SMC (t) for TBI

SMC (t) for TBI

razsniper
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Joined: 12 Sep 2017, 19:46

13 Sep 2017, 03:50 #1

So I have a question for the forum.

I am 100% P&T, 100% PTSD, 70%TBI, and a bunch of other things that are rated at 40, 30, 20, and 10 percent.  I am receiving SMC (k) and (s-1).  I put in a claim for A&A with a DBQ that was filled out by me and my PCP.  I received the increases for my TBI to the 70%, but the notification for the other items that I asked for increase were not on there, and the ones that were not service connected were not explained. Nor was the SMC's were explained.  I requested through the VA to send me the complete letter of completion of the claim. And she said to wait 30 days before calling back again then they can elevate the request. 

SO the question I have is what is needed other than the Aide and Attendance which I did request and I received the SMC (s-1) which is Housebound or Aide and Attendance.  I do not know of a form for the SMC (t)?  Has anyone on the forum received the SMC (t) and can direct me in the right direction?

Thanks
100% VA P&T
2 SMC's
Marine
Army
Air Force
Army National Guard
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JNoxon
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Joined: 04 Jun 2015, 23:05

13 Sep 2017, 05:00 #2

When you qualify for the SMC Rates, the VA computer notifies the Rater to look at the SMC's. It is not something that you usually apply for. It's done automatically handled at the VA.
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razsniper
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Joined: 12 Sep 2017, 19:46

13 Sep 2017, 16:50 #3

That is what I thought, but then I was told I had to apply with the Housebound/ A&A form and have my PCP and I to fill it out.  SO we did, and I received the SMC (s-1) housebound before I got the rating of my 70% TBI, so I would imagine that that would then trigger the automatic rater review to the SMC (t) for the TBI, but I am not sure what is needed for that! OR if I even qualify, but IF I do, that is a large chunk of money that I would not want to ask for IF I do qualify for.
100% VA P&T
2 SMC's
Marine
Army
Air Force
Army National Guard
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ParadigmGuy
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Joined: 19 Jul 2017, 03:49

13 Sep 2017, 19:08 #4

JNoxon wrote: When you qualify for the SMC Rates, the VA computer notifies the Rater to look at the SMC's. It is not something that you usually apply for. It's done automatically handled at the VA.
I'm in the process of retiring now, and when I went through the EBenefits site it had me fill out an A&A/SMC questionaire.  It now shows SMC as one of my claims.  I say this to show that maybe SMC must be requested now and it not automatically reviewed.
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2trill4925
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Joined: 16 Oct 2011, 02:17

13 Sep 2017, 19:29 #5

I'm not an RO employee, but my layperson understanding is that a requirement would be a need for A&A which it sounds like you have with SMC (L).

The rest of the requirements appear that the claimant would be in need of a higher institution of care (non residential) in the absence of in home A&A.  This sounds like a decision maker would have to make this determination based on medical opinion.

That's just my take, and I could be wrong.
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razsniper
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Joined: 12 Sep 2017, 19:46

13 Sep 2017, 19:47 #6

That is also how I read it too, now there are times when my back goes out on me and I am bedridden for a couple of weeks in a month that would fall in that category, but that may be 3 or 4 times a year.  I am not sure if that would be "enough" for that determination.
100% VA P&T
2 SMC's
Marine
Army
Air Force
Army National Guard
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Rotor Head
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Joined: 17 Nov 2013, 19:52

14 Sep 2017, 23:56 #7

You applied for SMC L (A&A) and they awarded SMC S instead?  Then you didn't have enough to meet the requirements for A&A.  Which you'll have to meet before looking at elevated levels (R or T).

Was that bed rest doctor ordered?  Is the spine service connected?  
All info supplied in an 'As-Is' condition.  No warranties expressed or implied.  See owner's manual for details...

SGT USMC 6112 '81-'87  

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2trill4925
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Joined: 16 Oct 2011, 02:17

15 Sep 2017, 00:41 #8

Good eye Rotor Head

I misread the OP
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razsniper
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Joined: 12 Sep 2017, 19:46

19 Sep 2017, 22:43 #9

Sorry All,  

Have been out of commission for a couple days.  I was in a motorcycle accident on Saturday the 16th of Sept.  I fractured my pelvis area in two places and my ACL is torn pretty badly.  Will need surgery for that in a few weeks when the swelling goes down.

As far as the SMC S goes, I believe they gave that for being 100% and one over 60%.  But could have been for housebound but the eBenefits site says for the latter.  The app my PCP and I put in says at the top for Housebound or A & A.  so IDK.  I am waiting for the full report back from this claim before I jump the gun on pointing fingers or something.  

I will be out of touch for a few weeks after my surgery on Wednesday the 20th of Sept. but I pray that everyone has a great day, and all goes well for everyone .

Be Safe

Razsniper  
100% VA P&T
2 SMC's
Marine
Army
Air Force
Army National Guard
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Rotor Head
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Joined: 17 Nov 2013, 19:52

22 Sep 2017, 00:38 #10

Put this claim stuff on the far back burner.  Focus on your upcoming events.  I wish you a full and speedy recovery.
All info supplied in an 'As-Is' condition.  No warranties expressed or implied.  See owner's manual for details...

SGT USMC 6112 '81-'87  

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Cruiser
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Joined: 27 Nov 2003, 23:33

22 Sep 2017, 05:21 #11

razsniper wrote: Have been out of commission for a couple days.  I was in a motorcycle accident on Saturday the 16th of Sept.
You are claiming to be so disabled that you require the assistance of another person to perform the basic activities of daily living (aid and attendance), but you can ride a motorcycle?  Please tell me that you were a passenger in a sidecar.

Cruiser
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razsniper
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Joined: 12 Sep 2017, 19:46

22 Sep 2017, 18:44 #12

Cruiser wrote:
razsniper wrote: Have been out of commission for a couple days.  I was in a motorcycle accident on Saturday the 16th of Sept.
You are claiming to be so disabled that you require the assistance of another person to perform the basic activities of daily living (aid and attendance), but you can ride a motorcycle?  Please tell me that you were a passenger in a sidecar.

Cruiser
I was in the side car
100% VA P&T
2 SMC's
Marine
Army
Air Force
Army National Guard
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razsniper
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Joined: 12 Sep 2017, 19:46

22 Sep 2017, 18:46 #13

Rotor Head wrote: Put this claim stuff on the far back burner.  Focus on your upcoming events.  I wish you a full and speedy recovery.
Thank you
100% VA P&T
2 SMC's
Marine
Army
Air Force
Army National Guard
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Cruiser
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Joined: 27 Nov 2003, 23:33

22 Sep 2017, 20:26 #14

razsniper wrote: I was in the side car
I'm glad to hear that because all I could think of was how absurd it would be for someone who can drive a motorcycle to be claiming aid and attendance.  Lord knows VA gets enough silly claims as it is without another one like that.  You had me worried for a minute.

Cruiser
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razsniper
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Joined: 12 Sep 2017, 19:46

22 Sep 2017, 20:52 #15

Cruiser wrote:
razsniper wrote: I was in the side car
I'm glad to hear that because all I could think of was how absurd it would be for someone who can drive a motorcycle to be claiming aid and attendance.  Lord knows VA gets enough silly claims as it is without another one like that.  You had me worried for a minute.

Cruiser
totally understand.
100% VA P&T
2 SMC's
Marine
Army
Air Force
Army National Guard
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