SMC Questions

[scottinmt]

Hello All,

It's been a few years since I last signed on and it seems most of my data has been purged from my profile.  I received my 100% P&T rating in the spring of 2016 backdated to the summer of 2015.  My conditions have seemed to worsen over time and I am now considering applying for SMC for being both housebound and relying on my wife to care for me due to mental and physical issues.  I do not have a service connected mental health diagnosis but have seen VA Psychiatrists since 2011.  It appears that being housebound is a SMC S rating but I am unsure of where what I'm calling "aid and attendance" falls.  Any help would be appreciated.  Thank you!

[Berta]

Thanks!  Now I understand this better-

If you can fulfill the Housebound criteria, you should claim housebound- or if you have any service nexus for the MH issue ( or if it is, in fact ,due to the ratings above*) you should claim it. Here is the HB form to file, 

https://www.vba.va.gov/pubs/forms/vba-21-2680-are.pdf

* An MH issue can be secondary to many SC diabilities, but that usualy takes a strong IMO/IME

In this case the veteranThe examiner concluded that it was more likely than not that the Veteran’s depression was proximately due to or the result of his ulnar neuropathy and/or lumbar spine DDD. 
This veteran had a difficut ordeal but he succeeded:

"ORDER

Severance of service connection for lumbar spine degenerative disc disease (DDD) was improper; restoration of service connection for lumbar spine DDD is granted.

Severance of service connection for depression secondary to service-connected conditions was improper; restoration of service connection for depression secondary to service-connected conditions is granted."

https://www.va.gov/vetapp21/files4/a21007480.txt

Not the best case I searched for ,but it shows that a MH issue can be secondary to a SC disability.

 

The examiner concluded that it The examiner concluded that it was more likely than not that the Veteran’s depression was proximately due to or the result of his ulnar neuropathy and/or lumbar spine DDD. 
was more likely than not that the Veteran’s depression was proximately 
due to or the result of his ulnar neuropathy and/or lumbar spine DDD. 

Edited December 7, 2021 by Berta
cloud

[broncovet]

Great idea, Scottinmt.  (Following my advice, and contacting CCK on SMC issues).  

It sounds like they gave great advice:  Apply for A and A.  Should you get denied, you may consider contacting CCK law, again.   However, if it "were" me, I would appeal to the BVA, and "only" if the board also denied me, would I hire CCK law.  

REason:  Its not that difficult for a Vet to appeal to the board.  You fill out the applicable forms, and probably a statement as to "why" you think their denial was wrong.  

But, its a different animal at the CAVC.  Importantly, if denied by the Board, MOST law firms will represent you (if they think you have good cause for appeal) at no cost.  That is, EAJA nearly always pays attorney fees at the CAVC level if the Veteran wins.  If the Veteran does not win at the CAVC, there are no fees due by the Veteran, as almost always, in Veterans law, the case is taken "on contingency".  This means that unless the judge orders additional benefits, which result in retro, you owe the attorney nothing.  But, check your fee agreement, but this is typical in Veterans law.  

[scottinmt]

Thank you Berta, I am in constant pain which has a lot to do with my mental condition and seeing my body fall apart (loss of strength and feeling in my hands and feet as well as the digestive issues) prevents me from doing the things I once enjoyed such as hiking, playing the guitar, pretty much anything that requires movement has lead to my depression.  I am on doses that exceed the max recommended for gabapenton and fluexetine.

[Berta]

I can certainly understand that  that these diabilities would cause anyone mental distress.

You stated your EED was 2015 for the award , but were these disabilities diagnosed prior to that date, maybe even by a private doctor?

You mentioned you had VA MH care back to 2011- would your records reveal that you had the same SC disabilities then ,but you had not filed a claim for them yet?

The DeLuca factor( searchable here) causes the VA to consider pain when adjudicating a disability.

Gabapenton is a strong pain medication and Fluoexetine is for treatment of depression. Your drug med profile in your VA medical records woud reveal when the VA started giving you these medications.

If there is a link ( nexus) to the same timeframe  that the diabetes and other issues disabled you, it would help support a claim for the MH issue.

Your VA psychiatric records might also help a lot,to prove the MH issue is due to the SC diabilities.

Do you receive SSDI ? and if so what is the SSDI for?

 

 

 

 

 

 

 

[scottinmt]

Berta,

Yes I have seen the VA for depression since 2011, I had been on meds at that time, I'm not sure how long I was off of them. The doctor who performed the C&P exams in 2016 told me I needed to see someone for depression as it was obvious to her that I had that going on.  It was actually the genesis for me to ask for a consult and to start seeing a psychiatrist.

I am on SSD, have been since 2018.  They never tell you why it was granted, but my claim explained my physical issues and the fact my brain just doesn't function well.  This is due to depression and the meds I take for pain relief and depression.  There is also a documented cognitive decline for those who suffer from long-term diabetes.

Edited December 8, 2021 by scottinmt