Citation Nr: 21067357 Decision Date: 11/04/21 Archive Date: 11/04/21 DOCKET NO. 18-44 638 DATE: November 4, 2021 ORDER Entitlement to special monthly compensation (SMC) at the housebound rate is granted, subject to the laws and regulations governing the award of monetary benefits. FINDING OF FACT The Veteran has a single service-connected disability rated as 100 percent (panic disorder with agoraphobia) and the evidence is at least in equipoise as to whether she is permanently housebound by reason of service-connected disability. CONCLUSION OF LAW Resolving reasonable doubt in the Veteran's favor, the criteria for SMC at the housebound rate have been met. 38 U.S.C. § 1114(s); 38 C.F.R. § 3.350(i). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from April 1989 to March 1991. In February 2020, the Board denied revision based on clear and unmistakable error (CUE) of an October 1992 rating decision that denied service connection for a panic disorder; denied earlier effective dates for service connection for left wrist carpal tunnel syndrome and panic disorder with agoraphobia; denied an earlier effective date for Dependents' Educational Assistance; denied an initial rating greater than 10 percent for left wrist carpal tunnel syndrome; and denied entitlement to SMC under the provisions of 38 U.S.C. § 1114(s) (housebound rate). The Veteran appealed this decision to the United States Court of Appeals for Veterans Claims (Court). By Order dated in July 2021, the Court granted the parties' Joint Motion for Partial Remand (joint motion) thereby vacating and remanding that portion of the Board's decision which denied entitlement to SMC at the housebound rate. The appeal as to the remaining issues was dismissed. Entitlement to SMC at the housebound rate The issue of entitlement to SMC at the housebound rate was inferred and addressed in the July 2018 statement of the case. The Veteran subsequently perfected this appeal and as noted, the Board denied the claim in February 2020. Pursuant to the joint motion, the parties agreed that the Board erred by not providing an adequate statement of reasons or bases in denying entitlement to SMC at the housebound rate. Specifically, that the Board provided no discussion or analysis as to whether the Veteran was permanently housebound by reason of service-connected disabilities such that SMC pursuant to 38 U.S.C. § 1114(s)(2) (housebound in fact) was warranted. SMC is payable at the housebound rate if the Veteran has a single service-connected disability rated as 100 percent and (1) has additional service-connected disability or disabilities independently ratable at 60 percent, separate and distinct from the 100 percent service-connected disability and involving different anatomical segments or bodily systems, or (2) is permanently housebound by reason of service-connected disability or disabilities. 38 U.S.C. § 1114(s); 38 C.F.R. § 3.350(i). The Veteran is currently service connected for panic disorder with agoraphobia (100 percent from September 21, 2012); right wrist carpal tunnel syndrome (30 percent from September 21, 2012); left wrist carpal tunnel syndrome (10 percent from September 21, 2012); and right knee scar (noncompensable from March 30, 1991). Statutory housebound and housebound in fact are two separate avenues, both of which are predicated on having a single service-connected disability rated as 100 percent. The Veteran's panic disorder with agoraphobia is rated as 100 percent disabling. On review, the Veteran does not have, nor does she contend, additional disabilities independently ratable at 60 percent. Rather, her attorney argues that she is permanently housebound. The requirement for "permanently housebound" is met when the Veteran is substantially confined as a direct result of service-connected disabilities to his or her dwelling and the immediate premises or, if institutionalized, to the ward or clinical areas, and it is reasonably certain that the disability or disabilities and resultant confinement will continue throughout his or her lifetime. 38 C.F.R. § 3.350(i)(2). On VA mental disorders examination in February 2013, the examiner noted that the Veteran's anxiety included panic attacks 3-4 times per week and agoraphobia (avoiding leaving her home and not going to the grocery store or drug store). On VA mental disorders examination in April 2014, the examiner indicated that the Veteran's self-report was highly questionable. It was noted that she claimed to have panic attacks every day for hours, but this was inconsistent with her reports of staying active, visiting her mother, and attending church. A September 2014 VA mental health note indicates she has been going to small car shows with a man she found interesting and who had treated her with respect, but she described feeling uncomfortable as this is unfamiliar to her. In March 2015, the Veteran underwent a private vocational employability assessment. She reported panic attacks if she needs to do errands and stated that her agoraphobia limits her outside interaction to her mother's house, church, and the auto parts store when accompanied by her mother or a friend. She cannot tolerate or function in a social setting without having a panic attack and when in public, she is always escorted by a friend or an aide. In a January 2015 affidavit, the Veteran stated that she does not leave her house except to go to a very small number of "safe spaces". This includes her mother's house, an auto parts store, and a hardware store. She stated it took her a long time to acclimate herself to being there and she needed assistance from others. She also reported that her mother runs all her errands, to include grocery shopping, banking, and other necessary public chores. VA records dated in January 2016 indicate that she was at Fleet Farm two weeks prior. However, she feels very isolated and does not like to leave her house. A March 2016 note indicates that a staff psychiatrist tried to return the Veteran's call, but she was at the store. Her mother had volunteered to take her knowing she needed to get out of the house. On VA mental disorders examination in February 2016, the Veteran reported taking clonazepam first thing in the morning because she wakes up feeling panicky. She reported big panic attacks after she gets out of scary situations (place she does not want to go). Testing was reflective of symptom over-endorsement and the examiner indicated her report of panic symptoms is questionable. VA records reflect continued treatment for panic disorder with agoraphobia. While the Veteran can leave her home for VA medical treatment, it is not without some level of anxiety. For example, a March 2017 telephone note indicates that the Veteran has been crying nonstop all morning. She was scheduled for oral surgery and was very anxiety ridden over it. It was noted that she would have an all-female staff and her boyfriend would bring her to and from the appointment. The record contains evidence both for and against the claim. That is, VA records indicate the Veteran suffers from agoraphobia and she reports that she goes very few places and is unable to leave her home without assistance. She is competent to report this information. See Layno v. Brown, 6 Vet. App. 465, 470 (1994). On the contrary, the Veteran is shown to leave her home at various times, albeit with assistance, and several VA examiners have questioned the credibility of her reports. On review, the evidence is at least in equipoise as to whether the Veteran is substantially confined as a direct result of her service-connected panic disorder with agoraphobia to her dwelling and the immediate premises and it is reasonably certain that the disability and resulting confinement will continue throughout her lifetime. Resolving reasonable doubt in the Veteran's favor, she is permanently housebound and entitlement to SMC at the (s) rate is warranted. 38 C.F.R. § 4.3. LAURA E. COLLINS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Carsten, 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.