Citation Nr: 18143834 Decision Date: 10/23/18 Archive Date: 10/22/18 DOCKET NO. 16-24 681A DATE: October 23, 2018 ORDER Entitlement to special monthly compensation (SMC) based on aid and attendance or on account of being housebound is denied. FINDINGS OF FACT 1. The Veteran is in receipt of service connected benefits for schizophrenia, undifferentiated type, evaluated as 100 percent disabling. 2. As a result of his service-connected disability, the Veteran was not blind or nearly blind in both eyes; was not institutionalized in, or confined to, a nursing home or other facility due to physical or mental incapacity; and did not need regular aid and attendance to perform activities necessary for daily living. 3. The Veteran was not permanently and substantially confined to his or her immediate premises due solely to his service-connected disability. CONCLUSIONS OF LAW 1. The criteria for SMC based on aid and attendance have not been met. 38 U.S.C. §§ 1114, 5107; 38 C.F.R. §§ 3.350, 3.352. 2. The criteria for SMC based on housebound status have not been met. 38 U.S.C. §§ 1114, 5107; 38 C.F.R. §§ 3.351, 3.352. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from December 1968 to April 1972. This matter is before the Board of Veterans’ Appeals (Board) on appeal from an April 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Winston-Salem, North Carolina. Entitlement to SMC based on aid and attendance or on account of being housebound. The Veteran sought SMC based on the need for aid and attendance or on housebound status. To establish entitlement to SMC based on the need for aid and attendance under 38 U.S.C. § 1114(l), the evidence must show that the Veteran experienced the anatomical loss or loss of use of both feet, one hand and one foot, blindness in both eyes with visual acuity of 5/200 or less, or being permanently bedridden or so helpless as a result of service-connected disability that he or she is in need of the regular aid and attendance of another person. 38 U.S.C. § 1114(l); 38 C.F.R. § 3.350(b). To establish entitlement to SMC based on housebound status under 38 U.S.C. § 1114(s), the evidence must show that the Veteran has a single service-connected disability evaluated as 100 percent disabling and an additional service-connected disability, or disabilities, evaluated as 60 percent or more disabling that is separate and distinct from the 100 percent service-connected disability and involving different anatomical segments or bodily systems; or, the Veteran has a single service-connected disability evaluated as 100 percent disabling and due solely to service-connected disability or disabilities, the Veteran is permanently and substantially confined to his or her immediate premises. 38 C.F.R. § 3.350(i). The Veteran is in receipt of service connected benefits for schizophrenia, undifferentiated type, evaluated as 100 percent disabling, effective October 3, 1980. In an October 2014 VA examination report for housebound status or permanent need for regular aid and attendance, the examiner noted that the Veteran was able to feed himself. The Veteran was unable to prepare his own meals as a result of memory issues. He did not need assistance in bathing, did not require nursing home care, was not legally blind, but was able to bathe himself and tend to his hygiene needs. The Veteran did require medication management and was not able to manage his own financial affairs because of his memory issues. The examiner noted that the Veteran had a normal gait and appearance, had a normal grip, fine motor movements, normal ability to feed himself, but had hand tremors. The Veteran had no restriction of his lower extremities, but had chronic knee pain. The Board notes that this disability is not service-connected. Additionally, the Veteran had no restrictions of his spine. The VA examiner noted that the Veteran had loss of memory and schizophrenia. He had no dizziness and his balance was normal. The examiner reported that the Veteran was able to ride a bicycle and could leave his home daily with no restrictions. In a June 2017 VA examination report for housebound status or permanent need for regular aid and attendance, the examiner noted that the Veteran was able to feed himself. The Veteran was unable to prepare his own meals. He did not need assistance in bathing, did not require nursing home care, was not legally blind, but was able to bathe himself and tend to his hygiene needs. The Veteran did require medication management and needed help setting up his prescriptions. He was able to manage his own financial affairs. The examiner noted that the Veteran was well-nourished, pale, and had a normal gait. He was able to feed himself. The examiner noted that the Veteran had chronic right knee pain that caused difficulty with walking. As noted above, the Veteran is not service connected for this disability. The Veteran had no restrictions of his spine. The examiner reported that the Veteran had memory loss due to advancing age, but was able to ambulate on his own. The examiner noted that the Veteran could leave his home daily. The Board notes that an October 2016 letter from a private physician noted that the Veteran was under their care for an orthopedic condition. The private physician wrote that the Veteran required the use of a caregiver. The Board notes that the Veteran is not service connected for an orthopedic condition, only for schizophrenia, and that this letter provided no rationale for the opinion provided. As a result, it presents no basis for a favorable determination. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). Additionally, a November 2016 letter from the Veteran’s VA psychiatrist noted that the Veteran required assistance with transportation, medication management, and independent activities of daily living. However, like the previous letter, there was no rationale provided for this opinion, and it is inadequate. Id. Finally, a November 2016 letter from the Veteran’s VA primary care provider noted that the Veteran’s medical conditions, to include right knee pain, arthritis, coronary artery disease, coronary artery bypass graft three times, cardiac stent, atypical chest pain, hyperlipidemia, schizophrenia, nervousness, hypertension, tremor, hearing loss, and neck pain warranted the need for assistance with activities of daily living, feeding, bathing, transportation, administration of medications, medical procedures, grocery shopping, cooking, and assistance with transportation with emergency care when needed. The Board notes, however, that the Veteran is only service-connected for schizophrenia. As a result, his non-service-connected disabilities have no bearing on whether he is entitled to SMC based on the need of aid and attendance or on account of being housebound. Entitlement to SMC based on the need for regular aid and attendance is not warranted. During the entire period on appeal the Veteran was in receipt of service-connected benefits for schizophrenia, evaluated as 100 percent disabling; that is his only service-connected disability. Therefore, there is no indication that the Veteran’s sole service-connected disability resulted in the loss of use of both feet, one hand and one foot, blindness in both eyes with visual acuity of 5/200 or less, or rendered the Veteran permanently bedridden. The preponderance of the evidence is against a finding that the Veteran’s service-connected schizophrenia rendered him so helpless that he was in need of the regular aid and attendance of another person. Entitlement to SMC based on the need for regular aid and attendance is denied. Entitlement to SMC on account of the Veteran being housebound is also not warranted. The October 2014 and the June 2017 VA examination reports noted that the Veteran could leave his home on a daily basis with no restrictions. As such, although the Veteran had a single service-connected disability evaluated as 100 percent disabling, the Veteran was not permanently and substantially confined to his immediate premises solely by this disability. Thus, entitlement to SMC on account of the Veteran being housebound is denied. Because the preponderance of the evidence is against granting SMC in this case, the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107(b). A. C. MACKENZIE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Abrams, Associate Counsel