Citation Nr: 18157492 Decision Date: 12/12/18 Archive Date: 12/12/18 DOCKET NO. 17-52 836 DATE: December 12, 2018 REMANDED Entitlement to special monthly compensation (SMC) based on the need for regular aid and attendance of another person or by reason of being housebound is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from August 1961 to June 1982. This matter is on appeal from an August 2016 rating decision. 1. Entitlement to special monthly compensation (SMC) based on the need for regular aid and attendance of another person or by reason of being housebound is remanded. Special monthly compensation (SMC) based on aid and attendance is payable where a veteran, as the result of service-connected disability or disabilities, has suffered the anatomical loss or loss of use of both feet, or of one hand and one foot, or is blind in both eyes, with 5/200 visual acuity or less, or is permanently bedridden or with such significant disabilities as to be in need of regular aid and attendance. 38 U.S.C. § 1114 (l); 38 C.F.R. § 3.350 (b). The Veteran submitted two aid and attendance examinations dated August 2011 and April 2016. However, both examinations list a number of non-service connected disabilities that render the Veteran in need of aid and attendance, and neither examiner even addressed the Veteran’s service-connected disabilities. Thus, the Board finds that remand is warranted for an opinion that addresses whether the Veteran’s service-connected disabilities warrant special monthly compensation based on the need of aid and attendance or housebound status. See Green v. Derwinski, 1 Vet. App. 121, 124 (1991). The matter is REMANDED for the following action: 1. Schedule the Veteran for a VA SMC aid and attendance/housebound examination to determine whether he is in need of aid and attendance or whether he is housebound. Any necessary tests and studies should be accomplished. After a review of the clinical evidence of record, the VA examiner should opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran is in need of aid and attendance from another individual due to any of his service-connected disabilities. The criteria in the applicable regulations should be used, including a determination whether the Veteran 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; inability to dress or undress himself, or to keep himself ordinarily clean and presentable; whether he is unable to feed himself through loss of coordination of upper extremities or through extreme weakness; or unable to attend to the wants of nature; or incapacity, physical or mental, which requires care or assistance on a regular basis for protection from hazards or dangers to daily environment. The examiner should also address whether it is at least as likely as not (50 percent or greater probability) that the Veteran is permanently housebound by reason of any of his service-connected disabilities. This requirement is met when the Veteran is substantially confined to his dwelling and the immediate premises on account of disability and it is certain that the disability or disabilities and resultant confinement will continue throughout his lifetime. It is important to note that the examiner should only ascertain if the Veteran meets the medical criteria for aid and attendance or is housebound based on his service-connected disabilities alone. His non-service-connected disabilities cannot be considered for the requested opinions. If the requested opinions cannot be rendered without resorting to speculation, the examiner must state whether the need to speculate is caused by a deficiency in the state of general medical knowledge, i.e., no one could respond given medical science and the known facts, or by a deficiency in the record or the examiner, i.e., additional facts are required, or the examiner does not have the needed knowledge or training. Jones v. Shinseki, 23 Vet. App. 382, 389 (2010). (The Agency of Original Jurisdiction should ensure that any additional evidentiary development suggested by the examiner be undertaken so that a definite opinion can be obtained.) Any opinion expressed must “contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two.” See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008). 2. Then, readjudicate the claim. If any decision remains adverse to the Veteran, issue a supplemental statement of the case and allow the appropriate time for response. YVETTE R. WHITE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD C. J. Cho, Associate Counsel