In this blog, The Veterans Law Group gives an overview of the VA SMC scheme in plain, simple language. It is not meant to cover every single SMC benefit or every detail of each benefit. Many SMC ratings are too technical or detailed for a general overview and our goal is to make the SMC scheme understandable to Veterans as a starting point for further inquiry.
What is Special Monthly Compensation?
Special Monthly Compensation (SMC) is a money benefit above and beyond the monthly disability compensation contemplated by VA's Rating Schedule. It is frequently, but mistakenly, thought that VA disability benefits are limited to those set forth in the VA Rating Schedule. As you may know, the VA Rating Schedule lays out the percentage rating of virtually all service-related disabilities, (the percentages depending upon the type and severity of the symptoms), and these percentages are given a corresponding compensation rate. However, under certain circumstances, the SMC benefit scheme provides a significantly greater compensation rate than the VA Rating Schedule.
Let’s take an example: A Veteran with a service-related disability causes complete loss of use of both hands. The highest possible rating under the VA Rating Schedule would be 50% for the dominant hand and 40% for the other non-dominant hand. Under the VA combined rating table, this would give the Veteran a 70% combined disability rating.
A Single Total Disability Rating & Other Service-Connected Disabilities Combining to 60% Rating or Greater
The SMC benefit scheme provides for additional compensation if the Veteran has a single total disability rating and other service-connected disabilities independently ratable at 60% or greater. This SMC benefit is often referred to as a “permanent housebound” rating.
A permanent housebound rating is the most common SMC benefit and the most frequently overlooked or misunderstood by VA adjudicators. Again, there are two requirements for a permanent housebound rating.
- First, a Veteran must have a single total disability rating. This requirement is satisfied if the Veteran has a single service-connected disability rated at 100% under the VA Rating Schedule or a single disability causing unemployability. (When a Veteran is found unemployable due to one or more service-connected disabilities, he/she will be entitled to the same monthly compensation as if he/she had a 100% schedular disability rating.).
- Second, the Veteran must have other service-connected disabilities combining to a 60% or greater rating.
The first requirement is the trickiest. Most permanent housebound ratings involve a finding of a total disability rating based upon individual unemployability (“TDIU”) due to a single disability. However, with TDIU ratings, VA adjudicators often make generic TDIU ratings, namely, finding that all the service-connected disabilities cause unemployability. Such a finding prevents a Veteran from obtaining a permanent housebound rating.
Under VA regulation 38 C.F.R. § 4.16, a Veteran is entitled to the same compensation rate as a 100% disability rating, if one or more service-connected disability(ies) prevent him/her from obtaining and maintaining employment. This benefit is called a total disability rating based upon individual unemployability, abbreviated “TDIU.”
Let’s take an example to see why. A Veteran has the following service-connected disability ratings: 70% for PTSD, 40% for back disability, and 30% for peripheral neuropathy of the left leg (left lower extremity). The VA PTSD examination states that the Veteran’s PTSD makes it unlikely that he/she could tolerate any work environment. The VA back examination states that the back disability would allow for limited sedentary employment. The VA neurology examination states that the Veteran would have difficulty in a sedentary job. If the VA adjudicator determines that the PTSD condition alone prevents employment, then the Veteran would be entitled to permanent housebound benefits. This is so because the Veteran has a single total disability (the PTSD causing unemployability) and other service-connected disabilities, (the back and the peripheral neuropathy of the left leg), combining to a 58, which rounds up to a 60% disability rating.
The VA combined rating table provides that combined ratings ending in the number 5 or greater are rounded up to the nearest 10% level. Combined ratings ending in a number 4 or less are rounded down to the nearest 10% level.
Yet, VA adjudicators often make generic findings of TDIU ratings: i.e., all of the Veteran’s service-connected disabilities are found to cause unemployability. In the above example, this generic finding would preclude the Veteran from obtaining a permanent housebound rating because he/she would not have a single total disability, as the adjudicator found that all his/her service-connected disabilities are needed to support a TDIU rating. To have a single total disability to qualify for a permanent housebound SMC benefit, the Veteran would need a finding that one of his/her disabilities (here, the PTSD) alone causes unemployability.
If a Veteran receives a generic TDIU rating, he/she should insist that the VA adjudicator make a more specific finding as to whether one of the service-connected disabilities alone precludes employment. The Veteran should argue that the generic finding is inadequate, as he/she is entitled to determination which would give the maximum potential benefits entitled under VA law.
Loss of Use of Organs & Body Parts
The bulk of SMC ratings involve loss of use or actual loss of organs and/or body parts. Here is a general overview of several levels of SMC.
- The VA provides a monthly compensation for loss of use of the following organs: one creative organ, one foot, one hand, both buttocks, blindness in one eye, deafness in both ears, and a 25% loss of breast tissue (usually due to a mastectomy).
- A Veteran is entitled to a monthly compensation rate if: the Veteran has loss of use of both feet, or loss of use of one foot and one hand, or loss of visual acuity (visual acuity of 5/200 or less) or is permanently bedridden with need of regular aid and attendance.
- A Veteran is entitled to a monthly compensation if: the Veteran has loss of use of both hands, loss of use of both feet with prosthesis preventing natural knee movement, loss of use of one arm with prosthesis preventing natural arm movement, blindness in both eyes with only light perception or blindness in both eyes requiring aid and attendance.
- A Veteran is entitled to a monthly compensation if: the Veteran has loss of use of both arms with prosthesis preventing natural movement, or loss of both legs with inability to wear a prosthesis, or actual loss of both eyes, or is blind in both eyes without light perception.
