VA Special Monthly Compensation (SMC) for Mental Illness: Ratings Over 100%
CCK Law: Our Vital Role in Veterans Law
Veterans may have service-connected disabilities so severe that they warrant a VA rating higher than 100 percent. A VA monetary benefit called Special Monthly Compensation (SMC) allows for this. VA SMC for mental illness can compensate a veteran for the additional accommodation or assistance that they need to meet their needs. Unfortunately, VA frequently makes mistakes with claims that should be eligible for SMC for mental illness.
In this blog, we will explain how:
- VA SMC for mental illness compensates veterans with a mental health condition, such as post-traumatic stress disorder, that impairs their lives more than accounted for by a regular VA disability rating.
- A&A, or Aid and Attendance of another person, is a type of SMC-related compensation that is often more flexible than veterans realize.
- There are several tips and pitfalls like lay evidence and proposals of incompetency to keep in mind with claims that may qualify for VA SMC for mental illness.
What Is VA Special Monthly Compensation (SMC)?
In most cases, a veteran receives special monthly compensation when they suffer from service-connected conditions so severe that they warrant a rating higher than 100 percent.
Each level of SMC has different criteria for when a veteran may receive it.
- Levels L through O list specific conditions and combinations of conditions that qualify a veteran to receive SMC. Level L contains the least severe of these conditions (and therefore, the lowest SMC rates) and Level O contains the most severe (and the highest SMC rates).
- Level K provides SMC for veterans who have, for example, experienced the loss (amputation) or loss of use of an extremity or organ.
- Level R provides for veterans who need aid and attendance from another person.
- Level S provides for veterans who cannot leave the house.
- Level T provides for veterans who have suffered a traumatic brain injury (TBI). It is important to note that a veteran may develop a mental health disability as a residual of a TBI.
What SMC Levels Are Most Common for Mental Health Conditions?
The SMC levels that would likely apply to a veteran suffering from a severe mental health condition would be levels R1, R2, and S.
- SMC-R1 and -R2 are for veterans who require aid and attendance due to their disabilities. Examples may include a veteran left permanently bedridden or a veteran suffering from a mental health condition that may cause them to harm themselves without the assistance of another person to prevent it.
- SMC-S is for veterans who are housebound due to their service-connected disabilities.
Veterans cannot get Aid and Attendance benefits and housebound benefits at the same time.
What Is Aid and Attendance (SMC Level-R1 or -R2)?
Special Monthly Compensation Level R, or Aid and Attendance of another person, is a tax-free monetary benefit that VA offers veterans who have been left permanently bedridden or otherwise dependent on others as a result of service-connected disabilities. In other words, they require daily assistance.
Important notes about Aid and Attendance:
- The condition must be so severe that the veteran requires supervision by another person, such as a family member, home nurse, or nursing home facility.
- The supervision does not necessarily need to be constant but must be regular.
- Hospitalization does NOT qualify as Aid and Attendance.
- A&A does not need to be provided by a trained medical professional, although if it is, there is potential for a higher rate of monthly compensation:
- If A&A does need to be performed by a medical professional, the veteran will receive VA compensation at the R-2 rate.
- If it can be performed by someone like a family member, the veteran will receive VA compensation at the R-1 rate.
TIP: “SMC A&A is also available to dependent spouses,” says Maura Black, a managing attorney at CCK. “Veterans get a higher rate of dependency benefits if their spouse requires A&A. Surviving spouses of veterans can also get a higher rate of Dependency and Indemnity Compensation, or DIC, if those spouses require A&A.”
How Much Does VA SMC for Mental Illness Pay?
Once a disabled veteran knows which SMC level they qualify for, they can look up the exact amount they should be receiving with the VA’s Special Monthly Compensation rates.
SMC rates change whenever there is a cost-of-living adjustment (COLA) increase. In 2024, this increase was 3.2 percent. Read more about the 2024 VA special monthly compensation rates.
Special Monthly Compensation is given instead of the standard VA Disability Compensation rates (except for Level K, which would not apply for mental illnesses).
When Does a Mental Health Condition Qualify for VA SMC?
A claim may qualify for VA SMC for mental illness when psychiatric symptoms interfere with performance of activities of daily living (ADLs) due to, e.g., memory or motivation impairment. For example:
- A veteran with depression may have difficulty remembering to take their medications or to turn off the stove when cooking.
- A veteran may lack the motivation or ability to bathe and groom themselves or use the toilet.
- A veteran may present a danger to themselves or others due to symptoms like suicidal or homicidal ideation, delusions or hallucinations, or other cognitive impairments.
“Keep in mind that a veteran may qualify for VA SMC for mental illness even if they do not need assistance with all activities of daily living,” says Claire Babcock, a lead advocate at CCK.
Examples of things generally not considered ADLs:
- Chores
- Grocery shopping
- Finances
VA SMC for mental illness is based on impairment to activities of daily living, not specific mental health conditions. However, the veteran’s mental health condition(s) must still be service-connected. Note that mental illnesses caused by service-connected conditions—e.g., if a loss of limbs led to severe depression—may also be considered service-connected due to secondary service connection.
What Are Proposals of Incompetency?
VA may issue an incompetency proposal when a veteran seems unable to handle their VA disability benefits on their own. An incorrect incompetence rating can be highly disruptive to a claim, as well as lead to SMC benefits passing to a fiduciary instead.
“Veterans and advocates should be cautious of possible proposals of incompetency,” says Babcock. “If a veteran submits evidence that they need help paying bills or managing finances, VA may trigger a proposal of incompetency.”
Under 38 C.F.R. 3.353, VA defines someone who is mentally incompetent as “one who because of injury or disease lacks the mental capacity to contract or to manage his or her own affairs, including disbursement of funds without limitation.” A veteran can be incompetent due to a mental health condition, advanced age, or physical infirmity.
How to Apply for VA SMC for Mental Illness
Eligible veterans are not required to apply specifically for SMC. VA is supposed to automatically give veterans SMC if their claim qualifies for it.
However, SMC and mental illness are both extremely complex areas of veterans law, and VA frequently makes errors. If you believe you qualify for VA SMC for mental illness but were not awarded it, you are encouraged to request assistance from a VA-accredited attorney or advocate.
There are ways disabled veterans can optimize a VA claim or appeal that may improve its odds of qualifying for SMC.
- As with most VA claims, medical evidence is highly valuable: letters from doctors, treatment records, VA’s form for Aid and Attendance (VA Form 21-2680), medical records, etc.
- But veterans are also encouraged to consider lay evidence when filing claims or appeals that might potentially qualify for VA SMC for mental illness.
“Lay evidence can be very helpful with SMC claims,” says Babcock. “Think about including statements from the veteran, their caregiver, or others with personal knowledge about the veteran’s symptoms and resultant need for A&A.”
Denied or Underrated by VA? Call CCK Today
The rules and regulations around SMC and mental health conditions are often poorly defined or misapplied by VA.
Since 1999, Chisholm Chisholm & Kilpatrick has argued many of the cases that have defined these and other challenging areas of veterans law. CCK attorneys and advocates have helped veterans recover over $1 billion in wrongfully denied benefits.
We may be able to help you too. Call us today at (800) 544-9144 or fill out an online form for a free case evaluation with a member of our team.
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