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Learn how one veteran secured Special Monthly Compensation for Aid & Attendance back to 2017, but faced denials for loss of use of feet and higher SMC rates. A vaclaims.net case study.
This case follows a veteran who served our country from April 1985 to April 2005. She had a long history of service-connected disabilities, including severe orthopedic issues affecting her feet, ankles, back, neck, and knees, as well as radiculopathy, adjustment disorder with depression, and sleep apnea. By June 2015, her conditions were so severe that VA found her permanently and totally disabled, and she was awarded a 100% rating based on individual unemployability (TDIU). Despite her high disability ratings, the veteran still needed to fight for additional benefits. In 2020, she formally claimed Special Monthly Compensation (SMC) for Aid and Attendance (A&A) and for loss of use of both feet. However, the Board of Veterans' Appeals (BVA) noted that the claim for SMC could be inferred from her earlier increased rating claims dating back to June 2015. Initially, the BVA granted her A&A from April 2020 but denied her other SMC claims. Unhappy with this limited grant, the veteran appealed to the U.S. Court of Appeals for Veterans Claims (CAVC). The CAVC agreed that the BVA's reasons for denying earlier A&A and the other SMC claims were inadequate. They sent the case back to the BVA for a fresh look. In this new decision, the BVA reviewed all the evidence again. They ultimately granted the veteran SMC at the L rate for Aid and Attendance, backdating it to November 1, 2017. This was a significant win, as it meant she would receive benefits for several additional years. However, the BVA still denied her claim for A&A prior to November 2017, stating the evidence didn't support a need for regular care before that date. They also denied her claims for SMC based on loss of use of both feet and the higher R-1 rate for additional aid and attendance, finding she didn't meet the specific criteria for those benefits.
To have secured SMC for Aid and Attendance (A&A) for the entire period back to June 2015, the veteran would have needed stronger, contemporaneous evidence from that earlier timeframe. While her family provided credible statements about her needs, the Board specifically noted that the medical evidence wasn't consistent with needing a caregiver on a regular basis *prior to November 2017*. This highlights a crucial point: lay statements are powerful, but for earlier effective dates, they need to be corroborated by medical records from that specific period. The veteran would have benefited from detailed doctor's notes, physical therapy reports, or other medical documentation from 2015-2017 that explicitly described her functional limitations and her inability to perform daily activities without assistance. Additionally, more specific lay statements from caregivers during that exact period, detailing the *type, frequency, and duration* of aid provided, would have strengthened her case. Regarding the denial for 'loss of use of both feet,' this is a very high bar to meet for SMC. The VA defines 'loss of use' as a condition so severe that the limb is essentially useless, similar to an amputation. Even with significant pain and disability from pes planus and plantar fasciitis, if the feet retain *any* functional use, this specific SMC category is typically denied. To win this claim, the veteran would need compelling medical evidence, such as an opinion from an orthopedic specialist, stating that her feet are completely non-functional for all practical purposes, making ambulation impossible or extremely limited even with assistive devices. Without such extreme findings, it's very difficult to meet this criterion. Finally, the denial of the R-1 rate indicates that while the veteran qualified for the L rate (regular A&A), her overall condition did not meet the even higher threshold for R-1. This rate is reserved for veterans with extremely severe disabilities, often requiring a second caregiver or constant supervision due to severe mental or physical incapacitation. To win R-1, the veteran would need to demonstrate a level of dependency that goes beyond the regular A&A criteria, with detailed medical and caregiver evidence explaining the extraordinary care required.
This case underscores the importance of consistent medical and lay evidence over time to establish an effective date for benefits, especially for Aid and Attendance claims.
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