Citation Nr: 20021916 Decision Date: 04/09/20 Archive Date: 04/09/20 DOCKET NO. 17-42 635 DATE: April 9, 2020 ORDER Entitlement to special monthly compensation (SMC) based on aid and attendance is granted. FINDING OF FACT The Veteran requires the regular aid and attendance of another person due to his service-connected disabilities. CONCLUSION OF LAW The criteria for SMC based on the need for regular aid and attendance have been met. 38 U.S.C. §§ 1114(l), 1154(a), 5107(b); 38 C.F.R. §§ 3.102, 3.350(b), 3.352. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service in the United States Marines Corps from February 1954 to February 1957. This matter is on appeal from a May 2015 rating decision. In July 2019, the Board remanded the appeal to afford the Veteran a VA examination. Entitlement to SMC based on aid and attendance. The Veteran contends that his service-connected disabilities require aid and attendance. Throughout the appeal period, the Veteran has been service-connected for right knee degenerative joint disease with meniscus tear, status post total knee replacement rated as 30 percent disabling and left knee internal derangement with traumatic arthritis and total knee replacement rated as 30 percent disabling. He is also in receipt of a total disability rating based upon individual unemployability. SMC based on the need for aid and attendance of another is payable when the veteran, due to a service-connected disability, is so helpless as to be in need of regular aid and attendance. 38 U.S.C. § 1114(l); 38 C.F.R. § 3.350(b). Pursuant to 38 C.F.R. § 3.352(a), the following criteria are to be considered for determining whether a claimant is in need of the regular aid and attendance of another person: (1) the inability of the claimant to dress himself or to keep himself ordinarily clean and presentable; (2) frequent need of adjustment of any special prosthetic or orthopedic appliance which, by reason of the particular disability, cannot be done without aid; (3) the inability of the claimant to feed himself through the loss of coordination of the upper extremities or through extreme weakness; (4) the inability to attend to the wants of nature; or, (5) a physical or mental incapacity that requires care and assistance on a regular basis to protect the claimant from the hazards or dangers incident to his or her daily environment. A veteran need show only one of the enumerated factors identified above to establish entitlement to aid and attendance. See Turco v. Brown, 9 Vet. App. 222, 224 (1996). Moreover, it is only necessary that the evidence establish that the veteran is so helpless as to need regular aid and attendance, not that there be a constant need. See Id. The performance of the necessary aid and attendance service by a relative of the claimant or other member of his or her household will not prevent the granting of the additional allowance. 38 C.F.R. § 3.352(c). In January 2015, the Veteran underwent an Examination for Housebound Status or Permanent Need for Regular Aid and Attendance by Dr. O.C. The Veteran was capable of feeding himself, but could not prepare his own meals. He sometimes required help bathing and shaving. The Veteran was not legally blind and did not require nursing home care or medication management. He was incapable of managing his own financial affairs. The Veteran appeared upright and walked with a cane. Dr. O.C. indicated that the Veteran could walk and stand independently but noted an unsteady gait. The Veteran required help dressing due to a lack of manual dexterity. Dr. O.C. indicated that the Veteran’s urinary incontinence and coronary artery disease limited his ability to perform self-care. Finally, the Veteran was afforded a VA examination in December 2019. The Veteran had a slow shuffling gait and used a walker. He required supervision at all times for assistance with ambulation due to fall risk. The Veteran had weakness and loss of power/strength due to his service-connected knee disabilities. He was confined to his bed 15 hours in a 24-hour period. The Veteran was unable to feed himself or prepare his own meals. However, this was due to weakness in the arms and hands, poor manual dexterity, and poor vision that were unrelated to his service-connected disabilities. The Veteran was not legally blind, but required assistance bathing and tending to his hygiene needs. His confusion, poor memory, poor communication, and poor hearing rendered him unable to manage his financial affairs. The Veteran had decreased function of the spine, trunk, neck, and upper extremities that was unrelated to his service-connected knee disabilities. He required assistance getting to the toilet due to the high risk of falls. The Veteran also required assistance with weight-bearing, balance, and propulsion due to weakness and the risk of falling. The Veteran was able to walk 1 block with assistance and able to leave his home 2 to 3 times per week. The Board finds that the Veteran’s service-connected disabilities prevent him from attending to the wants of nature. Additionally, his service-connected knee disabilities require care and assistance on a regular basis to protect him from the hazards or dangers incident to his daily environment. The December 2019 VA examiner found that the Veteran required supervision due to his risk of falling and that he required assistance attending to the needs of nature because he was unable to walk unassisted to the bathroom.   Therefore, the Veteran’s service-connected disabilities require the aid and attendance of another person. Based upon the forgoing, SMC based on the need for regular aid and attendance is granted. DAVID L. WIGHT Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R.R. Watkins, Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.