SMC L C and P Exam for PTSD - What to expect?

[Tbird]

SMC L C and P Exam for PTSD - What to expect? Applied for smc l c an p next month any advice appreciated.

[broncovet]

I have been through a C and P exam for SMC L "Aid and Attendance".  

They will likely ask you if you drove yourself.  Further, they will ask you about "Aid and Attendance", such as what tasks do they perform for you?  Things like, "Can you do your own laundry?"  Can you drive yourself to the store?  Can you mow your own lawn?  Why or why not?

    They may also try to figure out "why" you need A and A, that is, is it related to your SC condition(s), such as PTSD, or is it from another reason?

If you have "loss of use", this is a good time to tell them about that.  If you use a wheel chair or a walker, mention that.  If I recall, your neice did a lot of things for you.  You may want to write down all the things she does for you.  Remember, they can not deny A and A "just because" the person who helps you is a family member.  

Criteria for A and A (SMC L):

Quote

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; inability to attend to the wants of nature; or 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.

Also:

   

Quote

(c) Attendance by relative. The performance of the necessary aid and attendance service by a relative of the beneficiary or other member of his or her household will not prevent the granting of the additional allowance.

Dont "confuse" bedridden and A and A.  YOU do NOT need to be bedridden to get A and A, (but if you are bedridden, you should get A and A)  

Source:  https://www.law.cornell.edu/cfr/text/38/3.352

Edited January 12, 2020 by broncovet

[broncovet]

Example:  

   Let's say your neice calls you once a day to remind you to take your medications.  Tell the examiner that!  Tell the examiner what your helpers do for you.   Remeber, if you need help to "keep yourself or your place clean and presentable" that is a and A.  Can you mop your own floors?  Can you take out the trash?  Can you clean and vacuum your car?  How often are you driving?  Are you living alone?  

[Tbird]

thank you @broncovet this helps 

[broncovet]

Your welcome.  To prepare for the exam, I suggest you make a list ahead of times of the things your (neice or other attendant) does for you, so you know how to answer that question:  "Why do you need A and A?"  AND "How is this related to your SC conditions?"  

The good news, and one you should keep in mind:

If granted A and A, it "wont" be from your "date of claim".  Instead, the effective date should be from the date the doc says "you first needed" A and A.  

So, if your neice has been helping you for 4 years, be sure to tell the examiner, had it not been for your neice you would have had to be in a nursing home.  

Now, Alex says that is a key statement:  "Except for your attendant, you would be forced to go into assisted living".  Of course, I dont know if that is true for you or not, but if it is, be sure and mention it.   As always, fully telll the truth, but this exam is no place for you to "suck it up" and pretend you dont need help, when you do.  I assume you need help, or else the social worker would not have gotten it for you.  

Its not a bad idea to review your records, and especially the social worker who got you (temp) A and A.  What reason did it say that she did that (in your records)?  

Edited January 13, 2020 by broncovet

[Buck52]

BRONCOVET MENTION

 I have been through a C and P exam for SMC L "Aid and Attendance".

 broncovet, Was you awarded the A&A?

I am pulling for Ms T to win this  she deserves it more than anyone I know, she uses her wheel chair and depends on her niece just as someone would that was helpless , I can only Image Ms T Niece would be classified as Ms T Caregiver too

Ms T mention all your conditions that render you bedridden and let them know you fall a lot so you try not to get out as much as possible and when you do  you need your Niece assistance

Be careful about the nursing home fiasco I've seen a veteran apply for A&A and ended up in a nursing home and someone else had been choose his fiduciary 

Remember Ms T anything you mention to them about your health make sure its documented, so read your medical records before your C&P and try to remember whats in them.

  you can take them with you  and mark pages that you may need  to prove what you mention but wait until you see how the exam is going .

  if you think you got an examiner that don't like to read   then bring up some of these special needs you have and let him/her know  that your a lot worse since your last C&P   YOU WOULD NOT BE HERE IF YOU WASN'T ect,,ect,,

We certainly wish you the best

[broncovet]

Buck:  I went throught the A and A exam, and it was denied.  I think they gave me an A and A exam because I applied for housebound.  I simply told them the truth and answered their questions honestly.  

 

Edited January 13, 2020 by broncovet