Citation Nr: 18145050 Decision Date: 10/26/18 Archive Date: 10/25/18 DOCKET NO. 15-31 015 DATE: October 26, 2018 ORDER Entitlement to special monthly compensation (SMC) based on the need for aid and attendance is granted. REMANDED Entitlement to a rating in excess of 20 percent for recurrent lumbosacral strain with degenerative disc disease is remanded. FINDING OF FACT The Veteran has been shown to require the aid and attendance of another person to help with basic tasks which cannot be performed due to his service-connected disabilities. CONCLUSION OF LAW The criteria for SMC due to the need for aid and attendance are met. 38 U.S.C. §§ 1114(l), 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.350(b), 3.352(a) (2018). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from February 1966 to February 1986 in the United States Army. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from April 2013 and June 2014 decisions issued by the Department of Veteran Affairs (VA) Regional Office (RO) in Montgomery, Alabama. In October 2018, the Veteran testified before the undersigned Veterans Law Judge. The Board notes that the August 2015 VA Form 9 (substantive appeal) submitted by the Veteran’s former attorney did not clearly indicate that the Veteran wanted to appeal the issue of entitlement to SMC based on the need of for aid and attendance. The Veteran continued to submit evidence relevant to the claim and during the Board hearing, he clarified that he wanted to pursue an appeal of that claim. Therefore, the Board has accepted jurisdiction over the issue. See Percy v. Shinseki, 23 Vet. App. 37, 45 (2009). SMC – Aid and Attendance Special monthly compensation is payable where service connected disabilities render a Veteran in need of the regular aid and attendance of another person. 38 U.S.C. § 1114(l); 38 C.F.R. § 3.350(b). The Veteran is service connected for ischemic heart disease (60 percent disabling), posttraumatic stress disorder (PTSD) (50 percent disabling), peripheral vascular disease of the right leg (40 percent disabling), peripheral vascular disease of the left leg (40 percent disabling), diabetes mellitus (20 percent disabling), a low back disability (20 percent disabling), peripheral neuropathy of the right lower extremity (10 percent disabling), peripheral neuropathy of left lower extremity (10 percent disabling), and right ear hearing loss (noncompensable). The Veteran’s combined rating is 100 percent. In this case, the evidence indicates that the Veteran is confined to his bed or wheelchair, unable to stand unsupported, and unable to ambulate. He is unable to dress without assistance and unable to prepare meals. See September 2017 Examination for Housebound Status or Permanent Need for Regular Aid and Attendance. He is also unable to groom or bathe without assistance. He has relied on his wife to take care of his grooming, bathing, preparation of foods, assisting him in and out of bed, ordering and caring for his medications, injections, and wound care. See December 2017 statements from the Veteran and his wife. Based on the foregoing, the Board finds that the weight of the evidence indicates that the Veteran requires and attendance due to his service-connected disabilities. See 38 C.F.R. § 3.352(a). Therefore, resolving all reasonable doubt in his favor, the claim for SMC is granted. 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49, 56 (1990). REASONS FOR REMAND Regarding the Veteran’s service-connected low back disability, a VA examination was most recently conducted in April 2013. The evidence suggests that the disability has worsened in severity. Therefore, the Board finds that a remand is necessary for an additional VA examination. The matter is REMANDED for the following action: 1. Identify and obtain any pertinent, outstanding VA and private treatment records and associate them with the claims file. 2. Then, schedule the Veteran for an appropriate VA examination to determine the current level of severity of all impairment resulting from his service-connected low back disability. All indicated tests should be performed and all findings should be reported in detail. The examiner should provide all information required for rating purposes, to specifically include range of motion in active motion, passive motion, weight bearing, and non-weight bearing. If the examiner is unable to conduct the required testing or concludes that the required testing is not necessary in this case, he or she should clearly explain why that is so. The examiner must report whether there is a lack of normal endurance or functional loss due to pain and pain on use, including that experienced during flare ups; whether there is weakened movement, excess fatigability, incoordination; and the effects of the service-connected disability on the Veteran’s ordinary activity. The examiner should also ask the Veteran to identify the severity, frequency, duration, precipitating and alleviating factors, and extent of functional impairment resulting from flare-ups. The examiner should identify the extent of the Veteran’s functional loss during flare-ups and offer range of motion estimates based on that information. If the examiner cannot provide any of the requested findings without resorting to speculation, the examiner must state why that is so and provide a detailed rationale as to the reason why the requested findings could not be provided. 3. Confirm that the VA examination report and all opinions provided comport with this remand and undertake any other development found to be warranted. 4. Then, readjudicate the remaining issue on appeal. If a decision is adverse to the Veteran, issue a supplemental statement of the case and allow appropriate time for response. Then, return the case to the Board. Kristin Haddock Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. Mishalanie, Counsel