SMC(t) Criteria and Approval: A BVA Case Study
Here, we present a Board of Veteran Appeals case study on SMC(t) Criteria and Approval. Learn how to win your case.
From a medical standpoint, Traumatic Brain Injuries (TBI) are complex. Symptoms of TBI can vary and may present differently amongst people suffering from the injury. Special Monthly Compensation for Veterans is complex, as well. Adding to these complications, the definitions for things like “aid and attendance” are rather vague.
The sum total of these circumstances is that SMC(t) criteria and approval are highly subjective. An assertive VA disability benefits attorney can make all the difference. If you or a loved one must deal with these issues, it is important to see how the Board of Veterans Appeals works in these situations. Hopefully, the following case study will shed some additional light on these matters.
Summary of Facts
In this case, an Afghanistan War Veteran arrived at the VA suffering from various psychological symptoms. After an evaluation, it became apparent that the man’s condition had deep roots.
During a pair of 2009 evaluations, the Veteran said he “grew up in a rough neighborhood, and while growing up, he had thoughts of wanting to harm others.” However, he never acted on those feelings. Years later, during his time in the service, a knee injury prevented him from doing some physical activities. He said he was depressed because “all he had been able to do was sit and watch everyone else train.”
After only a month in Afghanistan, his condition deteriorated significantly. His symptoms included sleeplessness, “feelings of worthlessness, difficulty concentrating, decreased appetite, isolation from others, and suicidal ideations/plans.”
Because of his continued physical deterioration, the Military discharged the Veteran from service in 2010. The following year, he was diagnosed with Post Traumatic Stress Disorder. In 2013, largely based on lay testimony from his caregiver mother, the Veteran was re-evaluated and diagnosed with a Traumatic Brain Injury.
General Information
When VA doctors evaluate Veterans for the residual effects of Traumatic Brain Injuries, they look at three main areas:
- Cognitive: The primary focus here are executive brain functions, such as planning, prioritizing, goal-setting, and decision-making. Doctors also look at more pedestrian brain functions, such as memory, attention, and concentration.
- Emotional: TBI patients often exhibit clinical depression symptoms, yet they are not clinically depressed. Ongoing situational depression is usually a good indication of a brain injury. Most people pull themselves out of “the blues” but often cannot if they have brain injuries.
- Physical: Some physical brain injury symptoms include headaches, personality changes, sensitivity to light, and tinnitus (ringing in the ears).
Based on the Veteran’s symptoms, the VA gave him a 70% PTSD impairment rating. His caregiver’s lay testimony probably helped him reach that determination.
SMC(t) Findings
Despite the rating being less than 100%, the BVA concluded that SMC at the (t) rate was warranted for the entire period of the veteran’s post-service illness. To determine A&A, the BVA looked at practical, everyday things, such as:
- The Veteran had lived with his parents,
- His mother administered his meds, reminded him to do things like bathe and brush his teeth, accompanied him to medical appointments, and
- His mother also “helped him to calm down after nightmares and panic attacks, and accompanied him whenever he went outside the home.”
With regard to SMC(t) benefits, practical items can often be more important than the medical diagnosis. Of course, the Veteran must have medical evidence to support his or her request, but the BVA really wants to see how this diagnosis affects the Veteran’s day-to-day life.
Contact Assertive Attorneys
Severe disabilities fall outside the normal rating system and merit additional benefits. For a free consultation with an experienced Veterans disability lawyer, contact Cameron Firm, PC at 800-861-7262 or fill out the contact box to your right. We are here to represent Veterans nationwide.
We will provide assistance for many types of issues on appeal, including, but not limited to: Dependency Indemnity Compensation, Agent Orange, Total Disability based on Individual Unemployability (TDIU), Traumatic Brain Injury (TBI), PTSD, and other mental health issues. Not included are Special Monthly Compensation issues.
This article is for educational and marketing purposes only. Therefore, it does not create an attorney-client relationship.