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Special Monthly Compensation (SMC)

Special Monthly Compensation (SMC)

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.

  1. What is Special Monthly Compensation? Who is it for?
  2. How do SMC payments work?
  3. Special Monthly Compensation Rates 2019
  4. What are the different levels of SMC?
  5. How to File for SMC (Is there a Special Monthly Compensation form?)
  6. SMC(k) and the meaning of “Loss or Loss of Use”
  7. SMC(s) and the meaning of “Housebound”
  8. SMC(l) through SMC(o)
  9. The meaning of “Aid and Attendance”
  10. Combining multiple levels of SMC
  11. SMC Half Steps: SMC with other service-connected disabilities
  12. SMC(r1) and SMC (r2)
  13. SMC(t) for Traumatic Brain Injury (TBI) that requires aid and attendance
  14. Takeaways & Final Thoughts

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Video Transcript.

Maura Clancy: Good afternoon everyone. Welcome to today’s Facebook live discussion. My name is Maura Clancy, I’m here at Chisholm Chisholm & Kilpatrick in Providence, Rhode Island. I’m joined today by Lindy Nash and Emma Peterson, also of the firm. The three of us are attorneys here at Chisholm Chisholm in Kilpatrick. And today, we’re going to be talking about Special Monthly Compensation. A couple notes before we get into the substantive material for today. First of all, thanks for joining us and if at any point, you have questions that you would like to ask, we will be taking questions through the comments feature next to this video, so leave your questions there, we’ll do our best to answer as many of them as possible. What we will also do is be sure to post any articles or blog posts from our website that we think would be responsive to your questions also in the comments feed. So, keep an eye on those and today, we’re– like I said we’re going to be talking about Special Monthly Compensation or as we call it SMC. In general, Special Monthly Compensation is used to pay veterans for disabilities that are exceptional, special, sort of where the name comes from, and usually far and above what the typical schedular criteria will pay for certain disabilities. So, Lindy, can you start us off by giving us an overview, just generally what is Special Monthly Compensation or SMC? Who is it for and how does it work if a veteran is eligible for SMC, how does that affect the other payments that they receive through their typical disability compensation?

Lindy Nash: Sure. So Special Monthly Compensation, as we’ve said SMC, easier to call it that way. So, SMC is basically for veterans who have severe, very severe disabilities that have been service-connected. So, it’s usually kind of the point is that if your multiple service-connected disabilities, or even, you know, one or two that are so severe that the typical compensation table doesn’t really compensate you appropriately. So, the VA gives you kind of that higher level, a little bit more in a payment just to compensate you for how severely disabled you are. So, there are multiple types of SMC that we’re going to go through. We often refer to them by the letter and we’ll get more into that as well. But basically, when you think of SMC you kind of think of loss of use or loss of limbs, blindness, deafness, things along those line. Again, we’ll get into that in more depth as we go on.

Maura: And so, if it’s the case that a veteran is eligible for SMC, say for the loss of a hand, because as Lindy said, usually SMC comes into play, one of the common ways is through loss of limb, loss of one extremity, a hand or a foot, etc. If a veteran is receiving payments, say they’re receiving a 30% monthly payment for the hand but then they’re entitled to SMC based on loss of use of the hand, how do those payments work out? Is the veteran eligible to receive both payments?

Lindy: Yes. Sure. So typically, for the most part, SMC, that payment will replace whatever you’re getting on a monthly basis. However, there is one exception which is called SMC-K, and we’ll get into that more in-depth as well. So, a K will be added on to your monthly compensation rate. I believe right now, an SMC-K is about $108, again we’ll get into that more in a bit. But SMC-K is added on, however all other levels of SMC will replace your monthly rate.

Maura: And that’s typically because the amounts are higher.

Lindy: Yes. Yes. Exactly. So they’re not added on to what you, it’s usually a new rate altogether.

Maura: Great. And just for a point of reference, when we’re talking about SMC as I said before, we’re talking about more severe conditions. And so, as a result, the compensation that’s paid through SMC benefits is also higher to match the severity of the conditions that we’re dealing with. So just for reference, right now a current 100% rating, a monthly payment for that is about $3000. But the SMC rate, say for SMCL, which as Lindy said we’ll get back into later what the specific letters stand for. The payment for SMC-L is around $3800 a month, the payment for SMC-R1 is around $7600 a month, and the highest amount for SMC would be R1 and T, I believe and that is an excess of $8000 a month. So, we’re definitely talking about benefits that are more substantial than your typical monthly payments’ which is why this is a special form of compensation as the name implies. So, just a reference in terms how the payments differ and now we’re going to start talking about what different levels of SMC-R. So as Lindy mentioned before, we have SMC-K, we also have as I mentioned, SMC-L, SMC-R1. Generally speaking, how do we get the letter, so why do we refer to SMC by the letter?

Lindy: Yes. 

Emma Peterson: Sure.

Lindy: Go ahead.

Emma: So in the statute, the words SMC goes by subsection letter. The letters are not in order. They don’t necessarily correspond to a term or a phrase like L is not because of loss of use, it’s just L. I’m sure at some point, there might have been censor of correspondents but really, it goes from K which is the lowest, and you have S, L, O, M, and from there you get two R, and then from R, it goes to T which is the same. But they’re sort of not necessarily in any kind of coherent order. But they’re building blocks that build on each other.

Maura: Okay. So the letters refer, as Emma said, to the different sub-sections of the statue which is why we use the letters for shorthand, and typically, although not universally in the progression because S is the exception which again, we will talk about later. Typically, the amounts for SMC payments go higher as you go further through the alphabet. So, this stuff’s very complicated so bear with us as we go through it all. There’s a lot of different sub-parts and sub-requirements for each level of SMC and then there are a lot of ways in which the different levels of SMC interact with each other. So, as Emma said, they’re building blocks. Sometimes you can satisfy the lower levels, and build upon those to satisfy higher level which would increase your monthly amount. So, let’s get into some of the specifics. Emma, can you– actually, no. I want to start with Lindy because you already started talking about SMCK.

Lindy: Yes.

Maura: I think that’s the easiest so to speak–

Lindy: Sure.

Maura: –type of SMC level to conceptualize. So, give us a breakdown of what SMC-K is and how it works with other SMC levels, although you did allude to that before, but give us a refresher, please.

Lindy: Sure. And then, actually before I get totally into SMC-K, I just wanted to mention, I think we’ve want to talk about, is that when you file for SMC, you might be asking, “How do I get there? What do I do?” You actually don’t have to file specifically for SMC. I think that’s something I was going to get into as well. But you don’t need to file a specific form for SMC, it is kind of inherent in your increased, you know whenever you’re seeking the maximum rating, you are inherently seeking SMC if you submit evidence that shows that. So that is a question I think we got all the time, you know, “How do I get SMC? What do I do?” So typically, the evidence that you submit should kind of raise that flag for VA, but if you’re worried, you can always call your representative or file something with the ROs specifically saying, you’d like SMC. But typically you don’t have to. Did I miss anything?

Emma: No, that’s it. That is true for any kind of increase is that —

Lindy: Yes.

Emma: –you can always ask for it, better to be explicit. And just sort of get the ball rolling but if evidence raises it, you know not everyone’s going to know the ins and outs of SMC like we mentioned. The letters get confusing, we’re going to get into half steps that gets really, really sort of convoluted so, you know certainly work with a representative or an attorney or an agent, whoever you talk about these things. But you can certainly ask for it out front if wanted to.

Maura: But no requirement or a special from which is really nice when we’re talking about these kinds of benefits.

Lindy: Definitely. So anyway I just wanted to say that before I forgot. But anyway, so back to SMC-K, which is the level that we were talking about before, it is the lowest rate for SMC out there. As I sad it is $108 approximately right now. And typically, SMC-K is warranted for either loss or a loss of use of a body part or organ that a veteran has due to their injury, loss the use of. So again, loss of use, it doesn’t have to be amputated, there is no amputation requirement so you could have an amputative but that is not necessary for this K to be given to you. Typically, it would be loss of use of one hand, a foot, both buttocks I believe, reproductive organ, even breast tissue and there’s all sorts of other examples as well but those are kind of the ones that I immediately think of. And also just to go onto the loss of use, it’s kind of– I look to a regulation all the time, or a case lot to kind of cite what loss of use really means and I usually  think about it as there being no affective functioning remaining. So sometimes, VA wants to go back and forth about what that means and so we would often say that if you have no affective function remaining in that hand of foot or arm, then that would consider loss of use. So that is kind of what I think about that. Oh and you can also have multiple case, that’s something important to know as well. So the case can add up. You can have loss of use of the hand and breast tissue and that would be two different case added on to your monthly compensation.

Maura: Great. So good to know. So, distinguishing features of SMC-K, as Lindy said is that you can receive multiple case at the same time. You can stack them, so to speak and I think that was a good point that you made earlier. There is no amputation requirement. So when we talk about loss, loss of use of a particular body part which we will talking about a lot today, there’s no requirement that the body part be totally gone, no longer attached. So that’s good know.

Lindy: Yes, absolutely.

Maura: Emma, do you want to talk to us briefly about SMCS, what that level of SMC is about?

Emma: Sure. We’ll go actually just go right in, we’ll dive in from S, but then we’re going to backtrack, go to L, M, N, O, P and then to R. Okay, so we’re just going to go through all the alphabet soup we have here. So S is the next step up from K. It’s the next hi–the first sort of real true SMC level beyond SMC-K. And there’s sort of two ways that you can get it. The first is if you are house bound, meaning you really can’t — you can’t leave your home, your hospital, your care facility and the medical condition you have that causes you to be house bound is service connected and it’s not likely to improve, you can qualify for SMC-S. Now that doesn’t mean you can’t ever, ever leave your house. If you have to go to doctor’s appointments or some type of care, that’s fine. But it does mean that you are pretty much home bound the rest of the time, you just possibly can’t leave due to the nature of your disability. The other way to get SMCS statutorily is if you have one disability that’s a 100% disabling. And that one disability could cause you to be schedular a 100%, you’ve been received your rating from a diagnostic code that’s a 100 or that one disability on its own causes you to be unemployable so you get TDIU to that single disability, and then you’ve got more disabilities on top of that, that combined to at least a 60%, you can also get SMC-S. This is where the building blocks come in and the math gets confusing. But just know that 100%, whether it be schedular or TDIU plus a combined 60 will get you SMCS. So that’s the next highest level and you have the rate over there. What’s the rate for S?

Maura: The rate for S currently for single veteran with no dependents, that’s the point of reference that we usually use, is about $3400 a month.

Emma: All right, so that’s definitely $400 more a month out from the schedular 100 that’s certainly significant. And then from there, it just increases. So, after– as now we start getting into different body parts that you need to combine together to get to the different levels. So we have SMC-L, which could be awarded for if you a loss of use of two hands, two feet, your eyes, your hearing, or you need something call aid and attendance. So those things together, those combinations of things will get you SMC-L and then from there, you build even more. So we have SMC-M which has to be loss of both hands, both legs to knee, one arm at the elbow and one leg at the knee, blindness in both eyes, blindness requires aid and attendance, so again, it’s a little bit more than the L, you have more body parts in play, more conditions affecting your total functioning level. And it goes up from there, it just goes to higher levels of loss of use. So for example, if you did have a loss with your arm at the elbow, I suppose at your hand, both legs at the hip, got one arm at the shoulder, one leg at the hip or you’re completely blind, totally blind, that would get you an N. And then finally we get to O. And you get there by combining Ls, Ms, and Ns. So if you got two Ls, if you have two Ms or Ns, together in combination could you to the higher level of L, so it’s kind of like a booster. You’ve got so many conditions that are so disabling that together combined, they’re going to bump you up to SMC-O. And what’s O? I think it’s —

Maura: The rate for O is $5300.

Emma: Okay, so that’s definitely exponentially more than the 100% which is about $3000 and that is due to the severity of the disability. You know, it’s compensating you at special situation. So as Lindy said though, the loss of use that we’re talking about is not a complete and total amputation. And then term– the definition of loss of use is a little tricky and it can be hard for doctors to understand so it’s important to talk to your treatment providers and be very clear about– get good medical evidence about what that means and what it means is that, like Maura said, Lindy said, you have no remaining function and VAs set the terms that you could be equally or better served by an amputation with a prosthesis. So that can be a sort of hard pill for a medical examiner to swallow, to say, “Yes, we should amputate but we wouldn’t when amputation is not preferred.” But that’s really what it means, is that there’s no remaining function in that hand or leg or foot. And you can’t grasp your hand, you can’t walk with your feet, you need support amputate, you need cane or walker, wheelchair or whatever the case maybe. So those different combinations really build up together.

Maura: And something that you mentioned that is integral in those different levels is the concept of aid and attendance. Tell us what aid and attendance is, how you could suffice that requirement because that seems to be pretty important in terms of showing eligibility for SMC benefits.

Emma: Right. So aid and attendance, it kind of is what it sounds like, you need the aid attendance of another person to help you carry out your daily acti– daily living, daily activities. So if you need help getting dressed in the morning, bathing, hygiene needs, preparing meals and eating, you need someone to help you with the prosthetic or orthopedic device, you can’t adjust it on your own, you’re bedridden or you need someone to help protect you from your daily life, the hazards of daily life. So there are folks with mental health conditions that are so severe that they need someone to assist them just with day to day living, it’s not that they need someone to feed them, but they do need someone to help them, sort of navigate the ins and outs of daily life. That can qualify for aid in attendance. Now that aid in attendance on its own is at SMC level L. But then if you had another L, let’s say you start building up on that and bumping up a level. So I could see a situation where someone who has Parkinson’s or Parkinsonism who needs help, they have loss of use of both legs, but they also need aid in attendance due to their inability to feed themselves. Those two Ls together could get them to that SMC-O and that just ticks up from there.

Maura: That makes sense. And one thing that we have seen questions about before about aid and attendance is that or is the question that is that a benefit than can extend to the caregiver or to the veteran themselves? What’s– you know, is there any ability for any veteran who is eligible for benefits due to aid and attendance? Can their caregiver get paid that benefit? Do you know the answer to that?

Emma: So aid and attendance gets paid to the veteran. It is paid to the veteran, there are other programs and that’s a different Facebook live topic to talk about VAs caregiver programs. But aid and attendance is paid to the veteran themselves.

Maura: Great. And so, there’s clearly so many different levels of SMC in play. Lindy, what happens if there is one specific claimant who is eligible for different types or multiple levels of SMC? How do the payments work in that type of scenario?

Lindy: Yes. So, Emma kind of referenced this but some of the time, if you have multiple levels of SMC, they can combine together to give you that next level of SMC. So we talked about O so the level O,  you can get O by getting one L through N, plus another L through N. And so I know that sounds kind of complicated. And it’s confusing. It is. And we’ve struggled with that all the time which is why we have our book with us.

Lindy: But basically so, in an example like that, a veteran could be receiving L due to loss of use for something extremities. Plus L for A and A, due to PTSD. So that L plus another L combines to give you an O and therefore, you don’t get two Ls, that’s not how it works. They combine together to get you that next higher level of O for SMC.

Maura: Great. And Emma, earlier you mentioned half steps —

Emma: Oh yes.

Maura: –and the possibility that a veteran might be eligible for SMC but also have different service connected conditions that don’t necessarily warrant the assignment of SMC but are still rated high enough on the schedule that VAs has provided ways for even additional compensation on top of the levels that before we talked about. Can you walk us through some of the possibilities if someone has other disabilities that qualify for SMC, other disabilities that don’t qualify for SMC but are rateable at a certain amount?

Emma: Right. So there’s sort of two ways to bump up. So let’s say you’re at SMC-L because we’re talking about L a lot. I like L, come forward L. So yes, SMC-L but you have other conditions that separately combine to a 50. You can get a bump up to L 1/2. And if you have other disabilities that are rated at a 100%, you can get bumped up a full step to M. After my alphabet L, M, N, O, P. So you can get bumped up a full step, so there are ways beyond that just meeting more SMC building blocks that get that kicker up to the next higher level. And that’s why this stuff can get very confusing, really mathematical, really technical. A little dry, but at the end of the day, certainly really, really important benefit for those that need it because as we’ve been talking about the levels really increase exponentially. And for some in that situation, that money’s really necessary to make sure they’re getting the care that they need to help them out with their daily life.

Maura: And definitely based on the recognition that if you have certain disabilities that are so disabling that they warrant SMC, and there’s a possibility that you still have other disabilities that are rated so high, it doesn’t make any sense to not receive additional compensation to recognize the whole disability picture and all the impairments that the person has. Lindy, do you want to talk to us about SMC-R which I think we mentioned earlier. We mentioned that the rate for SMC at least for R1 is about $7600 a month and for R2, it’s the highest SMC rate at $8700 a month. Tell us about R1 and R2 and summarize for us please the difference between the two because this is, yes, another subsection of SMC that can get kind of complicated.

Lindy: Yes. Definitely. So as Maura said, there are kind of two sections to R. There’s R1 and there’s R2. So I’ll start with R1. Basically, you get to R1 by having an SMC-O or and SMC-P plus regular aid and attendance. So we’ve talked about this previously, I don’t have to get back into what O and P stand for, but say, a good example is a veteran would be wheelchair bound due to loss of use of both of his feet. So that would give you SMC-L. However, here she also has PTSD which requires A and A to give you another L, so that gets you to O. So once you have that O, and A and A, that gets you to R1. But the most important thing to know about R1 is that you might think to yourself, “Oh that sounds like pyramiding.” That A and A is both used for PTSD and the A and A that you need to finish the R1. However, under the regulation 3.350, it’s actually not pyramiding and it’s not overlapping and it’s okay in this situation. So that’s a really good thing to know going forward, and another nuance thing that’s really easy to mess and that the VA can often mess up, so it’s important really go through that slowly and recognize that you could qualify for R1.

Emma: That’s where the only situation in SMC where you can’t sort of double dip.

Lindy: Yes. Exactly.

Emma: You can’t have an L for loss of use of your lower legs and then an L for A and A due to loss of use of your lower legs, and those two Ls together won’t kick you up to the O. So it’s only once you reach O can you double dip and use A and A to boost you to R1.

Lindy: Yes. Exactly. So that’s R1 and then R2 is just a little bit– actually it’s a much higher benefit as Maura said compensation wise, but really the big difference from R1 and R2 is that the A and A required for R2 must be by a licensed medical professional so you know, if your husband or wife has been taking care of you and they qualify for A and A, they’re not a registered physician, they’re not medical professional, they just help you with your day to day life. That will qualify as regular A and A. However, if you have a nurse coming in to check on you every day, or I think even if your spouse is a nurse, that can technically qualify as a medical licensed professional so that would be R2. So that’s really the big difference is that for A and A in R2, they have to be a licensed medical professional whether that’s, your child or spouse or someone you hire from an organization. That would be the big difference.

Maura: Great. And finally, Emma, will you walk us through SMC-T which is also paid at the same rate as SMC-R2 that Lindy just discussed. Again, that rate is right around $8700 a month. Tell us what the requirements are for T.

Emma: Sure. So SMC-T is newer and that’s in recognition of sort of the severity of folks coming out with traumatic brain injuries from the service and just sort of encompassing nature of TBIs they can manifest in so many different ways affect your body so completely. So SMC-T is for those people who are service connected for TBI and they need aid and attendance due to that TBI. But they don’t have the other building blocks to get to that R level. They don’t have, you know, say loss of use of the legs and the hands and the feet, they just have a very severe TBI that requires aid and attendance. And if that care is the only thing keeping them from not having to go into facility for full time care, they can qualify for SMC-T and it gets paid out at the R2 level. So if basically again, if you have a TBI that requires aid and attendance and you don’t otherwise qualify for R2, and again that aid and attendance is the kind that is basically someone’s caring for you and helping you with your daily life and if it wasn’t for that care, you’d have to go into facility, you can qualify for SMC-T. So again, it’s in recognition of sort of just the severity and how globally a TBI can affect a person’s body.

Maura: Definitely. So, we’ve gone through a lot of the steps here. Again, thanks for bearing with us. This stuff is very complicated, there’s math involved, there’s a lot of weird strategy involved in terms of which disability is causing which effect and how does that affect your entitlement to higher levels of SMC. So, I think a big takeaway from what we’ve talked about today is this is not something that you have fill up a particular form for to apply for. If you’re seeking a higher rating for a service connected condition, SMC is what we call an inferred issue. So, if the evidence raises your entitlement, then VA is supposed to award you the benefit on that basis. But again, as Emma said earlier, definitely can’t hurt if you like you are entitled to one of these levels of SMC that we’ve been talking about to bring that issue to the attention of your representative or the regional office even to make it known that you are seeking that benefit explicitly. Although there is no specific form required which is nice, since sometimes the forms can be just yet another avenue to have to navigate. Did either one of you want to add anything to what we’ve talked about?

Emma: I think it’s– like any other increase rating claim we talked about, making sure that you have the evidence to help you out whether that be through lay statements of your family members are very helpful in SMC cases. And to the best of your ability, your own personal experience and lay evidence and medical evidence from any doctors that you see is very important to gather. VA will help you, they’ll assist you with that especially for the A and A, and the housebound, they do have special exams, those disability benefit questionnaires that we all know and love. They will fill those out for those two conditions to talk about it. But just gather as much of your own personal experience evidence as you can, and that can only help as opposed to hurt.

Maura: I think that’s a great point, especially the addition about the importance that lay evidence can have in these kinds of cases. So evidence that comes from the person that’s affected by the disabilities or people that know the person and observed the effects of these kinds of disabilities can be very helpful in these kinds of claims. Did we have any questions?

Lindy: I would just add one quick thing. I don’t know if we actually mentioned the statute. Did we give the number?

Emma: We didn’t give a number. We just talked right vaguely.

Lindy: Well just in case, you want to check it off for yourself, it’s 38 US Code 1114 so you can go there, you can check out all the different types of SMC, again it’s all by letter. So it is complicated but it’s there for you, to look for yourself and you can feel free to contact us with questions, but it is there for you so can look at it at home.

Maura: Great. It’s a good way to wrap it up. Thank you guys for joining me, and thanks everyone for joining us today. We hope that this was informative. Check back through the comments and see if there’s any information that we’ve posted in addition to this video that would be helpful to you and would answer your questions about SMC. And again, thanks again for joining us today.