SMC-l Aid and Attendance

[Paul USMC]

I have been 100% P&T since 1989. Recently my conditions have gotten worse and I went to my VA Doctor and she filled out an Aid & Attendance form very favorably. My question is will VA grant the SMC-l out right based upon her favorable findings. Or will they call me in for a C&P exam?

[broncovet]

Welcome to hadit.  

VA has "discrection" on whether or not to call for an exam.  If you look at the SMC housebound application, it calls for an exam.   As to whether or not this exam completed will suffice, I could guess that better if I saw the exam, but I can only guess if the exam is sufficient.  

If this is not a va doc, then you need to show the doctor is competent to make this medical determination.  Probably not if the doctor has a phd (doctors degree)  in basketball.   But if he can provide a CV where he regurarly diagnoses and treats people in your type of situation and has experience and training, your chances are good, if the exam is full and complete.  

[Paul USMC]

3 hours ago, broncovet said:

Welcome to hadit.  

VA has "discrection" on whether or not to call for an exam.  If you look at the SMC housebound application, it calls for an exam.   As to whether or not this exam completed will suffice, I could guess that better if I saw the exam, but I can only guess if the exam is sufficient.  

If this is not a va doc, then you need to show the doctor is competent to make this medical determination.  Probably not if the doctor has a phd (doctors degree)  in basketball.   But if he can provide a CV where he regurarly diagnoses and treats people in your type of situation and has experience and training, your chances are good, if the exam is full and complete.  

Thanks for your advise. To clarify I was examined by my VA primary care doctor and she completed the VA Form 21-2680 for SMC-l  Aid & Attendance and described all my service connected disabilities. The Doctor covered all the points necessary for a grant of SMC-l. 

[namvet6567]

11 hours ago, Paul USMC said:

I have been 100% P&T since 1989. Recently my conditions have gotten worse and I went to my VA Doctor and she filled out an Aid & Attendance form very favorably. My question is will VA grant the SMC-l out right based upon her favorable findings. Or will they call me in for a C&P exam?

A couple of questions:  On your 100% P&T decision did the VA address the issue of A&A or HB??  Was it denied at that time??  If not, I believe, that original A&A/HB issue remains open, especially if it was a 100% schedular award.  Anytime the VA makes a 100% schedular award they are required to consider A&A/HB.  I'm not positive on the 100% if it's cumulative.  I'm sure someone else will chime in, if there's anything I've misstated.

[Paul USMC]

44 minutes ago, namvet6567 said:

A couple of questions:  On your 100% P&T decision did the VA address the issue of A&A or HB??  Was it denied at that time??  If not, I believe, that original A&A/HB issue remains open, especially if it was a 100% schedular award.  Anytime the VA makes a 100% scheduelar award they are required to consider A&A/HB.  I'm not positive on the 100% if it's cumulative.  I'm sure someone else will chime in, if there's anything I've misstated.

I was awarded 100% combined Schedular Permanent and Total rating in 1989 and the VA did not address the Aid & Attendance issue at that time. I did not need the benefit then. I am now in my 70's  and my disabilities have worsened.  I recently applied for Aid & Attendance three weeks ago after my VAMC/Miami Primary Care Doctor favorably completed the VA Form 21-2680 for SMC-l Aid and Attendance. I was wondering if a C&P will be required by the VA as the VA Form submitted by my VA Primary listed all my disabilities that are required for SMC- l Aid And Attendance.

[namvet6567]

Based on my previous experience w/VA starting in '74, I would say they will probably require a C&P exam.  My reasoning is that there is less work to ordering a C&P than awarding the SMC request/claim.  And since they are rated on work completed, not quality of work, I would expect the C&P date is coming.  jmo  (sorry, but I've been wrong before)

[broncovet]

Since your prime care doc already filled out the exam, it sounds like it would be redundandt  to require another exam.   However, I did not read the exam, so I have no idea if the exam was sufficient for rating or not.   If you want to study this, you may be able to find out if the exam was sufficient or not.  There are certain things the exam must have to be sufficient for rating.  And, your doctor may or may not have complied with that criteria.  

Further, your rating specialist still has discrection here.  Its like picking the winner of an NFL game, the "consensus favorite" does not always win.  

You have little choice but to wait to see if VA requires another exam.  Based on what you posted, I would estimate the odds at 60 percent no exam 40 percent yes exam, making an assumption your prime care doctor knew what they were doing AND your rating specialist likewise knew what they were doing.  Either of these assumptions could be false.