SMC S1

[teacher1da]

I perused this site and found it informative and supportive.  I noticed on ebenefits under additional benefits that my husband is entitled to special monthly compensation under 38 U.S.C. 1114 subsection (s) and 38 CFR 3.350(I) from 8/31/2016 to 9/1/2016; rated date 2.4.2023.  Based on the information on this site, he has met the criteria regarding housebound (with my understanding for veterans who are unable to overcome their particular disabilities and leave the house in order to earn an income...) Senate Report No. 1745 June 27, 1960 .  And according to ebenefits, on account of bladder cancer in remission (Nehmer Granted) rated 100 percent and additional service-connected disabilities hypertensive heart disease s\p heart valve replacement, ptsd 70%-TDIU, independently ratable at 60 percent or more.  To my understanding, the bladder cancer rated 100% is temporary during treatment, the 100 percent evaluation decreased to 0 percent effective September 1, 2016.  As I investigated this further, I noticed the stated entitlement on a rating decision dated 1/20/22.  Note: a decision was made without a C&P examination.  Therefore, residuals were not taken into consideration.  Again, based on my limited knowledge on SMC qualifications, I assumed that my husband would qualify with ptsd tdiu and hypertensive heart disease.

I would like to take this case to the next level and file for SMC (s-1) since it was not awarded automatically.  I am not sure how to go about applying.  Do we need to provide a lay statement?  Do I provide copies of the C&P examination reports to show level of severity?  Please advise.   He has  gotten to 100% with many bumps on the road and we know VA does not always put us on a direct path.  We would appreciate any help to move forward.

Vietnam and Iraqi Vet

 

[Dustoff1970]

He should qualify immediately based upon what you have said.  You can fill out a VA form 21-526 and on the line for type of disability filing simply write Special Monthly Compensation SMC-S and give the effective date as the date he qualified for SMC-S that would be the date of the additional 60% rating for HTN heart disease.

Please note that for over 25 years I was rated at 70% PTSD with P&T TDIU and upon receiving 30% for Nam Agent Orange heart disease and OSA Sleep Apnea at 50% I was then automatically awarded SMC-S back dated to 2017 that was the date of my OSA claim.

Just as I did for other 526 form claims you should attached supporting evidence copies of all his VA serviced connected conditions and copy of their VA own decision letters awarding him TDIU and 60% for heart disease plus cite the correct 38 U.S.C laws and 38 CFR regulations that qualify him for SMC-S.  You can also just I have done attached a brief STATEMENT IN SUPPORT OF CLAIM explaining your contention for SMC-S.

Even tho the VA VBN raters have all this information in his C-File it is extra insurance to send the above evidence/documents to them again to make sure they know that you know and can prove it.  Send copies only of course.

In very recent time I have thanks to the BVA appeal board received 60% for heart disease and from the VARO 60% for GERD, 10% for Tinnitus and 0% for HTN high blood pressure.  He may be entitled to many years of back pay for SMC-S.

An experienced accredited VSO at a VARO office or others on this forum can provide you with the correct Title 38 laws and CFR regulations plus form numbers for your claim.  A google search will also yield this information.

My comment is not legal advice as I am not a lawyer, paralegal or VSO.

 

[toddt]

https://www.va.gov/pension/aid-attendance-housebound/

[broncovet]

I agree with the others, but add:

   Not only should you apply to get your SMC S back, (as Dustoff suggested) it sounds like your husband may well qualify for additional SMC.  Of course, IDK your husbands medical conditions, but it sounds like he has some serious issues.  

One that comes to the top of my mind:  Aid and Attendance (aka SMC L).  Are you taking care of him?  My guess is that you are.  But that is just a guess.  

Some people dont know that you can get A and A "even when performed by a family member".  Source:  https://www.law.cornell.edu/cfr/text/38/3.352#:~:text=The following will be accorded,special prosthetic or orthopedic appliances

In relevant part, above, (38 CFR 3.352) is item

Quote

(c) Attendance by relative. The performance of the necessary aid and attendance service by a relative of the beneficiary or other member of his or her household will not prevent the granting of the additional allowance.

My advice is to read over the link I provided above, and if you think you are performing A and A for him, then apply.  

[teacher1da]

Gentlemen, this is a wealth of information I was not able to retrieve from multiple sources on the internet; thank you so much for your assistance and support.  I am looking forward to moving ahead with filing for both.  I will share the results.

To confirm, VA Form 21-526EZ?

Thank you for your service. 

Edited December 20, 2023 by teacher1da

[broncovet]

My advice is to use the following form for A and A and/or housebound:

https://www.va.gov/find-forms/about-form-21-2680/

Do not fret about the effective date now.  The effective dates for SMC are different than "regular" compensation, because the claim date is always inferred.  This means you should get SMC on the effective date of "facts found" regardless of your date of application, because VA should have inferred it.  

Now, if you do get awarded smc and they use the date you applied (not the date you actually meet the criteria) then appeal the effective date and you should win.  

[teacher1da]

Moderators: Within days, my husband received the following decision letter: 

Entitlement to an additional payment of compensation is established when service-connected impairment imposes a special level of disability. Entitlement to special monthly compensation is not warranted in this case because the criteria regarding housebound have not been met. (38 CFR 3.350.

There is no indication that you are substantially confined to your dwelling and immediate premises due to disability, nor that you have a single service-connected disability rated as totally disabling and additional service-connected disabilities that are independently evaluated as 60 percent disabling. (38 CFR 3.350).

Very confusing, but I believe they didn't peruse the application.  

Thank you,

Vietnam/Iraq Vet