Housebound Question

[Dfinnusmc]

Hello all,

I was re evaluated for PTSD this month and was raised to 100% for Combat related PTSD from 70% also made P&T,

I have the Following conditions :

Tinnitus 10%,Lumbar 10%,Radicuapathy-secondary 10%,Pes Cavus 30%,IBS 30%,Sleep apnea secondary to PTSD 50%,

Should I be eligible for SMC-S Housebound ? I was  wondering if I should follow a NOD or submit a new Claim?

Thank you for any guidance

Edited July 25, 2020 by Dfinnusmc (see edit history)

[Tbird]

Thanks for letting us know this worked out for you @Dfinnusmc

 

[Buck52]

No because a Veteran needs to have 100%  or TDIU and an additional''separate & distinct  condition rated at 60% or higher.

Example I was 90% with a combined rating and was awarded the TDIU  WHIS PAY THE SAME AS A 100% RATING I was getting paid at the 100% rate

I then filed another separate & distinct claim (PTSD) and was  Rated 70%

with this extra separate rating /condition from the original  condition  they gave me the 100% scheduler rating and the I.U. was Moot   because of this other   S.C.condition (PTSD) That meet the SMC H.B. Criteria  and was awarded the SMC S H.B.

With all your other combined rated condition they do add up to a 74.485% at a 70% rating but they don't have a 60% rating or higher on any of them.

so see you missed it by 10%

if you had got 60% for sleep apnea OR any of your other conditions then you should have been inferred the SMC S.

Now with this said may be other  members can chime in here because I am not 100% sure combined rating will afford a veteran SMC.?

I believe the s.c. condition needs to be at least 60% or higher.

 

 

[GBArmy]

Buck I believe you are correct. You need a second unrelated s-c disability that is 60% or higher for Level S. Best explanation I have seen is CC&K's See https://cck-law.com/blog/special-monthly-compensation-explained/ Very complicated/confusing for my tiny brain cells.

 

 

[deedub75]

I thought you had to have one condition permanently rated at 100% (or TDIU) and one other separate condition rated at 60% or more to receive SMC(s).  Has that changed?  I'm 100% P&T and I don't have any one condition rated higher than 50%.  I have been able to get SMC(s) a couple of times when I have surgery and file for temporary 100%.  In the notes on eBenefits it says that I qualified based on being temporary 100% for the one condition I had surgery for and I had other conditions that added up to 60%.  

This is from the CCK Law website:

Examples

Since qualification for the second (2) type of SMC(s) is fairly clear regarding being housebound, we will provide some examples of the first (1) qualifier:

• If the veteran receives 100% for Ischemic heart disease and 60% for intervertebral disc syndrome (back condition), he/she would be eligible for SMC(s)
• If a veteran has a 70% schedular rating for PTSD, and is receiving TDIU based solely on the PTSD, and also has a 60% rating for Coronary Artery Disease (CAD), he/she will qualify to receive SMC(s)

 

[Buck52]

CCK Law quoted

''If the veteran receives 100% for Ischemic heart disease and 60% for intervertebral disc syndrome (back condition), he/she would be eligible for SMC(s)''

THIS IS CORRECT  BECAUSE THE VETERAN HAD A DISABILITY RATED AT 100% FOR IHD  (HEART DISEASES)...THEN HE HAD ANOTHER DISABILITY SERVICE CONNECTED FOR 60%% for the back condition) the 60% for intervertebral disc syndrome (back condition), he/she would be eligible for SMC(s) 

THERES 2 DIFFERENT CONDITIONS RATED AT 100% AND THE OTHER ONE RATED AT 60%

It' DON'T MATTER  rather or not he/she is P&T

 

And the veteran rated 70% for PTSD AND AWARDED THE IU  THIS AUTOMATICALLY MAKES HIM 100% ALTHOUGH HE IS CONSIDER TO BE 70%  & 60% FOR CAD  THIS QUALIFY[S  HIM FOR THE SMC H.B.

IU = 100%   the 60% for the CAD  QUALIFY'S  HIM for the SMC S H.B.

Edited July 26, 2020 by Buck52 (see edit history)

[Buck52]

deedub75

''I thought you had to have one condition permanently rated at 100% (or TDIU) and one other separate condition rated at 60% or more to receive SMC(s).  Has that changed?''

NO IT HASN'T CHANGED? WHY DO YOU THINK IT HAS?

[deedub75]

5 hours ago, Buck52 said:

No because a Veteran needs to have 100%  or TDIU and an additional''separate & distinct  condition rated at 60% or higher.

Buck,

This is what confused me.  It doesn't say one condition at 100%. Typo maybe?

[Buck52]

19 hours ago, deedub75 said:

Buck,

This is what confused me.  It doesn't say one condition at 100%. Typo maybe?

Yeah I see

Well TDIU P&T at 70% is basically  the same as a 100% rating, the benefits are the same.,,,as Although the veterans is 70% he get the benefits at 100%  and then if he had another separate condition service connected at 60%  then he should be inferred  for the SMC H.B....some times a rater won't catch that   then you NOD the rating and let them know you should be given the SMC S.H.B.

[Dfinnusmc]

Hi just wanted to update i was granted smc-s statutory. The veteran needs 1 single rating at 100% and any combination of ratings equal to 60%, it can be 1 rating at 60% or in my case 6 other ratings that equal to 60% or more hope this info can help others

[GBArmy]

Dfinnusmc That's good news for you! Congrats. If you have 6 other disabilities i"m thinking you have a lot of wear and tare on that VA road you've been on. I expect you have considerable claims experience and hope you can stick around and share some of your experiences with other veterans that may wonder how to handle the same disability that you have. We would welcome that input.

[Dfinnusmc]

Absolutely, i spoke to the Regional office and 2 different vso’s on process but end of the day I researched cfr38  isc 1114s and 38 cfr 3.350(i) and submitted a claim with an attachment laying out why i should receive housebound statutory and from start to finish it took 5 days.