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    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
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  • Can a 100 percent Disabled Veteran Work and Earn an Income?

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    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

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Vync

Would I qualify for SMC-S / housebound?

Question

After my heart attack in early April I have brain fog and am trying to determine if I qualify for SMC-S or housebound. I'm 100% P&T for 10+ years and filed a claim for heart attack at the beginning of May. I am not medically cleared to return to work yet.

Bilateral ratings
20%, 20%, 10%, 10% = 48%

Single ratings
40%, 30%, 30%, 30%, 20%, 10%,  10%,  10%,  10%

Factoring in the bilateral and singles, I calculate 96%

I also have a separate single rating of 60%

I looked up SMC-S laws and found:

Quote

38 U.S. Code § 1114. Rates of wartime disability compensation
...
(s) If the veteran has a service-connected disability rated as total, and
(1) has additional service-connected disability or disabilities independently ratable at 60 percent or more, or,
(2) by reason of such veteran’s service-connected disability or disabilities, is permanently housebound, then the monthly compensation shall be $2,993.

For the purpose of this subsection, the requirement of “permanently housebound” will be considered to have been met when the veteran is substantially confined to such veteran’s house (ward or clinical areas, if institutionalized) or immediate premises due to a service-connected disability or disabilities which it is reasonably certain will remain throughout such veteran’s lifetime.

 

Would I qualify?

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Short answer:  We dont know.

There are 2 ways to qualify for SMC S.  You probably dont qualify for statuatory SMC S, UNLESS you have a "single" 100 percent disability.  You can check with the M21 on that, but that is the way I read it.  A combined 100 percent does not qualify.  

However, you may qualify for "housebound in fact" if one or more of your doctors opines you either have agarophobia (fear of leaving your home) OR you are "substantially confined" to your home to SC condition(s).  

 

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On 6/5/2019 at 5:11 PM, Vync said:

I am not medically cleared to return to work yet.

Do you work from home? If not I would think you would not qualify for SMCs for housebound. JMO

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On 6/5/2019 at 2:11 PM, Vync said:

I'm 100% P&T

What is this rating for and is the other 60% rating a secondary to this rating?

I take it you are not TDIU.

Broncovet is right, there has to be one distinct rating for 100% P&T AND a separate 60% rating that is not secondary to the 100% rating. Say you have a 100% PTSD rating AND a secondary of Sleep Apnea at 100%. You would not be statutory SMC(s).

But if the SA was from a different nexus you would be statutory SMC (s).

if your 60% (or more) rating is a combined rating, none of the parts can be secondary to the 100% rating.

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Vync

Just my opinion here

If you have a  100% with combined ratings at 96%  =100%  (Total)

Then you filed another claim  and was awarded 60% on a separate condition   even if this was a secondary to another s.c. condition and recieved the 60%

you  should have recieved the SMC H.B. back then.

so you need to reopen this 60% claim for the correct EED.& Re quest the SMC  H.B.in fact'' be awarded   back to the date you was awarded the 60% state the CFR's above that you posted.

And if you can get a Qualified Dr 's Opine about your heart condition as  ''it will not improve in your life time and is chronic and  or of nature   then add this to your reopen claim as further evidence for the SMC H.B.

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Buck...

    Sorry, no.  Statuatory housebound is very specific and requires a "single" 100 percent rating.  Ratings combining to 100 percent do not suffice for statuatory housebound.  

Source:  M21 Mr:

Quote

IV.ii.2.H.10.b.  Defining a Single Disability for Housebound Purposes

 
A single disability evaluated as 100-percent disabling under a schedular evaluation is generally a prerequisite for entitlement to housebound benefits. 
 
Exception A total disability evaluation based on IU, which is in turn awarded based on one disability, satisfies the regulatory requirement of “a single SC disability rated as 100 percent” for the purposes of awarding SMC housebound benefits under 38 CFR 3.350(i).
 
Important:  A total rating based on IU when awarded for multiple disorders treated as one disability under the five options listed in 38 CFR 4.16(a) does not satisfy the regulatory requirement under 38 CFR 3.350(i) of, “a single SC disability rated as 100 percent.”
 
Example – IU award based on a single disability:  A Veteran is in receipt of IU based solely on depression evaluated as 70-percent disabling.  Subsequently SC is granted for coronary artery disease (CAD) and a 60-percent evaluation is assigned.  SMC (s) at the statutory housebound rate is awarded.
 
Analysis:  The Veteran in this instance would be entitled to the statutory SMC housebound rate. Under Bradley v. Peake, 22 Vet.App. 280 (2008), awarding IU based on the single disability of depression is a single disability evaluated as 100-percent disabling for purposes of SMC (s) entitlement.  CAD is an additional disability evaluated as at least 60-percent disabling.
 
Example – IU award based on multiple disabilities:  A Veteran is in receipt of IU based on two SC disabilities:– ankylosis of the right shoulder evaluated as 50-percent disabling and residuals of a left radius fracture evaluated as 20-percent disabling.  Both disabilities are due to a motor vehicle accident (MVA) that happened during the Veteran’s active duty service.  He is awarded IU based on the disabilities caused by the MVA.  The Veteran’s separate issue of CAD is later SC and evaluated as 60-percent disabling.  The CAD, by itself, does not render the Veteran unemployable.  SMC (s) at the statutory housebound rate is not awarded.
 
Analysis:  The Veteran in this instance would not be entitled to SMC at the statutory housebound rate.  There is no single disability evaluated as totally disabling for the purposes of entitlement to SMC.  Although the evaluations for the MVA injuries to the shoulder and left radius are considered to be a single disability for purposes of IU entitlement, they do not represent a single disability evaluated at 100-percent disabling for purpose of awarding SMC at the statutory housebound rate.
 

 

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