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?

[john999]

If you want to get evaluated for a higher level of A&A do have to file a claim first or can you get an evaluation from VA first before you file?  I got two 20% ratings for both feet and a 40% and 30% for my arms.  I got "S" but what do I need for higher A&A?  I am not even sure if it worth the effort to claim it.

[jamescripps2]

John, I would suspect that your easiest path to the higher award of "L" you would need loss of use of two feet, or loss of use of two hands, or loss of use of one hand and one foot to get you to an L rating. To get there, file for an increase on the hands and feet. Be shure and ask the examiner to check the external popliteal nerve, (common peroneal nerve, causing foot drop. See and understand 38 CFR 3.350 (2) (b).

As to the question of would it be worth pursuing? It could mean a substantial raise in compensation, an automobile grant, about $24,000.00 and special adaptive housing grant, about $117,000.00.

The granting of the "L" rating for loss of use could eventually be used as a building block to obtain the "O" rating, and maybe the R-1 or R-2 ratings.

[Paul USMC]

On 1/7/2024 at 10:48 AM, 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% 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.

My 100% P&T was awarded in 2005 but was made retroactive to 1989. The VA did not address the aid and attendance issue back the. More than 20 years went bye and that 100% P&T is now a protected rating. Recently my conditions have gotten worse so I approached my VA Primary Care Doctor and she favorably filled out the 21-2680 Aid and Attendance Form.  I am waiting for a VA decision and I am suspect of a P&T Examiner because they are not

your friend.

[Lemuel]

Paul my PC was not complete.  Ordered a bunch of consults which I have not been able to get to.  Catch 22.  

My TBI P&T is dated back to 1985, so similar there.  Doubt they will give us more than one year on the date of the P&T order.  But there is a case in the works.  Haskell vs McDonough.  Denied based upon specific requirements that were not included in the Code change.  The CFR has not been changed to match the new code.  So ADL requirements that do not apply as much as safety to the TBI victim are still in there.

It is a wait and see what the Decision is and if it is appealed to the CAFC.

[namvet6567]

On 1/6/2024 at 10:44 PM, 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?

If your 100% P&T award back to '89 was based on a single 100% schedular award, the VA was required to consider both A&A and HB, at that time, by awarding or disallowing both/either.  If they failed to do that then that is an open claim and could be a retro award of over $100k.  You may want to consider pursuing that claim.  They may correct their error, or you may have to appeal it for years.  Your choice.

[Paul USMC]

On 1/22/2024 at 9:17 AM, namvet6567 said:

If your 100% P&T award back to '89 was based on a single 100% schedular award, the VA was required to consider both A&A and HB, at that time, by awarding or disallowing both/either.  If they failed to do that then that is an open claim and could be a retro award of over $100k.  You may want to consider pursuing that claim.  They may correct their error, or you may have to appeal it for years.  Your choice.

Thanks for your response. I was rated 100% P&T in 1989 but it was a cumulative rating meaning not one disability was rated 100% by itself. It was a combination of disabilities that rounded off to 100% P&T.