Higher level aid and attendance

[Lonniebrinson]

I recently filed for aid and attendance. I was denied because the va said I do not meet the criteria for higher level of aid and attendance which will be (SMC-R2). Here's the problem I filed for basic  aid and attendance under 38 cfr 3.352(a) ( SMC-L). Do anyone have any idea why the va overlooked the basic level of aid and attendance ?

My current rating is SMC-P2. 

SMC-L loss of use of both feet

100% bowel incontinence

60% urine incontinence

60% IVDS

50% PTSD

 

[Mr cue]

I would make sure I appeal it.

I look at it like this they are not try to grant the smc l for aid attendance.

Because this would give u two smc l and would trigger the smc o.

Which I believe if you receive in home care by a company. Would granted the smc r.

On appeal I would state I am not look for smc r.

I am looking for smc l for the need of help of others.

Not sure if you had the aid and attendance comp exam. If you did I would include it.

A statement from wife kids about how they help u.

And explain that in the appeal.

 

The board and va seem like they don't like address smc claims once they get in the smc o r area.

I am fighting the same thing almost I was granted smc l for help of other.

The board state this is for all my condition.

This is done so I can't claim need of help for different condition that are different body parts.

In my case they will not even address the smc o or r after the us court of veterans appeal remand it to be address.

I receive in home care provide by a company.

 

Good luck and don't give up.

[Lonniebrinson]

44 minutes ago, Mr cue said:

I would make sure I appeal it.

I look at it like this they are not try to grant the smc l for aid attendance.

Because this would give u two smc l and would trigger the smc o.

Which I believe if you receive in home care by a company. Would granted the smc r.

On appeal I would state I am not look for smc r.

I am looking for smc l for the need of help of others.

Not sure if you had the aid and attendance comp exam. If you did I would include it.

A statement from wife kids about how they help u.

And explain that in the appeal.

 

The board and va seem like they don't like address smc claims once they get in the smc o r area.

I am fighting the same thing almost I was granted smc l for help of other.

The board state this is for all my condition.

This is done so I can't claim need of help for different condition that are different body parts.

In my case they will not even address the smc o or r after the us court of veterans appeal remand it to be address.

I receive in home care provide by a company.

 

Good luck and don't give up.

Thanks for responding. You're right they don't like awarding higher levels of SMC. I use a Condon catheter maybe it confused the rater they I need a license medical personnel to insert it. Thank you

[Mr cue]

I bet there is nothing about the license personal or the catheter. In the decision

They are to address all evidence favorable and unfavorable.

This how benefit of doubt works.

 

 

 

[Lonniebrinson]

1 hour ago, Mr cue said:

I bet there is nothing about the license personal or the catheter. In the decision

They are to address all evidence favorable and unfavorable.

This how benefit of doubt works.

 

 

 

Lol you're right again... Your opinion how should I appeal this matter supplemental explaining it on a 4138, HLR with a phone call or take it to BVA

[pwrslm]

Do not appeal yet. Get any document you can find on the internet that can be considered new evidence and submit a supplemental claim. Medical studies on the internet that show the severity of the condition, a statement from a care taker, and copies of VA M21r/USC/CFR are all things that may be considered new evidence. Get one of each supporting your claim and that documents the errors in the original decision, and then write a lay statement describing in detail what you consider to be errors in the denial. Include that with a supplemental claim and let them take the 90-120 days to process it. Just say the failed to comply with the M21/CFR/USC.

If there is a clear and unmistakable error (CUE), do not state so in this round, but instead detail the error step by step referencing M21/CFR/USC so that there is no question about what you state is true. CUE can only be claimed once, so instead of doing it up front, leave it for appeals.

If they deny it after that, think about a VSO that can communicate w/the RO directly. If that does not get it done, then appeal. Appeals are a lot longer than new evidence submissions and with the new appeals set up, you have up to a year to file supplemental and HR claims without losing your original claim award date. You can literally string out a claim for 5 years and get the back pay as long as you meet the new evidence requirement.

 

This is the guidebook that the VA MUST follow when they process claims.

Edited October 9, 2021 by pwrslm

[Lonniebrinson]

8 hours ago, pwrslm said:

Do not appeal yet. Get any document you can find on the internet that can be considered new evidence and submit a supplemental claim. Medical studies on the internet that show the severity of the condition, a statement from a care taker, and copies of VA M21r/USC/CFR are all things that may be considered new evidence. Get one of each supporting your claim and that documents the errors in the original decision, and then write a lay statement describing in detail what you consider to be errors in the denial. Include that with a supplemental claim and let them take the 90-120 days to process it. Just say the failed to comply with the M21/CFR/USC.

If there is a clear and unmistakable error (CUE), do not state so in this round, but instead detail the error step by step referencing M21/CFR/USC so that there is no question about what you state is true. CUE can only be claimed once, so instead of doing it up front, leave it for appeals.

If they deny it after that, think about a VSO that can communicate w/the RO directly. If that does not get it done, then appeal. Appeals are a lot longer than new evidence submissions and with the new appeals set up, you have up to a year to file supplemental and HR claims without losing your original claim award date. You can literally string out a claim for 5 years and get the back pay as long as you meet the new evidence requirement.

 

This is the guidebook that the VA MUST follow when they process claims.

Wow thanks for the ammo I will do exactly that. I can't believe the va rater overlooked my 100% Bowel incontinence. The M21-1 states a single 100% disability should be considered an Inferred claim and consider it for smc- L aid and attendance.. Thank you so much