Citation Nr: 21075473 Decision Date: 12/20/21 Archive Date: 12/20/21 DOCKET NO. 17-38 488 DATE: December 20, 2021 ORDER Entitlement to special monthly compensation (SMC) based on the need for aid and attendance of another person is granted. FINDING OF FACT The Veteran was unable to keep himself ordinarily clean, feed himself, and attend to the wants of nature. CONCLUSION OF LAW The criteria for entitlement to SMC based on the need for aid and attendance of another person have been met. 38 U.S.C. §1141(l); 38 C.F.R. §§ 3.350, 3.352. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from June 1964 to August 1970. He died in October 2018. The appellant is the Veteran's surviving spouse, who has been properly substituted by the Department of Veterans Affairs (VA) agency of original jurisdiction (AOJ). This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2016 AOJ rating decision. Although the appellant requested a Board videoconference hearing, the appellant withdrew that request in an August 2021 statement. VA has met all statutory and regulatory notice and duty-to-assist provisions. See 38 U.S.C. §§ 5100, 5102, 5103, 5103A, 5106, 5107, 5126; 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326. Neither the appellant nor her representative has advanced any procedural arguments in relation to VA's duties to notify and assist. See Scott v. McDonald, 789 F.3d 1375 (Fed. Cir. 2015) (holding that "absent extraordinary circumstances . . . we think it is appropriate for the Board and the Veterans Court to address only those procedural arguments specifically raised by the veteran . . . ."). The appellant contends that SMC was warranted based on the need for regular aid and attendance. SMC is payable at a specified rate if the Veteran, as the result of service-connected disability, is permanently bedridden or 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). Aid and attendance is appropriate if the record establishes a factual need for the benefit under the criteria set forth in 38 C.F.R. § 3.352(a). Pursuant to 38 C.F.R. § 3.352(a), aid and attendance is warranted if the following criteria are met: the claimant is unable to dress or undress himself or to keep himself ordinarily clean and presentable; the claimant frequently needs adjustment of a special prosthetic or orthopedic appliances which by reason of the particular disability cannot be done without aid (this will not include the adjustment of appliances which normal persons would be unable to adjust without such aid, such as supports, belts, lacing at the back, etc.); the claimant is unable to feed himself due to loss of coordination of upper extremities or extreme weakness; the claimant is unable to attend to the wants of nature; or the claimant requires care or assistance on a regular basis to protect him from hazards or dangers incident to his daily environment, due to his physical or mental incapacity. The Board finds that the Veteran met the criteria for regular aid and attendance due to service-connected disabilities, particularly his disabilities of the spine, left hand, left wrist, right hand, right wrist, and bilateral knees. A February 2016 private examination (received in March 2016) indicated that the Veteran could not feed himself (due to "[l]imited use of L[eft] hand -- food must be cut up into bite size pieces") or prepare his own meals. The February 2016 private examination additionally noted that the Veteran needed assistance bathing and tending to other hygiene needs because the Veteran "[c]annot reach lower extremities" and "[c]annot stand [and] needs assistance with transfers." The February 2016 private examination stated that the Veteran's "[m]ain limitation is lumbar pain [and] arthritis, not amputations[,] that is producing loss of function requiring assistance." Similarly, a December 2016 examination by a VA medical center (VAMC) physician (received in February 2017) noted that the Veteran had "[l]imited use" of his left hand, "mak[ing] eating difficult. Food must be prepared into bite-size portions." The December 2016 examination indicated that the Veteran needed assistance with bathing and hygiene: "Requires assistance transferring into and out of shower. Impaired mobility, assistance to wash R[ight] leg/foot." The December 2016 examination also stated that the Veteran needed medication management because he "cannot open pill bottles" and noted that the Veteran was "[n]ot able to arise from bed without help." In a March 2016 statement, the appellant reported that the Veteran "needs help getting out of bed in the morning because of the pain and stiffness from the arthritis [in his back, hands, and knees]." She noted that the Veteran's back disability inhibited his ability to bathe and use the toilet. The Veteran, in a March 2016 statement, also indicated that he required help getting in and out of bed due to his back disability, that he needed help transferring to and from his wheelchair because of his back and knee disabilities, and that others had to cut his food because he experienced difficulties holding utensils. Considering this evidence, the Board finds that the Veteran needed the aid and attendance of another person as defined in 38 C.F.R. § 3.352(a). Entitlement to SMC based on the Veteran's need for the aid and attendance of another prior to his death is accordingly granted. WILLIAM H. DONNELLY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board W. Ripplinger, 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.