Understanding Special Monthly CompensationUpdated July 21, 2020 Veterans Disability
In his second inaugural address, President Abraham Lincoln promised “to care for him who shall have borne the battle, and for his widow, and his orphan.” Lincoln’s life was tragically cut short less than six weeks later, but his commitment lives on, in the form of Veterans Administration disability payments.
VA Special Monthly Compensation is a segment of VA disability payments that compensates individuals with catastrophic service-related injuries.
Disabilities That Qualify for Special Monthly Compensation
- Loss of either foot or hand (including near-total loss of use)
- Paralysis or joint immobility
- Loss of eyesight (or vision that’s limited to light perception)
- Anatomical loss of reproductive organs (inclusive of loss of use)
- Complete loss of one or both buttocks
- Severe deafness in both ears (absence of bone and air condition)
- Complete Organic Aphonia (severe speech communication difficulties)
- Loss of a certain percentage of breast tissue due to radiation or mastectomy treatment
The VA must offer SMC to a qualifying veteran. There is no need to apply for it. The SMC process is much more straightforward than the general VA disability benefits process. For the most part, VA SMC is in lieu of, not a supplement to, other disability benefits. The normal qualification rules in terms of surviving spouses do not apply, either.
What Is Special Monthly Compensation?
Mental, physical, and other service-related disabilities make life more difficult for veterans or their surviving spouses. In some cases, depending on the nature and degree of disability, life is very difficult for these veterans, especially on a bad day.
VA Special Monthly Compensation is available for qualifying veterans who cannot function at work, home, or school due to a service connected disability.
The standard service connected disability rules typically only account for physical limitations. SMC injuries, such as anatomical losses and complete deafness, often have emotional impacts that exceed their physical impacts.
SMC veterans benefits rules vary significantly in different categories. But regardless of the nature of the disability, the condition must be a service connected disability. There must be medical evidence in support of this connection, and except in the case of a long-term condition, that report must have been made whole the veteran was still in the service.
The VA defines a service connected disability as:
- Caused While in the Military: Combat, active duty, and training-related injuries all fall into this category. Additionally, any disabling injury which occurred while the veteran was on duty, such as an off-base car crash during training, falls into this category.
- Aggravated by Military Service: If the car crash in the above example aggravated a pre-existing condition, that disability is usually not compensable, even if it otherwise qualifies for SMC veterans benefits. Instead, the aggravation must be directly related to military service. The rating system is usually different for these conditions, but that difference does not matter too much in SMC claims.
- Secondary Conditions: Injury complications are quite common, especially in the SMC context. Normally, these secondary conditions are not compensable. But the VA considers them service-related.
Example: Assume Jeff suffers severe hearing loss during the service, but the loss is not severe enough to qualify for SMC. If his hearing deteriorates later, for whatever reason, he might be eligible for SMC benefits.
- Toxic Exposure: These claims do not come up very often in these veterans disability matters. Exposure to certain chemicals during active duty, such as Agent Orange, often causes various chronic conditions, such as cancer. If the veteran has a presumptive condition, these benefits are easier to obtain.
Different rules apply for reservists, surviving spouses, and DoD monthly compensation disability claims.
What Are the 5 Different Levels of SMC Veterans Benefits?
The following five disability categories apply in SMC claims:
Category K (Special K, Even More Money, or Additional Benefit)
Most SMC benefits are instead of, not in addition to, other disability benefits. This category is the lone exception. Typically, veterans receive Special K as an additional benefit on top of other SMC benefits listed in categories L through O. However, veterans are also eligible for Category K if they do not otherwise qualify for SMC benefits.
Veterans Affairs caps the total amount of benefits at the Category O level, which is the highest Special Monthly Compensation category.
Special K applies to any loss of use, as outlined above. Note that these benefits are available per anatomical loss. So, if the veteran lost the use of both hands, the benefit level might be doubled.
The qualifying injuries are amputation or loss of use of both hands below the elbow or both feet below the knee, or a combination thereof (e.g. one foot and one hand amputation), partial blindness, or a bedridden state which necessitates A&A (Aid and Attendance).
Let’s examine some of these key monthly compensation terms more closely. Blindness means vision worse than 20/200 in the good eye, or a visual field dimension less than 20 degrees. As outlined below, A&A means the veteran needs consistent help with everyday activities. In this context, that usually means physical activities, such as getting dressed, eating, bathing, and using the bathroom. Aid and Attendance could also mean help with a mental disability, such as an inability to remember information.
Amputation or loss of use of the leg to the knee and/or the arm to the elbow, total blindness in one eye and near-total blindness in the other eye, or a combination of blindness and leg amputation.
Generally, loss of use does not mean loss of feeling. For example, Raphael might have some feeling in his hand. But if he is unable to flex it or grasp objects, he has no use of his hand.
Amputation of a leg to the hip or an arm to the shoulder, if the veteran cannot wear a prosthetic device, blindness in both eyes, severe deafness in both ears, or some combination of these disabilities.
Inability to wear a prosthetic usually means the injured limb cannot support a prosthetic, for whatever reason, or the prosthetic requires near-constant adjustment that the veteran cannot effectively perform alone.
This category is essentially the same as M, except for an added A&A requirement. The Veterans Affairs office pays regular aid and attendance benefits if one of the following applies:
- Daily activities, like feeding, bathing, and dressing, require help
- Illness renders the veteran essentially bedridden
- You live in a nursing home due to disability-related loss of mental or physical faculties
- Vision is limited to 5/200 or a 5-degree field of vision in the corrected eye
Housebound benefits are a bit different. These benefits are available if the veteran is reasonably independent in the above areas but cannot leave home due to a permanent disability. Veterans are ineligible for both A&A and housebound benefits.
Category N through O
These classifications normally require the total loss of an ear or eye, as opposed to general deafness or blindness, as well as the inability to wear a prosthetic device.
Category R (Regular Aid and Attendance)
Generally, Veterans are entitled to A&A benefits if they have a Category L through O disability which requires daily help in areas like dressing, cleaning, grooming, and frequent prosthetic adjustments. Regular aid and attendance benefits essentially help disabled veterans afford in-home care.
Category S (Housebound Benefit)
These benefits are available if the claimant is completely and permanently housebound, as outlined above. Additionally, the veteran must have one disability rated at 100%. Alternatively, the claimant could have a 100% disabling condition coupled with a 60% disabling condition. This second qualification has no housebound requirement. These two disabilities must affect different parts of the body.
Category T (Traumatic Brain Injury)
Veterans are eligible for Category T Traumatic Brain Injury benefits if they would be institutionalized without A&A care and they are ineligible for Category R benefits. Since a service-related TBI is always permanent, Category T is one of the most common types of VA SMC.
How Can I Receive VA Special Monthly Compensation?
Although the VA is supposed to offer SMC automatically to a disabled veteran, that does not always happen. Sometimes, medical records are misread. Additionally, the guidelines in this area are even more complex than the combined ratings table, so it is rather easy to make mistakes.
If any of the aforementioned physical conditions describe your daily life in any way, you are probably entitled to Special Monthly Compensation benefits. Frequently, a VA disability attorney can help get the ball rolling. Once the Claims Examiner sees clear evidence, the petition is normally approved.
A doctor’s report is often the central piece of evidence in any VA disability compensation claim or veterans disability appeal. Sometimes, this evidence is dated. Physical disabilities hardly ever improve over time, but they often get worse. And, remember that the VA very broadly defines service-related conditions in this context. So, even if the veteran was discharged several decades earlier, any disability progression is probably service-connected.
In these situations, a physical re-evaluation is normally required. If the VA refuses to schedule an exam, an attorney can partner with a doctor. The doctor examines the veteran and then records his or her findings.
These conclusions, especially if they are in an IME (Independent Medical Examination) report, must be very clear. Frequently, doctors equivocate in written reports. Physicians who routinely handle VA disability compensation claims understand the need for clarity.
Medical evidence must also contain some magic words. For example, doctors must affirmatively state that they examined the entire file. If this language is missing, most Claims Examiners dismiss the reports as conclusory.
Claims Examiners like to see certain facts in certain orders. That’s especially true since most of these bureaucrats do not read reports word for word. They simply scan them.
The Disability Benefits Questionnaire is a good example. The VA publishes about seventy different DBQs for different disabilities. These documents provide the keywords that Claims Examiners want to see. Typically, the DBQ does not replace solid medical evidence. But a properly completed questionnaire greatly improves the chances of approval.
Most claims offices drag their feet on SMC matters because they hope the claimants will not exercise their rights and simply go away. So, commitment is essential, and that’s something an attorney cannot provide. Commitment comes from within. Typically, veterans who actively plead their cases and assert their rights usually get what they need.
Special Monthly Compensation
SMC matters are typically outside the normal VA disability benefits process. This applies to both the financial benefits available and the procedure for obtaining them.
If you have a service-related SMC condition, then standard VA disability compensation benefits simply are not enough. Fortunately, Special Monthly Compensation is available for you and your family. Housebound benefits, A&A, and other SMC categories do more than compensate the individual for loss of enjoyment in life due to a disability. These benefits also compensate the family for the additional burden they bear and provide the resources to hire outside help, if necessary.