SMC is to be awarded without the need to file a separate claim.

[pacmanx1]

This is not a question, just passing on. 

A.B. v. Brown, 6 Vet. App. 35, 38 (1993). Veterans may claim SMC, or it may be raised by the evidence of record. See Akles v. Derwinski, 1 Vet. App. 118, 121 (1991); Bradley v. Peake, 22 Vet. App. 280, 294 (2008). SMC is “to be accorded when a veteran becomes eligible without need for a separate claim.” Bradley, 22 Vet. App. at 294 (emphasis added).

TransportRoom (cavc.gov)

Vet. App. CAVC Decision No. 21-539

Edited March 30, 2023 by pacmanx1

[Vync]

They are "supposed" to do this, but it is not always that automatic. I have mostly seen it happen after the VA has submitted a disability claim of some sort. The VA's medical care providers do not automatically refer potential SMC claims to the VBA for adjudication. I had checked with a VA nurse and a doc and they said they never send anything to the VARO.

Case 1: A friend of mine had problems with ED and wasn't all that old. Once he learned it was possible to file for ED secondary to medication side effects, they filed and won SMC-K. The VA did not proactively notice an ED diagnosis in his records and grant SMC-K.

Case 2: I had a heart attack leaving me out of work for three months. No idea if I would ever work again. Filed claim for heart attack, VA denied repeatedly. While waiting, I did therapy and eventually returned to work. Eventually SC was granted via HLR. I got a single 100% for the heart per the rating criteria, but just for three months. I already had a separate and unrelated single 60% for something else, so they actually did add SMC-S housebound without having to ask for it. I honestly did not expect to get SMC-S at all. I just wanted to ensure the heart attack was SC just in case my condition continued to deteriorate. However, the heart rating criteria required re-eval after three months (despite me already being 100% P&T), the evidence showed I had slightly improved to the 60% level and the SMC-S was removed simply because I did not meet the 100% + separate 60% criteria. The VA did not automatically consider extraschedular SMC-S housebound because I work remotely in a sheltered environment and receive other employer-provided disability accommodations.

[broncovet]

Yes.  That is why we need to know criteria for SMC, so, that we can apply when eligible. 

In summary, any of these things should result in SMC:

1.  Loss of use (hands, eyes, feet, legs, feet, reproductive organ(s), etc)

2.  Unable to leave the home to go to work.

3.  Need for Aid and Attendance. 

4.  Meeting the criteria for a single 100 percent plus an additional combined 60 percent or more separate and distinct.  

     If in doubt, apply.  If denied, you can consider whether or not an appeal is warranted.  If you think you meet the applicable criteria, then appeal.  

[pacmanx1]

16 hours ago, Vync said:

They are "supposed" to do this, but it is not always that automatic. I have mostly seen it happen after the VA has submitted a disability claim of some sort. The VA's medical care providers do not automatically refer potential SMC claims to the VBA for adjudication. I had checked with a VA nurse and a doc and they said they never send anything to the VARO.

 

15 hours ago, broncovet said:

That is why we need to know criteria for SMC, so, that we can apply when eligible.  Meeting the criteria for a single 100 percent plus an additional combined 60 percent or more separate and distinct.   

 

In reference to SMC-S, this should also be part of the DTMVB (Duty to Maximize the veteran’s benefits) and should be the rater’s job and not the medical doctors. I can see that the medical doctors could refer but once a veteran has the numbers (100% + 60% or TDIU + 60%) and meets the rating criteria then it should fall under A.B. V. Brown, 6 Vet. App. 35,38 (1993) to maximize the veteran’s benefit because the veteran should be seeking the maximum rating allowed by law and regulation. This is the job of the VARO and or the Board not the VAMC.

Also, Buie V Shinseki, 24 Vet. App. 242, 248 (2011) states:  Whenever a veteran has a total disability rating, schedular or extra-schedular, based on multiple disabilities and the veteran is subsequently awarded service connection for any additional disability or disabilities, VA's duty to maximize benefits requires VA to assess all of the claimant's disabilities without regard to the order in which they were service connected to determine whether any combination of the disabilities establishes entitlement to special monthly compensation under section 1114(s).  If, after such an assessment, VA determines that the claimant is entitled to special monthly compensation, the effective date of the award of special monthly compensation will be the effective date assigned for the award of benefits for the final disability that forms the relevant combination of disabilities.

Edited March 31, 2023 by pacmanx1