Citation Nr: 18140932 Decision Date: 10/09/18 Archive Date: 10/09/18 DOCKET NO. 15-14 567A DATE: October 9, 2018 ORDER Entitlement to a special monthly compensation based on a need for regular aid and attendance, or housebound status, is denied. FINDING OF FACT The Veteran does not require the regular aid and attendance of another person, nor is he permanently housebound, due to his service-connected disabilities. CONCLUSION OF LAW The criteria for entitlement to a special monthly compensation based on aid and attendance, or housebound status, have not been met. 38 U.S.C. §§ 1114, 5103, 5103A, 5107; 38 C.F.R. §§ 3.350, 3.352(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from October 1966 to October 1968. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a May 2014 rating decision of the Department of Veterans Affairs (VA) Regional Offices (RO) in Jackson, Mississippi. The Veteran claims that he is entitled to a special monthly compensation (SMC) for aid and attendance, or housebound status, because he claims that he is unable to prepare his meals or manage his medication. SMC is payable to a veteran who, because of his service-connected disabilities, is so helpless as to need or require the regular aid and attendance of another person under the criteria set forth in 38 C.F.R. § 3.352(a). 38 U.S.C. § 1114(l); 38 C.F.R. § 3.350(b)(3). When determining whether the regular aid and attendance of another person is needed, the following factors are considered: inability to dress or undress oneself, or to keep oneself ordinarily clean and presentable; frequent need of adjustment of any special prosthetic or orthopedic appliances which by reason of the particular disability cannot be done without such aid; inability to feed oneself through the loss of coordination of upper extremities or through extreme weakness; inability to attend to the wants of nature; or an incapacity, physical or mental, which requires care or assistance on a regular basis to protect the Veteran from the hazards or dangers incident to his or her daily environment. 38 C.F.R. § 3.352(a). For the purposes of 38 C.F.R. § 3.352(a), “bedridden” is a proper basis for determining whether the veteran needs regular aid and attendance of another person. “Bedridden” means that the veteran is actually required to remain in bed. 38 C.F.R. §§ 3.350(b)(4), 3.352(a). Voluntarily taking to bed or being prescribed bed rest for the greater or lesser part of the day to promote convalescence or cure is insufficient. Determinations that the veteran is so helpless as to be in need of regular aid and attendance will not be based solely upon an opinion that the veteran’s condition is such as would require him to be in bed, but must be based on the actual requirement of personal assistance from others. 38 C.F.R. § 3.352(a). A veteran does not need to demonstrate all the above factors to be found entitled to aid and attendance benefits, and the need for regular aid and attendance does not have to be constant. The particular personal functions that the veteran is unable to perform should be considered in connection with his condition as a whole. 38 C.F.R. § 3.352(a); see also Turco v. Brown, 9 Vet. App. 222, 224 (1996). Additionally, the performance of the necessary aid and attendance service by a relative or other member of the veteran’s household will not prevent a favorable determination. 38 C.F.R. § 3.352(c). SMC is also payable for housebound status where the veteran has a single service-connected disability rated as 100 percent and (1) has additional service-connected disability or disabilities independently ratable at 60 percent, separate and distinct from the 100 percent service-connected disability and involving different anatomical segments or bodily systems, or (2) is permanently housebound by reason of service-connected disability or disabilities. 38 U.S.C. § 1114(s); 38 C.F.R. § 3.350(i). A veteran will be considered housebound where the evidence shows that, as a direct result of his service-connected disability or disabilities, he is substantially confined to his dwelling and the immediate premises or, if institutionalized, to the ward of clinical areas, and it is reasonably certain that the disability or disabilities and resultant confinement will continue throughout his lifetime. Id. The Veteran is currently service connected for posttraumatic stress disorder (PTSD), rated at 100 percent, diabetes mellitus, type II, with microvascular changes and erectile dysfunction, rated at 20 percent, residuals of a stress fracture to the right tibia, rated at 10 percent, and diabetic neuropathy of the right and left lower extremities, each rated separately at 10 percent. Of record is a November 2013 Examination for Housebound Status or Permanent Need for Regular Aid and Attendance. The Veteran could feed himself. The examiner indicated that the Veteran was unable to make his own meals, but could make a sandwich or eggs. He did not need assistance in bathing or tending to other hygiene needs. He is not legally blind. He did not require nursing home care. His son helped the Veteran with his medication weekly. He had the ability to manage his own financial affairs. Regarding general appearance, the Veteran was noted to be a well-developed male with an occasional unsteady gait. He did not have any restriction in his upper extremities. While the Veteran had diabetic neuropathy, there was no restriction to his lower extremities. There was no restriction of the spine, truck, or neck. The examining physician indicated that the Veteran travels only if he must and that he was isolated due to his PTSD. He went to doctor appointments and would occasionally go to the store. He recently divorced from his wife, who was his primary caretaker, and needed someone to cook for him to help control his blood sugar. Also of record is a March 2014 statement from the Veteran where he indicated that his wife filed for divorce, and as a result, he needs someone to cook balanced meals and clean for him. The Board finds that entitlement to SMC for regular aid and attendance is not warranted. The evidence of record does not reflect that the Veteran has an inability to dress or feed himself. See 38 C.F.R. § 3.352(a). Although the Veteran indicated that he is unable to cook balanced meals for himself since his divorce, the Board finds that this does not result in the Veteran being unable to feed himself “through the loss of coordination of upper extremities or through extreme weakness,” as the regulation describes. See id. Further, there is no evidence that he has a mental capacity which requires the care or assistance on a regular basis to protect him from the hazards of his daily environment. Id. Additionally, the Board finds that entitlement to SMC for housebound status is also not warranted. He is service connected for PTSD at 100 percent, but his other disabilities do no result in at least an independent combined 60 percent rating. Thus, entitlement to a statutory SMC rating is not warranted. 38 U.S.C. § 1114(s); 38 C.F.R. § 3.350(i). Further, the record does not reflect that he is permanently housebound due to his service-connected disabilities. Although the Veteran experiences an occasional unsteady gait due to his service-connected neuropathy, the November 2013 examining physician found that this did not result in any restrictions to his lower extremities. The examiner noted that the Veteran’s PTSD has limited ability to travel due to his PTSD, but he occasionally goes to the store. Further, a review of the Veteran’s VA medical treatment records reveals that the Veteran goes fishing and goes out of the house with his son. Accordingly, the Bord finds that the preponderance of the evidence is against the claim and entitlement to SMC based on the need of the regular aid and attendance of another person, or housebound status, is not warranted. 38 U.S.C. § 1114; 38 C.F.R. §§ 3.350, 3.352(a). H.M. WALKER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Angeline DeChiara, Associate Counsel