I see from the asknod statistics that the most viewed items seem to be articles about Special Monthly Compensation- or SMC in VA parlance. I think, to VA, it is an inconvenient truth; an entitlement that has to be granted but the failure to grant can be (and will be) excused as an innocuous administrative oversight. Well, that’s what the VAOIG is for. Errr, right?
Well, as they say down at Rentawreck®, “Not exactly.” About the only thing the IG will ever do is note the RO was in need of remedial training on the applicability of ancillary SMC entitlements and the VARO Director and VSCM sign a memorandum agreeing shit happens and never to get caught doing it again. Keep in mind, this isn’t the equivalent of a USAF ORI (Operational Readiness Inspection) where a 130 sets down unannounced at your airpatch and disgorges 20 officers with orders to implement a Defcon 1 test of readiness. You don’t get any warning. If the Base Commander is out duck hunting off base and incommunicado, say bye bye to that first star. The OIG, on the other hand, telegraphs its intentions weeks in advance. In Seattle, they call the RO travel coordinator to book rooms at the Alexis Hotel across the street. I’m sure the rhetorical question on everyone’s’ lips is ‘Gorsh. I wonder why they’re in town?’

My mantra is far more direct. I prefer to go on the warpath. Fine. Administratively oversight me once, shame on me. Administratively oversight me twice and I call malfeasance and sharpen up the class action punji sticks for similarly situated SMC Veterans. If I have 25 cases of this proclivity to underrate Veterans on the proper SMC rate, then to me its not an innocuous oversight but a conscientious, perennial effort to ignore procedural due process under §3.103(a):
(a) Statement of policy. Every claimant has the right to written notice of the decision made on his or her claim, the right to a hearing, and the right of representation. Proceedings before VA are ex parte in nature, and it is the obligation of VA to assist a claimant in developing the facts pertinent to the claim and to render a decision which grants every benefit that can be supported in law while protecting the interests of the Government. The provisions of this section apply to all claims for benefits and relief, and decisions thereon, within the purview of this part 3.
The VBA gomers drive by this procedural due process guarantee every day pretty much the same way they did §3.303(b) until Walker v. Shinseki (2014). Pretty soon it’s just a blur and they begin to ignore it. You do not see the word “may” in there. The operable phrase is the “It is the obligation”. As many times as you remind them of it and get it corrected in Phoenix, you’re playing Whack-A-Mole a week later in Roanoke.
Our Recently Emasculated Plastic Fantastic Lover
Bow your heads in prayer for poor Mr. Potato Head™. He was recently gender-neutralized to satisfy some offended soul. I used him back in 2013 (with free advertizing for Hasbro Toys) as a perfect example of the essence of the building blocks of SMC. Once you attain 100%/TDIU, the SMCs from L to N are applicable.
SMC (SPECIAL MONTHLY COMPENSATION)-WHAT IS IT?

Something I think many Veterans fail to grasp are the intricacies and nuances of phraseology used in §3.350 that confuse rather than illuminate. Take the VA’s unique way to describe loss of use of the lower extremities. §3.350(a)(2)(i) summarizes this in VAspeak:
(i) Loss of use of a hand or a foot will be held to exist when no effective function remains other than that which would be equally well served by an amputation stump at the site of election below elbow or knee with use of a suitable prosthetic appliance. The determination will be made on the basis of the actual remaining function, whether the acts of grasping, manipulation, etc., in the case of the hand, or of balance, propulsion, etc., in the case of the foot, could be accomplished equally well by an amputation stump with prosthesis;

First you have to go back to §4.10 to grasp functional loss. What VA will studiously avoid telling you is that, just as in PTSD/MDD c&ps, VA gets first right of denial. In other words, it would be futile to obtain and submit a beautiful IMO (Independent Medical Opinion) from your neurologist stating your fall danger is so great that you are almost guaranteed to get a cerebrovascular accident (CVA as in concussion) with resultant permanent brain damage if you insist on perambulating unattended. By all means, get the IMO but hold on to it until VA denies you. You never play (M) 21 and show your cards to the dealer at the beginning. Here’s why:
The responsibility for determining whether there is loss of use rests with the adjudicator; the Board may not ask a clinician to determine whether there is “loss of use.” See VBA Live Manual M21-1, IV.ii.2.H.1.b.

I’ve had raters who wrote that “no doctor has, as yet, declared that the Veteran has elected that his leg should be amputated below the knee with use of suitable prosthesis so the claim for loss of use of the lower extremity remains denied.” One has to wonder where they found that phrase in the M 21. Even worse. Obviously they tried it on Mr. Dempsey W. Tucker in Tucker v. West (1998) and here I was fighting it twenty years later in 2018:
The relevant inquiry concerning an SMC award is not whether amputation is warranted but whether the appellant has had effective function remaining other than that which would be equally well served by an amputation with use of a suitable prosthetic appliance. See 38 C.F.R. §3.350(a)(2), § 4.63. The Board concluded that because his situation did “not warrant amputation,” the appellant was not eligible for SMC. Tucker v. West, 11 Vet.App. 369, 374 (1998).

One of the intricacies of SMC is to understand it is an entitlement awarded based on quality of life issues above and beyond what any 100% rating can provide. Many people qualify for the concept of unemployability due to a 100% rating or a TDIU comprised of a single disability. Once you pass through this qualifying portal, your entitlement to any of the higher SMCs (S, L,M,N,O,R1,R2,T) begins, assuming the disabilities are independently ratable, service connected and you qualify. The more serious the loss or combination of losses, the higher the rating. SMC ratings are based almost entirely on an increasing degree of severity as enumerated under SMC P in §3.350(f). However, there isn’t enough paper to cover every conceivable combination of SMC. Being able to argue two entitlements for A&A is just one avenue of many. Unfortunately, very few attorney websites delve into these discussions. Meaningful, boots on the ground SMC intelligence discussions on the Internet are in short supply. Most Vet Attorneys and agents don’t have time to discuss the matter. Their paralegals are trained to do intake and VSOs have never heard of it. I have great respect for Hadit.com but here again, people with little or no hands-on litigation experience try to convey their stories as the ‘how-to’. Sherpas they ain’t. What’s sauce for the goose is most definitely not sauce for the gander in SMC.

As usual, VA gets to be the arbiter and determine the definition of ‘qualify’. I can’t think of how many Vets who go for SMC S and discover that their TDIU is based on §4.16(b) and not (a). Bingo. You don’t qualify. Your IU was based on multiple disabilities-not one single, independently ratable disease or injury. Considering my argument above about §3.103(a) and the holding in Buie v. Shinseki (2010), VA is required by law to maximize your entitlement(s) as high as they can. VA interprets that to mean if you beg for it, they have to consider it- but not a moment before you begin begging, mind you. That is not how this is supposed to work. Granted, VA is not renowned for being self-starters, but the moment you qualify for SMC L, there should be an in-depth review to see what else is behind Door number 2.
Therefore, if you are doing this yourself pro se, I suggest you be anally specific when filing for the higher SMCs. Be sure to point out the date the first doctor stated your disability arose to a compensable SMC level. Cite to the regulation that supports your authority. Below is an example.
redact 526 for LOU and highest SMC 2
One of the most clever SMC traps VA employs is to award SMC L under §3.350(b)(3) for Aid and Attendance and throw everything but the kitchen sink into the rationale. Trying to extricate a single one (interstitial disease in the example above) and expand it to merit a separate A&A entitlement to SMC L thus becomes an art form. Once again your biggest and best cite to precedence will always be the Buie holding requiring VA to obey §3.103’s codicil to maximize what you should get short of pyramiding under §4.14. A 100% schedular rating for it is essential to even begin the argument for entitlement. Here’s the authority in M 21ese:
The M21 suggests that SMC(l) has a schedular/extraschedular requirement. See M21-1, Part IV, Subpart ii., Chapter 2, Section H, Topic 8, Subtopics a-c. Specifically, the M21 indicates that a single disability evaluated at 100 percent disabling may be required for a grant of aid and attendance, and that without such a total disability, referral to the Director of Compensation may be warranted for extraschedular consideration.

In addition to the above, the VA ADJUDICATION MANUAL, M21-1MR, Part IV(ii), Ch. 2, § I(58)(e) notes “veterans entitled to SMC at the [(o) rate or (r) rate] are, by definition, very seriously disabled” and the rater should “apply a liberal interpretation of the law in determining the need for A&A”. (emphasis added).
Winning SMC claims is not for the faint of heart. It takes a long time to fathom some of the various routes you can take to get where you should be. It hinges in great part on how much you have already muddied up the waters before you begin your quest for higher SMCs in earnest. Half of my battles for my SMC clients are navigating around the cards my client was dealt before I got there. Fortunately for us, VA’s finest no more comprehend SMC than they do the Unified Field Theory so we’re relatively safe once we escape the the local yokels’ jurisdictions and proceed to appeal. Well, almost. I’ve seen some pretty lopsided BVA SMC decisions that were so obviously bogus that we were able to resolve them at the Rule 33 conference. The worst one was the VLJ granted LOU for two (2) losses of use of left and right lower extremity under SMC K but refused to combine them into one SMC L Loss of use of BOTH lower extremities. This, of course, fenced him out of his rightful SMC R1 entitlement. I guess what’s scary is to think of how many Veterans with VSOs who might have walked away from this thinking the BVA gomer was right in his interpretation. What am I saying. They don’t teach SMC to VSO service officers. It’s like the flat earth society. The world ends here. Do not attempt to exit the reservation.

Thank you to all the cartoon contributors. Please remember that although we do not share the same politics, the humor is still indisputable. I can’t wait for my neighbor Gary Larson to amass a new collection. After an extended hiatus, he’s back in the cockpit again. How cool is that? ”Neighbor’ meaning he lives on Fox Island which is about a .30 ’06 round to the east of me. Hey, in this day and age where Mr. Potato Head© can be divested of his gender-affirmative prefix noun-let alone have his personal pronouns redefined- I should be able to claim BFF status with whomever I choose.

Lastly, if you should choose to do battle with VA over the higher SMCs, you would be well-advised to seek counsel to do so. I’ve been doing it since 2012 but I still enjoy walking point and learning new ways to spank these chuckleheads. As quickly as VA comes up with a denial band aid, we have to learn how to counterattack. I’m sure it’s been that way since the War of 1812.


Good morning sir,
I have a question in need of your expertise advice for additional SMCs. Like the previous question, I am still puzzled about the ½ and full steps on the SMC chart.
Injury Snapshot:
I am currently 100% P&T, Car Grant recipient, HISA approved, SAH approved, Chap 31 ILP client for SEH rehab concerns, SSDI recipient, Medically Retired from work, and now SMC L ½ rated, effective 09/29/2021 due to all of my injuries. I just recently won a CUE for not rating my surgically repaired left hip replacement due to reevaluation of 90% after 1 year. They had to back date my CUE to 7/29/2019, which was the day that I was originally awarded the Aid & Attendance for the Left Drop Foot, along with the standard verbiage was, “In need of A&A of being so helplessness….”
I have gone through the Pain Clinic, Spinal Cord Stimulator patient, RFA patient, Left Ankle surgery (2018), Botched VA Left Hip Replacement (2015), and 2 revision hip surgeries (2018). Diagnosed with Restless Leg Syndrome. And cannot performed a few of ADLs too.
I have a chair lift in my home for stairs, ramp accessible, grab bars in shower and near toilet, ADA raised toilet with toilevator installed, about to get adaptable auto attachments, VA approved motor scooter, right ½ inch-built shoe due to left leg longer due to botched surgery, left shoe modified with AFO inserted into the shoe, due to I cannot put on myself
I strongly feel that I have been short changed on my proper rating! I have listed my injuries below for a better visual.
Current Disabilities:
Left hip replacement: 90% (additional 2 resurface hip surgeries)
Depression: 70%
Radiculopathy of left lower extremity with drop foot: 60%
Lower Back: 40%
Radiculopathy of the lower extremity (femoral) with left drop foot : 30%
DJD right ankle: 20%
residuals of fracture of left medial malleolus: 20%
Radiculopathy of the right extremity: 20%
R knee: 10%
R hip flexion: 10%
R hip extension: 10%
R hip abduction: 10%
R wrist sprain: 10%
L hernia scar repair: 10%
L ankle scar repair: 10%
L thigh myositis ossification: 10%
L thigh ext: 10%
L Ostemacia (soft bone): 10%
Nonservice connected for Flat Feet: 0%
Questions:
1.) Do you think I am due the ½/ or full step in SMC lineage? The recent Decision Letter only showed rating rationale for the previous 2 (hip and right sciatica) injuries, but failed to mentioned their selected injuries and not mentioned of the other (right hip, knees, atrophy, and drop foot), It seems like they were just to make me go away?
2.) I thought I should have been SMC N or at least M for loss of hips or loss of legs, which was not afforded to myself?
3.) Should they have evaluated all of my mentioned injuries, since they were not the same/repeats?
5.) Should I get a separate evaluation for calf atrophy for muscle injury? The DC code is 8520, but should be in the Muscle Injury DC range?
thx in advance
Here’s my response. First, no offense intended N Shari, but I abhor being called sir. I enlisted. The only thing that gets my goat worse is “Welcome Home” from someone who was probably protesting the war when I did actually return to the world in ’72. You folks are 50 years too late, so stop it. Don’t waste your breath. I doubt any of us boots on the ground folks will ever forget that bitchslap. No amount of apologizing can erase it.
So… the envelope, please.
First, you are not 100% rated. From your list of disabilities provided, you are TDIU or, I suppose, in the VA vernacular, 100% combined. When you go down the combined road, VA will pile up every single thing you are rated for and use it as the predicate for the A&A. The only way to improve the SMC rating is to get something new that is independently ratable and not part of that A&A rating. Well, that or artfully find the way to divorce the needed element from the conglomerate and develop it as a standalone SMC L. This VA “everything but the kitchen sink” technique often screws you out of SMC S in the period before you got to SMC L for the A&A. It’s useful though to prove you have separate and distinct rated disabilities to prevent the kitchen sink scenario. Once VA declares a disease/injury the predicate for a standalone 100% and some others as the 60% separate and distinct rationale, they have made a decision that is protected. Use Medrano v. Nicholson, 21 Vet. App. 165, 170 (2007) (The Court is not permitted to reverse findings of fact favorable to a claimant made by the Board.). Thus, they cannot come back and insist all the SMC S ingredients are the reason for the A&A. The reason is simple. If they grant you SMC S, there must be a subgroup of ratings 60% or higher that comprises the “independently ratable” quantity to qualify. It would be injustice to later say it’s all one “disease entity” or “physical injury”. This is how you begin to prepare your defense-waaaay before you get to SMC L for anything.
By rights, your 90% for the hips should be your TDIU. The PTSD should have pushed you to SMC S. Then, the aggregate stuff could be used later to butress an A&A with the 70% PTSD used to grant your half-step to the intermediate rate between L and M (L 1/2). If you look at your most recent Code Rating sheet, you will see how they break it down. The actual description of the A&A should list all the things they use(d) to grant it.
By operation of law, §3.103 admonishes the Secretary to grant every benefit they (pronoun?) can come up with. Buie precedence instructs that there is no law saying the disabilities have to be arranged chronologically- or in any particular order at all- for that matter. Failure to perform this step produces absurd results which is forbidden under Sambonis v. Brown 1994.
VA groups similar maladies in subsets. If you had multiple SFWs, they would be rated separately ( see §4.25(b). But… if you got one more new one at 50% it would not be separate and distinct and independently ratable for a half-step bump if the predicate for the A&A was all the other muscle group disabilities. It would just be added to the A&A mix.
§3.350(f)(3), excluding TB which you did not mention you have, says:
(3) Additional independent 50 percent disabilities.
In addition to the statutory rates payable under 38 U.S.C. 1114 (l) through (n) and the intermediate or next higher rate provisions outlined above, additional single permanent disability or combinations of permanent disabilities independently ratable at 50 percent or more will afford entitlement to the next higher intermediate rate or if already entitled to an intermediate rate to the next higher statutory rate under 38 U.S.C. 1114, but not above the (o) rate. In the application of this subparagraph the disability or disabilities independently ratable at 50 percent or more must be separate and distinct and involve different anatomical segments or bodily systems from the conditions establishing entitlement under 38 U.S.C. 1114 (l) through (n) or the intermediate rate provisions outlined above.
Similarly, §3.350(f)(4), in pertinent part, states:
(4) Additional independent 100 percent ratings.
In addition to the statutory rates payable under 38 U.S.C. 1114 (l) through (n) and the intermediate or next higher rate provisions outlined above additional single permanent disability[singular] independently ratable at 100 percent apart from any consideration of individual unemployability will afford entitlement to the next higher statutory rate under 38 U.S.C. 1114 or if already entitled to an intermediate rate to the next higher intermediate rate, but in no event higher than the rate for (o). In the application of this subparagraph the single permanent disability independently ratable at 100 percent must be separate and distinct and involve different anatomical segments or bodily systems from the conditions establishing entitlement under 38 U.S.C. 1114 (l) through (n) or the intermediate rate provisions outlined above. So, we now look at your L & 1/2 which under VA law is
(i) Where the multiple loss or loss of use entitlement to a statutory or intermediate rate between 38 U.S.C. 1114 (l) and (o) is caused by the same etiological disease or injury, that disease or injury may not serve as the basis for the independent 50 percent or 100 percent unless it is so rated without regard to the loss or loss of use.
So, let’s examine the SMC L and ½ half rating you have. First, it’s really couched in SMC as SMC P (L 1/2 + K for LOU of the one foot). VA is giving you TDIU for either the 70% PTSD or the hip(s) at 90%. They are the only two that qualify as a single standalone rating of 60% or more under §4.16(a). Radiculopathy of left lower extremity with drop foot at 60% has to be the 1/2 step kicker under §3.350(f)(3). You should have a single rating under DC 8520 at 80%- not 60% if they have held loss of use. But §3.350(f)(3) permits combinations of disabilities to add up to 50% to qualify to whereas (f)(4) has to be a true schedular 100%.
The Oral Briefing utube link above to Barry v. Denis the Menace argues whether multiple awards of (f)(3) -or (f)(4)- can be awarded. I personally think so but you don’t see a JD after my name nor a Judge in front of it.. I do not see anything in the language of either reg subsection specifically limiting it. Logic dictates that VA is not overly generous so they would never set up a merry-go-round where you could keep collecting 1/2 step gold rings each time you passed the dispenser. I do think personally that both bumps could, and should, be awarded at least once though. F3 and F4 are sure ambiguous and the default setting should be the interpretation which grants the greater benefit to us.
I just had a recent shootdown on a L 1/2 bump and here’s why I lost and am appealing it.
VA’s M 21, which is not law or even germane most of the time, says (distilled)
The M21 suggests that SMC(l) has a schedular/extraschedular requirement. Specifically, the M21 indicates that a single disability evaluated at 100 percent disabling may be required for a grant of aid and attendance, and that without such a total disability, referral to the Director of Compensation may be warranted for extraschedular consideration of aid and attendance.
In addition to the above, the VA ADJUDICATION MANUAL, M21-1MR, Part IV(ii), Ch. 2, § I(58)(e) notes “veterans entitled to SMC at the [(o) rate or (r) rate] are, by definition, very seriously disabled” and the rater should “apply a liberal interpretation of the law in determining the need for A&A”.
Boy howdy is that ever a lot of permissive ‘mays’ and purely subjective language to arrive at a requirement for a 100% schedular or combo interpretation. I’m not buying it.
Breniser v Shinseki 2011 is your North Star to get over the hump of trying to assemble all your disabilities using 3.350(f)(3)(4) to get to N or higher. VA calls SMC O the maximum rate. It is, technically. Anything above that has to be a need for a higher level of A&A as in R1, R2 or T. There are 4, and only 4 ways to get to O. You need any two of the four conditions in §3.350(b)(1-4)-i.e., LOU of the upper or lower extremities or a hand and a foot, blindness, the need for A&A or being Bedridden. Period. Think back to your old Chutes and Ladders game.
You are suggesting you should be able to endlessly get bumped up using all the existing ratings you have. Check out SMC N. You’d need to physically have your legs removed at the hip in order to employ it as a kicker bump to SMC O.
So, how do you get to a higher rating? Based on what you present, I don’t see a path. The recent HLR review I got on 9/28 says:
“Note: a 100% disability and a need for regular assistance with the activities of daily living is required to meet requirements for entitlement to special monthly compensation based on Aid and Attendance. However, the 100% disability can be a single SC disability or multiple SC disabilities of a single disease entity such as Parkinson’s disease or multiple sclerosis. The 100% disability can be the sole factual basis for the need or it can be a combination of need for aid and attendance due to the 100% disability or other SC disabilities to qualify. The actual need for Aid and Attendance (A&A) must be wholly or partially due to service-connected (SC) disability evaluated as 100-percent disabling. This means that we must have evidence the 100% condition has at least a small part in the need for aid and attendance. (§3.352, §3,351(c)(3), 38 CFR 3.350)[sic]”
But note the clear and uncomplicated language used in §3.351(c)3) cited as their authority…”(3) Establishes a factual need for aid and attendance under the criteria set forth in § 3.352(a). Then look in §3.352(a) and tell me where it says you need that 100% or combo of shit equaling 100%. I’ll wait. The closest thing is the postscript catchall at the end of the laundry list for inability to accomplish the daily activities of living says ” or incapacity, physical or mental, which requires care or assistance on a regular basis to protect the claimant from hazards or dangers incident to his or her daily environment.”
This is why the BVA and the higher Courts refuse to consider the M 21 as the authority. The VA makes this shit up out of whole cloth and then tries to pawn it off on you like you just graduated from turnip wagon driving school and are educationally challenged.
I will never use M 21 in my legal briefs to support my argument. It will get you laughed out of the BVA or the CAVC. You’re relying on what? The M 21? Gidouttahere. They change that on average 135 times a year depending on how much new CAFC/CAVC precedence overturns the established parameters in the current version of M 21.
A possible scenario exists for you, N Shari, to say your PTSD creates, in its own right, a need for A&A independent of all the other stuff used to grant A&A #1. It appears most of your disabilities revolve around your musculoskeletal disabilities-ergo, the need based solely on that huge subset of neuropathies. If your PTSD can be shown-alone- to cause inability to remember to take medications, or protect you from the hazards of life, then try that avenue. You simply do not have multiple Breniser conditions which can advance you.
Lastly, I will tell you I had a guy come to me who amassed 22 10% ratings to reach a combo 100%. VA kept reducing him on one or another back to 0% claiming improvements. He had a hard time going to work because he was always at QTC c&ps attempting to protect his precarious 100% from reduction. You never get anywhere trying to glue 10%s and 20s together to get to 100% and, by extension, the higher SMCs. It wasn’t built that way. SMC is a quality of life booster for after you get to 100%. It’s designed to help you out with the exorbitant costs of becoming severely disabled. VA purposefully designed it with a gazillion Catch 22s to make it sound richly rewarding but with no means to advance to the higher levels. Whoa there, buddy. You weren’t born on a Thursday. You don’t qualify for SMC. I can’t impress on Veterans how long it takes to develop any level of mastery to be able to gerrymander your SMC into the highest and best rating. Each Veteran’s combo of disabilities has to be studied, analyzed and parsed to figure out how to assemble them to yield the best outcome.
I wish I had better news in this regard, sir. I also apologize if I lost you or others after about three paragraphs. SMC is like trying to turn water into wine. It tasks me but I love it. It’s akin to advanced Alchemy 401.