Special Monthly Compensation due to TBI, or SMC(t), is a level specifically for veterans who suffer debilitating residuals of a Traumatic Brain Injury (TBI). Many medical professionals refer to Traumatic Brain Injuries as the signature wound of the Iraq and Afghanistan Wars. Roadside bombs and other IEDs cause many of these wounds, even if the Veteran was several blocks away from the blast and suffered no other physical injuries. Explosive blasts trigger shock waves that disrupt brain functions.
Due to the prevalence and severity of such injuries, Congress recently expanded the Special Monthly Compensation program. SMC(t) is now the highest-paying such program. In addition to free VA medical care, available benefits include up to $9,467.04 a month in monetary benefits for veterans with a spouse, two parents, and one child. However, as outlined below, these benefits are only available in limited situations.
Qualifying for SMC(t) Benefits
These benefits are not additional disability benefits. Instead, SMC is a completely different program. The VA designed these benefits as compensation for Veterans who are more than disabled. These claimants must essentially be bedridden and unable to care for themselves. The specific SMC(t) requirements are:
- Need for Aid and Attendance: Under 38 C.F.R. 3.351(a), Regular Aid and Attendance (A&A) means “helplessness or being so nearly helpless as to require the regular aid and attendance of another person.” In brain injury situations, this A&A usually means help with things like going to the bathroom and bathing. A&A could also mean the need for protection in public.
- A&A is Necessary for Independent Living: This factor further defines the Veteran’s need for A&A. Essentially, if the Veteran did not have an in-home caregiver, the Veteran would be in a hospital or nursing home.
- Ineligible for SMC(r)(2): This requirement does not come up very often. SMC(r)(2) assistance is a higher level of aid reserved for Veterans who need help from licensed in-home caregivers for things like injections and physical therapy. Truthfully, if the Veteran qualifies for this higher level, the claimant would probably not apply for SMC(t).
The A&A caregiver need not be licensed and need not be full-time. Typically, a spouse or adult child is the Veteran’s caregiver.
Obtaining SMC(t) Benefits
Theoretically, the VA is supposed to identify and take the initiative in developing SMC(t) cases. Veterans need not apply for these benefits. Bureaucrats are supposed to consider SMC(t) benefits if the Veteran meets the minimum qualifications discussed above. That procedure does not happen all the time, but the mindset does make it easier to obtain SMC(t) benefits.
If Veterans establish a service-connected TBI and a need for A&A, they usually obtain maximum SMC(t) benefits.
Frequently, combat-related brain injuries are easy to document. That is especially true if the Veteran sustained other injuries which required immediate hospitalization. In other cases, the connection is more difficult. If the Veteran was not otherwise injured, a TBI is harder to document. An attorney might need to provide additional medical records from stateside doctors.
In terms of A&A necessity, before-and-after testimony is usually effective. For example, a spouse could testify that before Jim went to Iraq he was very independent. Now, he needs help with basic activities of daily living and/or he has a hard time interacting with people in public. Real stories like these are usually more compelling than buzzwords unless the witness is a degreed professional.
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, and accompanied him to medical appointments.
- 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 Dedicated Attorneys
Severe combat-related brain injury victims often need help that standard disability benefits cannot provide. 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. It does not create an attorney-client relationship.