Citation Nr: 21073750 Decision Date: 12/10/21 Archive Date: 12/10/21 DOCKET NO. 11-26 661A DATE: December 10, 2021 ORDER Entitlement to special monthly compensation (SMC) based on the need for the regular aid and attendance of another person is denied. FINDING OF FACT The Veteran does not require the regular aid and attendance of another as a result of his service-connected disabilities. CONCLUSION OF LAW The criteria for SMC based on the need for regular aid and attendance are not met. 38 U.S.C. §§ 1114, 5107(b); 38 C.F.R. §§ 3.350, 3.352. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the United States Air Force from March 1969 to March 1995. This matter comes before the Board of Veterans' Appeals (Board) on appeal from March 2010 and an April 2014 rating decisions of the Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ) in Columbia, South Carolina, which addressed increased ratings for low back strain with painful motion and traumatic arthritis of the sacroiliac joints, and right and left lower extremity lumbar radiculopathy. In July 2021, the Board found the issue of entitlement to SMC based on aid and attendance of another person had been raised by an October 2015 VA examination associated with the lumbar spine disability. Thus, this matter was remanded for additional development. See Akles v. Derwinski, 1 Vet. App. 118 (1991). The directives of the Board's July 2021 remand having been substantially complied with the case is returned for appellate review. 1. Entitlement to special monthly compensation (SMC) based on the need of aid and attendance of another person Special monthly compensation (SMC) is payable where a Veteran has a service-connected disability or disabilities that render him or her so helpless as to be in need of the regular aid and attendance of another person. 38 U.S.C. § 1114 (l); 38 C.F.R. § 3.350 (b)(3). A veteran will be considered to be in need of regular aid and attendance if he or she (1) is blind or is so nearly blind as to have visual acuity of 5/200 or less in both eyes, or contraction of visual field of vision to five degrees or less; (2) is a patient in a nursing home due to physical or mental incapacity; or (3) establishes a factual need for aid and attendance or "permanently bedridden" status under the criteria set forth in 38 C.F.R. § 3.352 (a). 38 U.S.C. § 1114 (l); 38 C.F.R. § 3.351 (b)-(c). A factual need for aid and attendance includes the inability to dress, undress, keep ordinarily clean and presentable, feed oneself, or attend to the wants of nature. It also includes the frequent need of adjustment of any special prosthetic or orthopedic appliances or either physical or mental incapacity that requires care or assistance on a regular basis to protect against the hazards or dangers incident to a claimant's daily environment. 38 C.F.R. § 3.352 (a). The Veteran is service connected for low back strain with traumatic arthritis of the sacroiliac joints, neurogenic bladder, right and left lower extremity radiculopathy of the sciatic nerve, right and left lower extremity radiculopathy of the femoral nerve, hypertension, right shoulder tendonitis, surgical scar low back, and erectile dysfunction. As noted, while the Veteran did not file a formal claim for SMC, an October 8, 2015 VA examination report noted, among other things, that functional loss associated with the lumbar spine disability affected his ability to dress his lower body and bathe. Thus, the Board determined that the Veteran should be provided an opportunity to report for a VA examination to ascertain whether he needs the aid and attendance of another person due to his service-connected disabilities. A September 2021 VA aid and attendance or housebound examination was provided. It was noted that the Veteran's lumbar spine and sacroiliac joint disabilities limited the distance of ambulation to one to two blocks before having to rest on his rollator. He also had a neurogenic bladder that caused frequent stops for urination and having to wear absorbent material. He had limited motion in flexion and extension of the spine due to multiple spinal surgeries. In addition, he had right shoulder cuff pain with lifting, pushing, and pulling activities. However, the examiner found that the Veteran was able to feed himself, prepare his own meals, and did not need assistance bathing and tending to other hygiene needs. The Veteran was not legally blind and did not require nursing home case. He also did not require medication management. The examiner found that the Veteran had the mental capacity to manage his benefit payments or was able to direct someone to do so. On physical examination, the Veteran had a normal gait and was addressed appropriately for the season and weather. He required a rollator and walking cane for support with ambulation. He also had a bilateral knee brace for support during physical activity. However, he had no restriction in being able to leave the house. (Continued on the next page) As there is no indication that the Veteran's service-connected disabilities present him with the inability to dress, undress, keep ordinarily clean and presentable, feed oneself, or attend to the wants of nature, or involve the frequent need of adjustment of any special prosthetic or orthopedic appliances or either physical or mental incapacity that requires care or assistance on a regular basis to protect against the hazards or dangers incident to a claimant's daily environment, entitlement to SMC based on being in the need of regular aid and attendance is not warranted. 38 C.F.R. § 3.352 (a). S. L. Kennedy Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Sarah B. Richmond, 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.