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...Consider the need for SMC and A&A

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chris_2pher

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Hello everyone. First post here. Hope all is well.

Currently 70% PTSD with TBI and on IU since 2010. I also have 40% total of other ailments (back, neck, knees). My wife is my official VA caregiver and on the Post 9-11 Cargiver program.

In 2018, I made attempts to get a higher rating but was denied not long after the OTC appointments. I then submitted an appeal to the BVA.

In Feb of 2024, I received a letter from the VBA that a 100% rating for PTSD with TBI residuals was granted. A few more pages in the letter regarding Diagnostic Code 8045. It is written that the 'VA should consider the need for Special Monthly Compensation for such problems....."

It also states a remand for sleep apnea.

I have searched the internet about this topic but still don't understand. I did not apply for SMC at all. Does this mean they are going to switch me? What do they mean about remand?

Please chime in if you have any insight. I would love to hear from you. Thank you in advance.

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The VA has a duty to maximize your benefits.  Further, the maximum "is not" 100 percent, contrary to a popular myth.  100 percent is about 3737 per month, while SMC R2 is over $10,000 per month.  Therefore, 100 percent "is not" the max benefit.  

"Within reach" for you is "at least" SMC S.  SMC S, (statuatory) whenever the Veteran has a single 100 percent (tdiu counts) plus additional disabilities that combine to 60 percent seperate and distinct.  You may even already be there.  I have not reviewed your file, nor your disabilities so IDK, but the Board has.  Thus, at a minimum, the BVA wants the VARO to "adjuticate" SMC S, that is, to consider you for it.  (Its about another 450 or so per month).  

A service connection for OSA would almost certainly put you at SMC S, if the other rating(s) did not.  Remember, they have to be "seperate and distinct", and I dont know about that.  

Service connection for SMC is inferred.  That means the VA is supposed to award it, whenver you meet the criteria, that is, you do not have to apply for it.  Its presumed you want it once you reach 100 percent.  This said, if SMC has not been awarded, you can still apply.  It wont be the first time VA failed to adjuticate or award SMC, even tho they are supposed to.  This is regulation, and the Board insists the VARO follow regulation and adjuticate SMC.  Generally, when ever you are awarded a single 100 percent, the VARO should adjuticate SMC S.  Thus, the Board remanded the claim to do that.  

You can read the decision, it should specify the reasons for remand, but, for sure that is one, based on your post.  In short, its good news, you could/should be getting additional compensation and/or retro.  

Now, if you have "loss of use" of hand, foot, reproductive organ, eyes, ears, etc. OR if you need help of others for ADL (daily living activities like bathing eating, dressing, etc, then you could should be eligible for aid and attendance.  You should apply for any of these if you need A and A, have loss of use due to Service connected injuries.  

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2 hours ago, broncovet said:

The VA has a duty to maximize your benefits.  Further, the maximum "is not" 100 percent, contrary to a popular myth.  100 percent is about 3737 per month, while SMC R2 is over $10,000 per month.  Therefore, 100 percent "is not" the max benefit.  

"Within reach" for you is "at least" SMC S.  SMC S, (statuatory) whenever the Veteran has a single 100 percent (tdiu counts) plus additional disabilities that combine to 60 percent seperate and distinct.  You may even already be there.  I have not reviewed your file, nor your disabilities so IDK, but the Board has.  Thus, at a minimum, the BVA wants the VARO to "adjuticate" SMC S, that is, to consider you for it.  (Its about another 450 or so per month).  

A service connection for OSA would almost certainly put you at SMC S, if the other rating(s) did not.  Remember, they have to be "seperate and distinct", and I dont know about that.  

Service connection for SMC is inferred.  That means the VA is supposed to award it, whenver you meet the criteria, that is, you do not have to apply for it.  Its presumed you want it once you reach 100 percent.  This said, if SMC has not been awarded, you can still apply.  It wont be the first time VA failed to adjuticate or award SMC, even tho they are supposed to.  This is regulation, and the Board insists the VARO follow regulation and adjuticate SMC.  Generally, when ever you are awarded a single 100 percent, the VARO should adjuticate SMC S.  Thus, the Board remanded the claim to do that.  

You can read the decision, it should specify the reasons for remand, but, for sure that is one, based on your post.  In short, its good news, you could/should be getting additional compensation and/or retro.  

Now, if you have "loss of use" of hand, foot, reproductive organ, eyes, ears, etc. OR if you need help of others for ADL (daily living activities like bathing eating, dressing, etc, then you could should be eligible for aid and attendance.  You should apply for any of these if you need A and A, have loss of use due to Service connected injuries.  

Thanks for the enlightenment. So does this mean I get SMC in addition to my current VA Compensation? or does it switch over? I do have a caregiver, my wife, to assist with ADL as well. She had to quit her job for me. I'm wondering if she loses the Caregiver status and stipend if I get switched to SMC. I'm unsure why they may adjudicate me at SMC S since im not house bounded.  I'm still confused for why they granted 100% rating for PTSD with TBI residuals rather than 2 individual ratings. Please forgive my multiple questions for I am still uncertain with the what-if scenarios. Simply worried.

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Smc is a separate tier. Instead of “regular” tier you are paid at SMC tier, they aren’t stackable. Smc has nothing to do with caregiver. Housebound doesn’t mean being a vegetable or chained to your house. Remand means sent back to RO level to fix something. It’s in your decision letter. 

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On 3/17/2024 at 1:56 PM, broncovet said:

The VA has a duty to maximize your benefits.  Further, the maximum "is not" 100 percent, contrary to a popular myth.  100 percent is about 3737 per month, while SMC R2 is over $10,000 per month.  Therefore, 100 percent "is not" the max benefit.  

"Within reach" for you is "at least" SMC S.  SMC S, (statuatory) whenever the Veteran has a single 100 percent (tdiu counts) plus additional disabilities that combine to 60 percent seperate and distinct.  You may even already be there.  I have not reviewed your file, nor your disabilities so IDK, but the Board has.  Thus, at a minimum, the BVA wants the VARO to "adjuticate" SMC S, that is, to consider you for it.  (Its about another 450 or so per month).  

A service connection for OSA would almost certainly put you at SMC S, if the other rating(s) did not.  Remember, they have to be "seperate and distinct", and I dont know about that.  

Service connection for SMC is inferred.  That means the VA is supposed to award it, whenver you meet the criteria, that is, you do not have to apply for it.  Its presumed you want it once you reach 100 percent.  This said, if SMC has not been awarded, you can still apply.  It wont be the first time VA failed to adjuticate or award SMC, even tho they are supposed to.  This is regulation, and the Board insists the VARO follow regulation and adjuticate SMC.  Generally, when ever you are awarded a single 100 percent, the VARO should adjuticate SMC S.  Thus, the Board remanded the claim to do that.  

You can read the decision, it should specify the reasons for remand, but, for sure that is one, based on your post.  In short, its good news, you could/should be getting additional compensation and/or retro.  

Now, if you have "loss of use" of hand, foot, reproductive organ, eyes, ears, etc. OR if you need help of others for ADL (daily living activities like bathing eating, dressing, etc, then you could should be eligible for aid and attendance.  You should apply for any of these if you need A and A, have loss of use due to Service connected injuries.  

Hi Broncovet. Is there a way I can send you thru private message, some paperwork from the VBA?, so you can have a better idea of my situation.

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How about you take a sharpie and block out your indemnifiable information such as your name address and social security no etc. and post it hear so all of us can look at it. Or you can send it to me in a private message and I will do it for you and post it.

To send a PM click on my name or broncovet's and click on private message. I will send you one now to reply to.

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The form to apply for aid and attendance and SMC S (housebound) are on the same form.  My advice is to fill it out, as well as apply for an increase on your disabilities which may have worsened as well as other conditions which may have been caused by a service connected condtion, such as meds for high blood pressure.  

Here is the form.  Read the directions:

https://www.va.gov/find-forms/about-form-21-2680/#:~:text=Use VA Form 21-2680,monthly compensation or pension benefits.

Specifically the regulation says you CAN be granted the benefits "if" Aid and attendance is provided by a family member.  

https://www.law.cornell.edu/cfr/text/38/3.350

 

 

Source:

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.

https://www.law.cornell.edu/cfr/text/38/3.352

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