SMC-S multiple items

[SPO]

I know the regulation reads 1 condition at 100% and another 60% on top of that to qualify.  However,  If I have multiple joints (psoriatic arthritis) effected by the same condition that total to 100% and still at least 60% in other ratings, would that qualify for SMC-S?

[FormerMember]

Well, you have it right for the most part, sir. The only qualifier that you don't "sound out" is that the balance of the ratings that constitute your extra 60% (or more) must all be independently ratable and be separate and distinct from your psoriatic arthritis disability. You'd need to employ §4.25 to add them up. You cannot use anything "left over" from your psoriatic arthritis ratings to fill in the 60% to get to SMC S under §3.350(i)(1). 

Obviously, an alternative, but far more arduous path to get to SMC S would be to get a diagnosis of being "housebound in fact" under §3.350(i)(2).

Best of luck.  

[SPO]

So I have a 60% rating for psoriasis, the psoriatic arthritis is secondary to this.   Is that considered separate and distinct?

[FormerMember]

That's where the VA and I digress. VA likes to throw anything and everything associated with a disease into the same basket. The actual language, as parsed in numerous CAVC cases, is the unique language used in §3.350(f)(3) and (4)-

-  must be separate and distinct and involve different anatomical segments or bodily systems.

Based on this, and all the cases I've won citing to this interpretation of the language in the regulation, psoriasis is rated under §4.118. Arthritis is rated under Musculoskeletal (§4.71a) between DC 5002-5010. As such, they are two separate and distinct disease processes/ bodily systems. This is what  I always argue at bar.

With that said, look at DM II or Parkinson's. VA tends to lump everything together. DM II gets PN and DR (diabetic retinopathy) thrown in on top. Sometimes even renal deficits. I've won L using that argument. Parkinson's gets the same full meal deal treatment with all the extremity deficits combined with facial muscle sag, trouble swallowing, etc. I've won using this argument too.  

What VA does with the SMC S will in large part control what happens some time in the future with an a&a rating. VA will definitely argue the psoriatic arthritis is secondary to the psoriasis under §3.310- which it is. But, for rating purposes under §4.25(b), they are separate and distinct and involve different bodily systems. 

Trust me when I say someone will come along and disagree with me on this subject but my experience is based on actual hands-on litigation for clients-not speculation and conjecture about what VA might or might not do. SMC is very difficult to fathom. My advice is to stress that the two diseases are not one. 

Best of luck, sir.

[blahsaysme2u]

this is great info @asknod thanks for such detailed breakdown. 

[Mr.B]

Bradly vs Peake 

[SPO]

Does anyone know of any legal precedent that applies to scheduler 100%.   1 condition that effects multiple joints but add to 100% (by VA math).  The va rated them as about 13 different items.    The case mentioned above seems to apply to using TDIU as the 100%.   I am not TDIU.