be rated at the R1 level. I have loss of use of my lower extremities which was at 100% and then I was given a suprapubic cathator which is another 100% rating. So thats how I was put in the r1 rating. I can only guess that an r1 exam would include both physical and regular questions for you unless you have any qualifying conditions already in your medical records. Good luck!

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SMC is a quality of life issue. You assemble it like Legos. Okay. There is no requirement to get to SMC S prior to ascending to SMC L. LOU (loss of use) of lower extremities is one SMC L. If you had LOU above the knees, It would be M. If the catheter causes you to need Aid and Attendance, that is another SMC L. Two Ls advance you to SMC O. If one of the Ls is for A&A, then you get R1. You could have two entitlements to A&A and get R1. The c&p for SMC is basic. You have to prove by medical records you have been dx'd with LOU of two extremities. VA does use the VAF 21-2680 for determinations. I've never heard of a SMC L c&p taking four hours. Generally, you medical records reveal the determination you have been dx'd with the LOU or the need for A&A- but not always. The M 21 states only a VA examiner can make a LOU/ A&A determination. Thus, even if a QTC/VES/LHI doctor says yes, VA can still say no. I am currently in that situation with one of our Hadit members right now. He deserves A&A and they refuse to grant. The good news is the Mariano v Principi decision. If you have a dr. saying yes and VA says no, that's equipoise and by operation of law, they have to grant it. Sadly, I almost always have to go to the BVA to achieve them.

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