The Department of Veterans Affairs (VA) pays Special Monthly Compensation (SMC) to qualifying veterans with especially serious disabilities or combinations of disabilities. VA should automatically give you Special Monthly Compensation if you qualify for it. You do not have to apply. If, however, you believe you qualify for SMC but are not receiving it, you can call your VA regional office or contact an attorney.
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Jonathan: Good afternoon I’m Jonathan Greene with the law firm Chisholm Chisholm & Kilpatrick. With me today is Maura Clancy and Christian McTarnaghan, both also attorneys with Chisholm Chisholm & Kilpatrick. Today we’re going to be talking about Special Monthly Compensation. We want to pause for a second to let our viewers catch in.
Jonathan: Hello again. So as previously stated we’re going to be talking about special monthly compensation. So as the name implies this is compensation that is, for lack of a better word, special. And we’ve talked before about the rating schedule and how the general idea is to compensate veterans for the average impairment in earning capacity. Special monthly compensation is for–not focused on earning capacity but on– it’s additional compensation given out for certain disabilities, conditions because generally speaking, the severity of them warrants additional compensation. So we’re talking about pretty severe stuff, loss of limb type stuff. So Maura, what is special monthly compensation and who is it for?
Maura: So special monthly compensation as Jon sort of already alluded to is special compensation that VA gives to veterans who suffer from particularly severe injuries. The most commonly available way to sort of conceptualize it is to think about the loss of a limb, the loss of hearing, sight, other types of things. So things that go beyond just a disabled body part or a typical impairment that a veteran might experience due to service. These are things that sort of go beyond that. It’s total loss of physical functioning of certain body parts and so that’s what SMC is designed to compensate for, those severe losses. Any veteran with a service-connected disability that warrants SMC for the ways that we’re going to talk about today can get this type of payment.
Jonathan: And is this something that is on top of their monthly compensation or does it sort of replace it?
Maura: It sort of replaces it. So there’s one exception that we’ll talk about. There’s one type of SMC. It’s called SMC K that you can receive on top of your other monthly compensation. But generally SMC is compensating you for the disabilities that you would otherwise be rated for. And it’s at an amount that’s higher than the standard compensation on a monthly basis. So it replaces it. So say you have a foot that has arthritis in it, you might be receiving a standard monthly percentage from VA. If you experience loss of use of that foot, such that you are entitled to SMC, you’re going to be getting the SMC rate, not the rate for the arthritis anymore because it’s going to be significantly higher for that type of disability.
Jonathan: And as you just heard Maura mention SMC at the K rate, it’s hard to talk about SMC without talking about all of these different levels with the letters. Those letters correspond to subsections of 38 USC 1114. And generally speaking, the further down the alphabet you go, the more money there is with a few exceptions. So please just bear with us. It’s confusing stuff. We’re going to be referencing a lot of letters but that does correspond to the statute. You’re welcome to look them up. Maura has her book with us. We can dig right in if we need to. So let’s start and talk about some of the amounts that we’re talking about. So Christian, how much money are we talking about here?
Christian: Sure. So whereas a veteran at a hundred percent level or a TDIU level would be receiving about $3,000. A little bit under $2,900 a month, SMC L, and again, bear with us. We’re going to explain what all these letters mean. You would get paid at $3,700 a month. And then SMC R-2, which is the highest level of compensation is about $8,500 a month. So it’s significantly more than what a veteran can get just for that 100% rating.
Jonathan: Okay. That’s quite the range. So as Christian said, $3,400 for a hundred percent disability rating and then SMC goes all the way up to $8,500 and you can even get K ratings on top of that. We’ll get into that a little bit. So starting with K, what is SMC at K rate Maura?
Maura: So SMC K corresponds to the portion of the statute that is subsection K and that type of SMC is available when you have loss of use of a variety of essentially organs or body parts. So if you have loss of use or actual loss of a hand or foot, so you might have an amputation issue where you have actually lost the body part or you might just have an inability to use it. You can receive K for multiple types of things as I said before. So loss of use of a creative organ, reproductive organs specifically, loss of vision in an eye, loss of hearing in an ear, loss of breast tissue. There’s a variety of things that would warrant the assignment of an SMC K payment. That payment monthly is only about a $105. But the interesting part about SMC K that’s different from other types of SMC is that you can receive that in addition to your monthly payment amount. So as we were talking about earlier, SMC usually replaces the monthly compensation that you receive from VA. But in the instance of SMC K, you can add multiple Ks, multiple K amounts to your monthly compensation rate. You can be paid for multiple Ks at the same time, in addition to whatever other compensation you’re entitled to.
Jonathan: So K is unique in that it does as Maura said, operate differently. We represent a lot of disabled Vietnam veterans. A lot of them were exposed to Agent Orange. We got a lot of diabetes cases. A lot of erectile dysfunction cases. They all get K for loss of use of creative organ. That’s where we most commonly see it. But as Maura said, there’s a number of ways you can get Ks. You can get multiple Ks. All of it adds up. So let’s get into some of the more specific or a higher level stuff which is as Maura said, loss or loss of use. So loss is pretty obvious. If you actually lose a limb, then that’s pretty clear. But what does it mean by loss of use, Christian?
Christian: Yes. So loss of use is a term of art where it means a really specific thing. The obvious one is it’s got the–that some part of your arm or leg is gone but basically loss of use can also exist when the function of a part of your body, most commonly we see this in the feet and hands and things like that, basically doesn’t function any better than it would if it were missing. And so for a feet that’s as if, you know, if you can’t walk. It’s as if, you know, your feet aren’t there anymore. If you have a similar sort of impairment then that would also be considered loss of use.
Jonathan: The way I think of it is, if they’re going to–if you would be as well served if it was amputated with a prosthetic in place, then that’s loss of use.
Christian: Yes. But amputation is not required.
Jonathan: Yes. So it’s important to know, we’re not just talking about straight up amputation. You don’t have to actually have lost the limb. But we make arguments all the time about the level that the function is lost and that it should equate to loss of use. Okay. So we talked about K. Now we’re moving down the alphabet. We’re going to talk about some of the higher levels. And this is where it gets kind of tricky. So let’s–if it isn’t already, let’s talk about L through O and how those work and there is some important interplay there. So Christian, could you walk us through a little bit about the L through O range?
Christian: Yeah, absolutely. And it’s even hard for us to remember. I had to write this down. I always have to look back to the statute and the regulation to remind myself when I’m working on one of these cases. But if you have loss of use of both feet or loss of use of one hand and one foot, you could be entitled to an SMC L rating. And so keep in mind that loss of use doesn’t mean that it’s missing. It also can mean that basically it’s as lacking in function as if it were missing. Also as Maura alluded to earlier, it’s not only about your extremities. It’s also blindness in both eyes can get a veteran an SMC L rating and that’s basically 5/ 200 vision which is incredibly bad vision. Permanently bedridden or require regular aid and attendance. That’s another way that a veteran could get an SMC L rating.
Jonathan: And aid and attendance is a big one. And I would say that that’s an argument that we often make, that a veteran should be entitled to, not just whatever level of compensation they have but that–at the L rate because of aid and attendance. It’s less concrete sometimes than the loss or loss of limb or loss of use of the limbs. But it’s one we commonly make. So let’s–why is L important or why is the way that you get to L important? And I guess what I’m talking about is what happens when you get multiple levels of this?
Christian: Sure. Absolutely. So once you get farther down the alphabet, like we said before, the farther down the alphabet you get, the more severe the disability is, the more money a veteran would be entitled to per month. And so once you achieve an L, if you can achieve another L for some other disability that you have then you could be entitled to SMC O. And SMC O is paid, like I said I always have to refer a paid out at $5,200 a month. So that’s a lot more than what SMC L is. So let me give an example. I think that’s how I’ve learned to understand SMC O. If you have loss of use of both of your hands and then you also have–that would entitle you to an L rating. And then you also have loss of use of both of your feet. That would entitle you to another L rating. And so you have an L rating for the loss of use of your hands and an L rating for the loss of use of your feet. When you add those two together, you’re able to be entitled to SMC O.
Jonathan: Okay and so 2 Ls make an O?
Jonathan: 2 Ms make an O. 2 Ns make an O. And L and an M make an O. And L and an M make an O. So what is M?
Christian: So M would be anatomical loss of use of both hands, both legs at the knee, one arm at the elbow, plus one leg at the knee. Blindness in both eyes and this is more severe blindness than the L. It’s light perception only or and/or blindness requiring regular aid and attendance. And then N would be even a little bit more severe than that and that’s loss of use of both arms at the elbow, both legs all the way up to the hip, one arm at the shoulder and one leg at the hip and complete loss of sight including loss of being able to perceive any sort of light. And so it’s just another tip more serious than SMC M.
Jonathan: We are talking obviously about some pretty severe disabilities here and to make it even more confusing, there’s something which is these half steps. So you can get– it’s not just limited to getting an L rate or getting an M rate or getting an N rate. But you can also get an L and a half rate or an M and a half rate or an N and a half rate. What are these half rates and how do they come in?
Maura: Well one of the ways that you can get a half rate is if you have SMC at the L or the M rate but then you also have other service-connected disabilities and if those service-connected disabilities combine to a total rating of 50%, you might be entitled to a half step in your SMC level. So the idea is that your SMC compensation at the L or the N rate or whatever the case may be is compensating you for those particular disabilities. But if you have another disability that’s at 50 percent combined which is more than obviously the 10, 20, something less severe, then the idea is that VA is going to give you the half step in your SMC rate to give you additional compensation on top of what you have for the SMC. So as we talked about earlier, SMC replaces your monthly compensation because it pays you significantly more in many cases. But if you also have an additional 50% combined for other service-connected disabilities, you can get a half step that way to give you additional compensation.
Jonathan: And when we’re talking about all of this loss of use, loss of limb type of stuff, it’s often measured as to where you lose it. So you lose your hand, you lose your arm at the elbow, you lose your arm at the shoulder, the half rates also come into play where one of the places where you have lost the limb or lost use of the limb is at the higher level rate. But then the other limb that is factoring into how you get the disability rating is at the lower rate. So then you kind of get the half step. So it’s not easy stuff. But because of the levels of compensation that we’re talking about, it’s well worth looking into it and making whatever arguments you can. I wanted to just quickly talk about, how do you even get SMC? I mean so you file for a disability, are you saying I want SMC or how does it come in?
Maura: So SMC is unique in another way because you don’t have to fill out a particular form or a special application with VA. Usually when you’re asking for service connection or you’re asking for an increased rating, you typically have to send something in in writing. Sometimes it’s on a particular form and you have to say that you want this particular type of benefit. SMC doesn’t work that way. Anytime you’re making a claim for a higher rating for a particular disability, if the evidence that you’re sending to VA shows that you are entitled to SMC at any of these rates, if the evidence shows that maybe your service-connected arm disability is now resulting in loss of use, then VA is supposed to award you whatever level of SMC you’re entitled to based on that evidence. So you do not need to file a specific claim for it or use any type of form. If you believe that you are entitled to SMC but VA has not granted it to you, you could certainly contact the regional office or a representative and see about getting that process started. But it’s not the type of thing that requires any particular action on your end.
Jonathan: Okay. And I also wanted to quickly mention because we did talk about this L through O rate which Christian went through. There’s also something called P, right? What is a P rate equate to?
Christian: Yes so a P rate would be if you have 3 extremities, the loss of use of 3 extremities and it would be paid out to the similar rate of O.
Jonathan: Okay. All right so we’ve taken you through K through O essentially. And as we said these–generally speaking, as you go down the alphabet, you’re getting more money. One exception to that is actually S which interestingly falls pretty far down the alphabet but actually it pays less than L. So although it does pay more than 100% rate. So what is S and how do you get S?
Christian: So there are two ways that a veteran can be entitled to S. The first way is getting a total rating for one disability or IU on the basis of one disability. So that’s how you get the 100, plus other disabilities that are rated collectively at 60% or more. And the other way would be housebound status.
Jonathan: Okay establishing that somebody is so severely disabled that they are effectively housebound?
Christian: Confinement will continue for the rest of the veteran’s life.
Jonathan: And the first method that Christian went through kind of demonstrates how important it is to frame your arguments for you advocates out there, that when you’re arguing for something like TDIU, it does matter what you’re throwing in there for factoring into the TDIU because if you could get TDIU established for just one disability, everything else could add up to 60, then there’s your S. It’s a few hundred dollars more a month on top of the 100% disability rating. So it does make a difference. All right. Now we get into the really high SMC rating. Let’s talk about R. And R has a couple different levels to it. So bear with us that- with that. Maura, you want to walk us through R?
Maura: Sure. So we talked about earlier how if you have 2 SMC L levels, they combine to an O. So one of the first starting points for R is that you are entitled to SMC O. So you can achieve that by, as we said earlier, the 2 Ls. So showing that you have the disabilities that would meet those requirements. So the first thing you need is entitlement to SMC O and then in addition you need entitlement to aid and attendance. We’ve talked about aid and attendance. I don’t know that we’ve really gone into a whole lot of detail about what it is. But the need for aid and attendance is when a veteran’s disabilities, service-connected disabilities require somebody to physically help them with the activities of daily living. So they need help bathing, dressing themselves, preparing meals, feeding themselves, things like that. So if it’s the case that the veteran has those needs, they might be entitled to the aid and attendance benefits. But more importantly, they meet the aid and attendance requirement whenever it’s a requirement for SMC such as the R rate. There’s also R-2. So what I just described was R-1. So now there’s the second level of R which is R-2. And the primary difference between the two is that SMC R-2 requires you to need the care of a licensed medical professional. So it’s not just a person that can help a veteran get out of bed, take a shower, eat a meal, things like that. It needs to be care that can only be administered by a medical professional.
Jonathan: And as Christian spoke about earlier, the monetary difference is about $1,000. You get about $8,500 a month for R-2, $7,500 for R-1. We’re talking about for a single veteran. So there’s a significant difference between the R-1 and the R-2. So obviously, for the viewers, we kind of take you through this algebraic formula. 2 Ls or 2 of the L through N rate added together gets you to O, plus aid and attendance gets you to R-1, plus a higher level of aid and attendance gets you to R-2. Where does bedridden come in?
Maura: I think bedridden is one of the considerations when assigning R-2. So this would sort of go into the different standard of care that’s required for the veteran. It’s not simply aid and attendance where the veteran is able to do some degree of performing their activities of daily living. But they just need some assistance from a non-medical professional. What VA means by bedridden is that the person is literally confined to bed. It’s not that they go through periods where they’re bedridden. It’s not that they’re prescribed bed rest only under some circumstances. It’s that they’re actually bedridden and unable to leave the bed at all times.
Jonathan: So the—we had talked about aid and attendance and what that means and then the higher level of aid and attendance. Is it possible for veterans to get compensation for these caregivers?
Maura: So the aid and attendance benefits that we’re talking about today, these are benefits that go to the veteran. SMC benefits are for the veteran and aid and attendance is one section of that type of consideration for that benefit. There are programs that will pay an allowance or some type of compensation to caregivers. Those are typically confined to post 9/11 veterans with very severe disabilities that stem from service. But for the purposes of our conversation today, these are benefits that go to the veteran themselves.
Jonathan: So I can say from my experience, we’ve seen a fair amount of R ratings, R-1 and R-2, but they are rare. I think fortunately for people that whose conditions are so severe they warrant an R-1 or R-2, I’d like to think that VA gets those right without the requirement to appeal the heck out of it and mess with it. But we do see them. We have had cases where we have had to appeal for those type of ratings. Christian, you want to walk us through one where I believe in this case we got somebody the R-1 rating.
Christian: Absolutely. So this case actually was– required going all the way to the court and getting it back down to the Board before we were able to get the veteran the rating he deserves. So we had a client that had loss of use of his upper and lower extremities. So that’s what we were talking about before, significant loss of use. So more than at the L rate, it was actually at the M rate. And so he had loss of use consistent with the M rate for his upper extremities and also loss of use consistent with the M rate for his lower extremities. So again, that’s 2 rates of the M. And that’s what got us to O and then because our client, this veteran, also needed regular aid and attendance. That’s how we were able to get him what he deserved at the R-1 level.
Jonathan: There is also something called–or there’s a subsection T. And what is T for and what does it equate to?
Christian: Yeah. So T is for traumatic brain injury, veterans who have traumatic brain injuries only. And we actually had another Facebook Live video where we talked about traumatic brain injuries in depth and we talked about it there. But basically if you have a traumatic brain injury and you need regular aid and attendance for the residuals of that traumatic brain injury, then you’re able to get SMC T. There’s also a few other sort of if you’re not able to get R-1 but you have the aid and attendance necessary because of your TBI, you can get a T and then, or if you need to be hospitalized for the severity of your TBI in a nursing home or some other sort of residential program, you could also be entitled to T and I didn’t have this memorized but it’s paid at the same rate as R-2.
Jonathan: That’s right. So it matches the highest rate available which is the R-2 rate. T is relatively new. It’s been around for a few years now but it wasn’t around when I started practicing. So it is something that obviously is targeting as more evidence and as more is known and discovered about the severity of TBIs. So as previously discussed by Maura, this is stuff that there isn’t a special form that needs to be filled out when you’re filing for increased rating for your service-connected disabilities. It is presumed that you’re seeking the highest rate possible and SMC is part of that. So if you’re wondering how you get into the SMC universe, if you’re filing for an increase rating and you feel that you’re entitled to any of this stuff, feel free to reach out. You can find us at cck-law.com. And there’s lots of information we have about the different levels of SMC that we blogged about. And you’re also willing to– you’re more than welcome to reach out to us to see what we can do. But it is important to note that this isn’t something that needs to be formally raised. It should be raised by the evidence of record. So Maura and Christian, thank you very much. I don’t know if we had any other questions. But I think– we wish you all a good afternoon.