Citation Nr: 18140077 Decision Date: 10/02/18 Archive Date: 10/02/18 DOCKET NO. 13-08 732 DATE: October 2, 2018 REMANDED Entitlement to a higher level of special monthly compensation (SMC) is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1969 to January 1971. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2010 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In October 2016, the Veteran and his spouse testified before the undersigned. In July 2017, the Board issued a decision granting SMC based on the need for regular aid and attendance, which was implemented by the RO in August 2017. However, the Veteran subsequently appealed the Board’s decision to the extent it implicitly denied entitlement to a higher level of SMC to the United States Court of Appeals for Veterans Claims (Court). Following a January 2018 Joint Motion for Partial Remand (JMPR), the July 2017 decision was vacated in part and remanded so as to allow the Board to provide adequate reasons and bases as to the implicit denial of a higher level of SMC. 1. Entitlement to a higher level of SMC is remanded. The Veteran contends that he meets the criteria for two SMC-L awards; thereby, entitling him to SMC-O and SMC-R(1). Specifically, through his representative, the Veteran asserts that he meets the requirements for two SMC-L awards based on separate disabilities, one rating based on loss of use of his feet due to his bilateral knee and hip disabilities and another rating based on his need for aid and attendance due to his heart disability, rated as 100 percent disabling. See August 2018 Representative Correspondence. Notably, an April 2016 VA examiner indicated that the Veteran required aid and attendance due to the combination of his service-connected disabilities, especially his heart. Additionally, in January 2016, the Veteran submitted a VA Form 21-2680, Examination for Housebound Status or Permanent Need for Regular Aid and Attendance. It was noted that the Veteran required nursing home care, as he required assistance with cooking, bathing, and toileting. Thus, the Board finds that the Veteran may be entitled to SMC-R(2). However, the existence of the need for such care shall be determined by a VA physician pursuant to 38 U.S.C. § 1114 (r)(2). Accordingly, the Board finds that a VA examination and medical opinion should be obtained to evaluate whether the Veteran’s service-connected conditions separate from the loss of use of his feet result in the Veteran’s need for aid and attendance and whether there is a need for a higher level of aid and attendance. Updated VA treatment records should also be secured. The matter is REMANDED for the following actions: 1. Obtain any outstanding VA treatment records. 2. Then schedule the Veteran for a VA Aid and Attendance examination of all service-connected disabilities to determine the level of regular aid and attendance required by the Veteran, to include whether there is a need for a higher level of care. All indicated tests and studies should be conducted. The claim folder should be made available to the VA physician for review and such review should be noted in the report. The VA physician must answer the following questions: a. Does the Veteran’s service-connected disabilities, other than the loss of use of his feet (due to his bilateral knee and hip disabilities), result in such impairment that it would require the aid and attendance of another individual to assist the Veteran in his activities of daily living and care? In addressing this question, consideration should be given to the Veteran’s lay statements, to include his July 2018 affidavit. b. Does the Veteran’s service-connected disabilities result in such impairment that it would require a higher level of care consisting of the daily personal health care services of a skilled provider without which the Veteran would require hospitalization, nursing home or other institutional care? In addressing this question, consideration should be given to the January 2016 VA Form 21-2680. The examiner must provide a thorough explanation for any opinion offered, citing to the examination findings or other evidence in the record when necessary to support the conclusions reached. If the examiner is unable to provide an opinion without resorting to speculation, he or she should explain why this is so and what, if any, additional evidence would be necessary before an opinion could be rendered. S. BUSH Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K. Forde, Counsel