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SMC increase

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David6684

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I am 100% P and T with SMC-S and have filed claims to reach SMC-M 1/2.  I filed 11 claims 9 of which are related to Parkinson's disease. and two to service-connected Stage III Kidney failure. The VA has already given me 30% for Bowel problems because of PD which was 0%.  A rating of 30%for bowel issues is the highest rating I can get.  The rest of the claims are being deferred, because of the number of claims that have to be sorted out.
 
On 9 of the exams the QTC MD  found in favor of the things I claimed.  However, on two , Chronic fatigue syndrome he nixed. I was wondering since I have not filed a claim since 2011, and have been treated for fatigue, Can the VA consider fatigue alone rather than chronic fatigue?  I am well aware that the examiner can only list their findings, but the rating section relies heavily on their opinions.
 
The QTC MD wrote this about "Restless leg Syndrome"
 
"The claimed condition is less likely than not (likelihood is less than approximately balanced or nearly equal) proximately due to or the result of the veteran's service-connected condition of Parkinson's disease."
 
"Rationale: the veteran has right lower extremity neuropathy causing pain and paresthesia,  the veteran also has a history of  Parkinson's disease with tremors at rest (day or night). The veteran's leg symptoms are consistent with those seen in Parkinson's associated tremors and they do not represent a separate or distinct disorder.separate diagnosis of Restless leg syndrome.
 Does this mean the VA will add RLS to my current rating of Parkinson's disease which in total is rated at 70%?  I take medication prescribed by my VA Neurologist for RLS.



 

 

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Sounds like it since it is a symptom of Parkinson’s (as they wrote it) and not caused by a different externality. I’d have to get into the nitty gritty , though, to sure since low back injuries sometimes have a separate radiculopathy rating. 

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RLS may be related to your kidney issues. 
 

Co-Existing Conditions

There are several conditions which can accompany or may be linked to restless leg syndrome:

  • End-stage renal disease
  • Iron deficiency
  • Neuropathy
  • Use of certain medications(including antinausea medications, antipsychotic medications, antidepressants, and allergy medication)
  • Use of alcohol, nicotine, and caffeine
  • Pregnancy
  • Sleep Apnea

Also, RLS can lead to fatigue if it keeps you awake at night. So, consider RLS secondary to CKD, then fatigue secondary to RLS.

As far as the SMC, which criteria do you fall under? Are you considering loss of use of both feet? Or another criteria? They could come back with L 1/2 if your condition causes loss of use of both feet and you have added rating of more than 50%.
 

You may receive an SMC-L 1/2 designation if any of these situations are true for you:

  • You’ve had one foot and the other knee amputated, or
  • You’ve had one foot amputated, and have lost the use of the other knee, or
  • You’ve had one foot and one elbow amputated, or
  • You’ve had one foot amputated, and have lost the use of one elbow, or
  • You’ve had one knee and one hand amputated, or
  • You’ve had one knee amputated, and have lost the use of one hand

Or:

  • You’ve lost the use of one foot, and have had the other knee amputated, or
  • You’ve lost the use of one foot, and have had one elbow amputated, or
  • You’ve lost the use of one foot and one elbow, or
  • You’ve lost the use of one knee, and have had one hand amputated, or
  • You’ve lost the use of one knee and one hand

Or:

  • You have blindness in one eye and total blindness in the other eye with only the ability to perceive light, or
  • You have blindness in both eyes, and have lost the use of one foot (rated as less than 50% disabling), or
  • You have blindness in both eyes, and have total deafness in one ear

Or both of these are true: 

  • You have a disability or situation listed in the SMC-L designation, and 
  • You have one or more additional permanent disabilities rated as 50% or more disabling”

You may receive an SMC-M 1/2 designation if any of these situations are true for you:

  • You’ve had one knee amputated, and have had one leg amputated so close to the hip that you can’t wear a prosthesis, or
  • You’ve had one knee amputated, and have had one arm amputated so close to the shoulder that you can’t wear a prosthesis, or
  • You’ve had one elbow amputated, and have had one leg amputated so close to the hip that you can’t wear a prosthesis, or
  • You’ve had one hand and one elbow amputated, or
  • You’ve had one hand amputated, and have lost the use of one elbow

Or:

  • You’ve lost the use of one knee, and have had one leg amputated so close to the hip that you can’t wear a prosthesis, or
  • You’ve lost the use of one knee, and have had one arm amputated so close to the shoulder that you can’t wear a prosthesis, or
  • You’ve lost the use of one elbow, and have had one leg amputated so close to the hip that you can’t wear a prosthesis, or
  • You’ve lost of use of one hand, and have had one elbow amputated, or
  • You’ve lost the use of one hand and of one elbow

Or you have total blindness with only the ability to perceive light:

  • In one eye, and have physically lost the other eye, or
  • In one eye, and have total blindness without the ability to perceive light in the other eye, or
  • In both eyes, and have lost the use of one foot (rated as less than 50% disabling)

Or you have blindness in one eye, and:

  • You’ve physically lost the other eye, and have total deafness in one ear, or
  • You have total blindness without the ability to perceive light in the other eye, and have total deafness in one ear, or
  • You have total blindness with only the ability to perceive light in the other eye, and have deafness in both ears (rated as 30% or more disabling), or
  • You have total blindness with only the ability to perceive light in the other eye, and have had one foot amputated, or
  • You have total blindness with only the ability to perceive light in the other eye, and have lost the use of one foot (rated as 50% or more disabling), or
  • You have total blindness with only the ability to perceive light in the other eye, and have had one hand amputated, or
  • You have total blindness with only the ability to perceive light in the other eye, and have lost the use of one hand

Or: 

  • You have blindness in both eyes and total deafness in one ear, or
  • You have blindness in both eyes that requires you to have daily help with basic needs (like eating, bathing, and dressing), and have lost the use of one foot (rated as less than 50% disabling)

Or both of these are true: 

  • You have a disability or situation listed in the SMC-M designation, and 
  • You have one or more additional permanent disabilities rated as 50% or more disabling”

 

I hope this helps!

I would wait for a few things to be sorted out since they are required to consider you for SMC based on your conditions. In the meantime keep seeing the doctor and complaining about all of the conditions for which you are applying for compensation.

Blessings,

Lisa C

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My advice is to "focus" on the criteria.  "The criteria" for SMC (above level SMC S) generally means you need aid and attendance (at various levels) OR you have loss of use of body organs or body parts.  

Lady Vet has given at least some of the criteria for Increased SMC.  A few more are here:

https://www.law.cornell.edu/cfr/text/38/3.350#:~:text=The special monthly compensation provided,of regular aid and attendance.

Specifically, my advice is to read the above over and see if you think you meet any or all of the criteria, in 38 cfr 3.350, which I provided a link above.  If you have loss of use of body organs, parts, or need aid and attendance, then you should be able to get a higher level of smc.  Since I have not reviewed your file, I wont speculate on what, if any, level of smc increase you qualify for.  

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