Citation Nr: 18140268 Decision Date: 10/02/18 Archive Date: 10/02/18 DOCKET NO. 16-32 638 DATE: October 2, 2018 REMANDED Entitlement to Special Monthly Compensation (SMC) to include aid and attendance benefits is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1966 to February 1970. 1. Entitlement to SMC to include aid and attendance benefits is remanded. The Board finds that more development is necessary prior to final adjudication of the claim on appeal. Special monthly compensation is payable to individuals who are permanently bedridden or are so helpless as a result of service-connected disability as to be in need of the regular aid and attendance of another person under the criteria set forth in 38 C.F.R. § 3.352 (a) (2017). 38 U.S.C. § 1114 (l) (2012); 38 C.F.R. § 3.350 (b)(3) (2017). Determinations as to need for aid and attendance must be based on actual requirements of personal assistance from others. In making such determinations, consideration is given to such conditions as the following: inability of the claimant to dress or undress himself or to keep himself ordinarily clean and presentable; the frequent need of the adjustment of any special prosthetic or orthopedic appliance which by reason of the particular disability cannot be done without aid; the inability of the claimant to feed himself through loss of coordination of upper extremities or through extreme weakness; inability to attend to the wants of nature; or incapacity, physical or mental, which requires care or assistance on a regular basis to protect the claimant from hazards or dangers incident to his daily environment. 38 C.F.R. § 3.352(a) (2017). The Veteran underwent “Examinations for Housebound Status or Permanent Need for Regular Aid and Attendance” (VA Form 21-2680) in June 2015, January 2016, May 2016, September 2017 and October 2017. Notably the May 2016 physician indicated that the Veteran needed assistance with meal preparation and cleaning while the October 2017 physician noted that the Veteran had poor balance, exercise intolerance and poor dexterity in his fingers. However, the physicians did not provide specific opinions on whether the Veteran was in need of aid and attendance by reason of his service-connected disabilities. Notably, a VA examination has not been conducted to determine whether his service-connected disabilities, to include ischemic heart disease, diabetic nephropathy/renal insufficiency, diabetes mellitus, peripheral neuropathy of the bilateral lower extremities and hypertension, render him in need of a regular aid and attendance from another person. Accordingly, on remand the AOJ should afford the Veteran a VA examination to help address whether he is in need of aid and attendance as a result of service-connected disabilities. The matter is REMANDED for the following action: 1. The Veteran should be requested to provide the names, addresses and approximate dates of treatment of all medical care providers, VA and non-VA, who have treated him for the disabilities on appeal. After the Veteran has signed the appropriate releases, those records should be obtained and associated with the claims folder. 2. After the above development has been completed, schedule a VA examination for aid and attendance. The examiner should provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran is in need of aid and attendance by reason of his service-connected disabilities, utilizing the criteria outlined in 38 C.F.R. § 3.352 (a). The examiner should conduct a thorough review of all of the evidence of record. The examiner is asked to focus on the service connected disabilities and whether these disabilities render the Veteran in need of aid and attendance. In the opinion, the VA examiner should specifically address whether the Veteran requires the aid and attendance of another individual to perform many of the activities of daily living solely because of or as the result of his service-connected disabilities. A complete rationale should be provided for any opinion rendered. BISWAJIT CHATTERJEE Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD James A. DeFrank, Counsel