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Dustoff 11

SMC-S PTSD CONFUSION

Question

CONFUSION!!!!!!!!!.  For what it is worth here is a September post from a veterans wife

 

  "Hello everyone. My husband was just awarded sc for sleep apnea by the BVA. They sent it back to the RO to be awarded. This will now give him SMC-s since he is 100% for PTSD alone and the sleep apnea award will put his other combined totals above 60%. The va.gov website says he should see a change in pay in 1-2 months. Anyone with experience with this and how long did it take for your award to show up after BVA granted appeal? And do they give retro for SMC-s?"
 

There seems to be confusion among knowledgeable veterans, advisers on different veterans forums as to whether or not OSA Sleep Apnea at 50% rating level secondary to PTSD can be used as part of 60& requirement for qualifying for an SMC-S award assuming that the vet is 100% for PTSD  or TDIU due to PTSD only.  Some pros say yes and others say no. There are many confused vets including me with claims and appeals on this issue in the works.

I would also like to hear from any vet who has received SMC-S  due to secondary SC of Sleep Apnea due to a 100% PTSD only rating.  Thanks Everyone

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Congratulations on your BVA win!!

Yes, you should get retro if awarded SMC S.  SMC is ALWAYS inferred, meaning you dont have to apply for it.  You should get paid BACK TO THE DATE YOU FIRST became eligible for SMC S.  That is, if Sleep apnea made you eligible for SMC, then you should get it back to the date of your OSA award.  You may not find that out until you get the envelope from VARO implementing the BVA decision.  Unfortunately, VA often gets the effective date wrong.  

How long" questions are guesses.  We dont know.  And VA wont tell us.  I cant tell you how long it takes Va to go to the water cooler, much less process a Vets claim or even implement an appeal.  Some Vets here have complained that the VARO did not implement BVA decisions (that is, pay the retro) promptly, like they are supposed to do.  

Edited by broncovet

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I reemember just off the top of my head

When I was inferred the SMC -S I never got any retro?

    ..I got retro filing the ITF  it was about 11 months of retro for filing a 70%PTSD Claim  thats how long it took for them to approve it  but as for as getting any retro for the SMC.S I don't think they included that..if I was suppose to get it?

or unless in the ITF they included it?

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Buck...if you think your retro was "off" then you should file for an audit of retro.  It would not be the first time vA ever made a mistake.  

Yes, you are supposed to get retro on SMC S, just like everything else...based on the effective date.  

I dont know what your effective date was.  Remember, tho, there is no "claim date" with SMC S.  THe effective date is the date you first met the criteria for smc, because there isnt a requirement you have to apply for it.    Even if you do apply, VA should grant the effective date the date you first applied...there is no "date of claim" for SMC.  Remember the effective date general rule?

The effective date is the later of the facts found or the date of claim.  With SMC, there is no date of claim since its inferred whenever you meet the critieria.  

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Latest info I found from a reliable source who is also recipient of SMC-S due to a 60% combined rating of several  separate secondary disabilities in addition to his TDIU P&T based upon a  single 60% rating.

He also confirms that a 50% rating for Sleep Apnea secondary to PTSD will qualify a vet for SMC-S if the vet's TDIU is based solely upon his only single PTSD rating OR the vet is 100% scheduler for PTSD.  The vet must have additional rating to add to the 50% in order to reach or surpass the required additional 60%.

This is at least the second confirmed qualifier for SMC-S due to secondary OSA Apnea to PTSD (TDIU) from knowledgeable sources who have received such ratings.   Apnea is also considered separate and distinct from  PTSD    See his quote here as follows.

"38 CFR 3.350 (1 - for statutory housebound)

(i) Total plus 60 percent, or housebound; 38 U.S.C. 1114(s). The special monthly compensation provided by 38 U.S.C. 1114(s) is payable where the veteran has a single service-connected disability rated as 100 percent and,

(1) Has additional service-connected disability or disabilities independently ratable at 60 percent, separate and distinct from the 100 percent service-connected disability and involving different anatomical segments or bodily systems


Being "secondary" doesn't make it related.  Again, secondary service connection is just a different path.  Once service connected, that's it.  The path taken no longer matters.  The OP should be receiving SMC S based upon the disabilities listed.  All of the additional disabilities are separate and distinct from the PTSD evaluation.

In my own case, I have IU based upon a 60% spinal rating.  ALL of my additional ratings are secondary to that spinal rating (GERD, ankle, bilateral pes planus, etc) and I draw at the SMC S rate."

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 A the secondary condition  when service connected to another service connected condition  becomes part of the 1st service connected condition?(I read that some where in the CFR's but can't remember what #?..

if it does then that wipes out the percentage the veteran gets for the secondary condition  because it becomes part of the original  S.C. Condition  but OSA may be the exception to the rule?

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    • Enough has been said on this topic. This forum is not the proper forum for an attorney and former client to hash out their problems. Please take this offline
    • Peggy toll free 1000 last week, told me that, my claim or case BVA Granted is at the RO waiting on someone to sign off ,She said your in step 5 going into step 6 . That's good, right.?
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    • I took a look at your documents and am trying to interpret what happened. A summary of what happened would have helped, but I hope I am interpreting your intentions correctly:


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    • Tinnitus comes in two forms: subjective and objective. In subjective tinnitus, only the sufferer will hear the ringing in their own ears. In objective tinnitus, the sound can be heard by a doctor who is examining the ear canals. Objective tinnitus is extremely rare, while subjective tinnitus is by far the most common form of the disorder.

      The sounds of tinnitus may vary with the person experiencing it. Some will hear a ringing, while others will hear a buzzing. At times people may hear a chirping or whistling sound. These sounds may be constant or intermittent. They may also vary in volume and are generally more obtrusive when the sufferer is in a quiet environment. Many tinnitus sufferers find their symptoms are at their worst when they’re trying to fall asleep.

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