Citation Nr: 18143958 Decision Date: 10/22/18 Archive Date: 10/22/18 DOCKET NO. 15-04 413 DATE: October 22, 2018 REMANDED Entitlement to special monthly compensation (SMC) based on the need for regular aid and attendance is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1996 to October 2005. 1. Entitlement to special monthly compensation (SMC) based on the need for regular aid and attendance is remanded. With regard to the Veteran’s SMC claim, a veteran will be considered to be in need of regular aid and attendance if he or she: (1) is blind or so nearly blind as to have corrected visual acuity of 5/200 or less in both eyes, or concentric contraction of the visual field to 5 degrees or less; (2) is a patient in a nursing home because of mental or physical incapacity; or (3) establishes a factual need for aid and attendance under 38 C.F.R. § 3.352(a). See also 38 C.F.R. § 3.351(b), (c). The criteria to be considered in establishing a factual need for aid and attendance include: the inability of a claimant to dress or undress himself, or to keep himself 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 aid (this will not include the adjustment of appliances which normal persons would be unable to adjust without aid, such as supports, belts, lacing at the back, etc.); inability of 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. See 38 C.F.R. § 3.352(a). The Veteran underwent a VA examination for his aid and attendance claim in February 2014, more than four years ago. Although generally, the mere passage of time is not a sufficient basis for a new examination, the Veteran and the Veteran’s representative have indicated that the Veteran’s condition has worsened since the February 2014 examination. See Palczewski v. Nicholson, 21 Vet. App. 174, 182-83 (2007) (holding that the mere passage of time, without evidence of worsening, does not require a new examination); see also VAOPGCPREC 11-95 (1995), 60 Fed. Reg. 43186 (1995). In addition, the Veteran’s spouse submitted a statement in which she expressed that she helps the Veteran bathe, dress and undress, and take his medicine in order to prevent the Veteran from overdosing on his medication. The Veteran’s spouse stated that after the Veteran’s mental disabilities, physical disabilities, and sleep apnea got worse, the Veteran fell asleep while trying to cook noodles and the Veteran’s children had to put out a fire caused by the Veteran. These most recent statements from the Veteran, the Veteran’s representative, and the Veteran’s spouse suggests a worsening of the Veteran’s disabilities since last examined by VA, warranting an updated aid and attendance examination. See Snuffer v. Gober, 10 Vet. App. 400, 403 (1997); see also VAOPGCPREC 11-95 (1995), 60 Fed. Reg. 43186 (1995). In order to determine whether the Veteran is entitled to SMC based on the need for regular aid and attendance, the Veteran must be provided an additional VA medical examination to evaluate the current effects the disabilities have on the Veteran’s ability to perform daily living activities. The matter is REMANDED for the following action: 1. Obtain updated VA treatment records. 2. Then, schedule the Veteran for a VA aid and attendance examination to address whether the following are present as a result of service-connected disabilities: Inability to dress or undress himself or to keep himself 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 aid (this does not include the adjustment of appliances which normal persons would be unable to adjust without aid, such as supports, belts, lacking at the back, etc.); inability to attend to the wants of nature; inability to feed himself through loss of coordination of the upper extremities or through extreme weakness; 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. (Continued on the next page)   The claims file must be reviewed in conjunction with the examination. The supporting rationale for all conclusions and opinions expressed must be provided. LESLEY A. REIN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M.D., Associate Counsel