Citation Nr: 21008330 Decision Date: 02/16/21 Archive Date: 02/16/21 DOCKET NO. 18-51 579 DATE: February 16, 2021 ISSUE Entitlement to special monthly compensation (SMC) at the housebound rate, prior to May 22, 2019. ORDER Entitlement to special monthly compensation (SMC) at the housebound rate, prior to May 22, 2019, is denied. FINDINGS OF FACT Prior to May 22, 2019 the Veteran did not have a single service-connected disability rated as 100 percent and an additional service-connected disability independently ratable at 60 percent and was not permanently housebound by reason of service-connected disabilities. CONCLUSION OF LAW The criteria for entitlement to a special monthly compensation (SMC) at the housebound rate have not been met. 38 U.S.C. § 1114 (s); 38 C.F.R. § 3.350 (i). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty in the United States Army from November 1960 to December 1965. This matter comes before the Board of Veterans’ Appeals (Board) on an appeal from a September 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida. The Veteran provided testimony before the undersigned Veterans Law Judge at a September 2020 video conference Board hearing. The hearing transcript has been associated with the record. In an October 2020 decision the Board denied an initial disability rating in excess of 10 percent for coronary artery disease from April 12, 2010 to April 24, 2013. The Board also denied an initial disability rating in excess of 60 percent for coronary artery disease from April 24, 2013 to May 22, 2019. The Board did grant the Veteran an initial disability rating of 100 percent for coronary artery disease from May 22, 2019. At that time the Board inferred the issue of entitlement to special monthly compensation (SMC) at the housebound rate. At that time the Board remanded the issue for additional development and consideration by the agency of original jurisdiction (AOJ). In November 2020 the RO issued a rating decision which granted entitlement to special monthly compensation based on housebound criteria from May 22, 2019. As this decision does not constitute a full grant of benefits, the claim is still on appeal before the Board. Upon review of the Veteran’s claim file, the Board finds that there has been substantial compliance with the Board's October 2020 remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998); Barr v. Nicholson, 21 Vet. App. 303, 307 (2007). Therefore, the Board will proceed to the merits of the issue on appeal. Please note that the case has been advanced on the docket pursuant to 38 C.F.R. § 20.900 (c). 1. Entitlement to special monthly compensation (SMC) at the housebound rate, prior to May 22, 2019, is denied. As previously stated, in the October 2020 decision the Board inferred a claim for SMC based on the Veteran's claim for a higher rating and his current entitlement to a 100 percent rating for his service- connected coronary artery disease. SMC housebound is payable where 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. This requirement 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 U.S.C. § 1114(s); 38 C.F.R. § 3.350(i). A housebound in fact determination requires a Veteran’s inability to leave his /her place of residence and immediate premises in order to earn any income. However, it does not require a total inability to leave the place of residence and immediate premises for all circumstances. Leaving home for medical purposes cannot, by itself, serve as the basis for finding that a Veteran is not substantially confined for purposes of SMC housebound benefits. Howell v. Nicholson, 19 Vet. App. 535, 540 (2006). The limitations must be the result of the Veteran’s service-connected disabilities. Non-medical indicators of housebound status may include but are not limited to an inability to walk substantial distances or leaving the home with assistance only occasionally for appointments; grocery shopping, or church, or an inability to mow one’s lawn. The record reflects that the Veteran has already been granted a total disability rating due to individual unemployability effective September 2015, which is the date that the record reflects that he retired due to his service-connected disabilities. Prior to May 22, 2019 the Veteran was service- connected for coronary artery disease rated as 10 percent from April 12, 2010 and 10 percent from April 24, 2013; post- traumatic stress disorder (PTSD) rated as 70 percent from June 25, 2015; diabetes mellitus, type II rated as 20 percent from January 5, 2016; diabetic peripheral neuropathy sciatic nerve left lower extremity rated as 10 percent from January 5, 2016; diabetic peripheral neuropathy sciatic nerve left lower extremity rated as 10 percent from January 5, 2016; diabetic peripheral neuropathy femoral left lower extremity rated as 10 percent from January 5, 2016 and 20 percent from March 25, 2019; diabetic peripheral neuropathy femoral right lower extremity rated as 10 percent from January 5, 2016; tinnitus rated as 10 percent from June 25, 2015; bilateral hearing loss rated as non-compensable from June 25, 2016; and osteoarthritis rated as non- compensable from August 19, 2015. As such, prior to May 22, 2018 the Veteran did not have a single, permanent service-connected disability rated 100 percent disabling; therefore, he does not meet the legal criteria for payment of compensation at the housebound rate under that criterion. See 38 U.S.C. § 1114 (s); 38 C.F.R. § 3.350. The Board has considered whether there is evidence in the record showing that the Veteran is housebound by reason of his service-connected disabilities. See 38 C.F.R. § 3.350(i)(2). The evidence does not show that the Veteran is permanently and substantially confined to his home as a result of his service-connected disabilities as he is shown to have attended medical visits at medical facilities. In a January 2019 VA treatment note the Veteran reported that he was able to travel independently on public transportation or drive his own car. Additionally, the Veteran testified at the September 2020 Board hearing that between 2013-2015 he was able to leave his house for work. Although the Veteran testified that he had to retire in 2015 due to his service-connected conditions, the evidence does not suggest he was unable to leave his home following retirement. In November 2020 the Veteran was afforded an examination for Aid and Attendance or Housebound Status and it was noted that the Veteran was not permanently bedridden, was not currently hospitalized and was able to travel beyond his domicile. His mode of transportation was a private vehicle accompanied by a family member. The Veteran reported that his daily activities included playing with the dogs and going to his backyard. The Veteran did not use an orthopedic or prothetic appliance. His imbalance did not ever affect his ability to ambulate. The Veteran reported that he became dizzy once or more a day and suffered from moderate short-term memory loss. The examiner noted that there were no body part or system impairments that affected the Veteran’s ability to protect himself from the daily environment. The examiner did note that the Veteran’s toileting abilities as well as his abilities to feed, dress and undress, and groom himself were all normal, although he did have some difficulty bathing himself. The Veteran was able to walk in his home without the assistance of another person. The examiner also noted that the circumstances in which the Veteran could leave his home were unrestricted. Further, although the Veteran is in receipt of TDIU based on his service-connected disabilities, the statutory requirements for SMC at the housebound rate were still not met as of May 22, 2019 because there was no single disability evaluated as totally disabling for purposes of entitlement to SMC. See Bradley v. Peake, 22 Vet. App. 280, 293 (2008) (holding that a TDIU rating could qualify for compensation at the 38 U.S.C. § 1114 (s) rate, but only if the TDIU was based on a single disability). (Continued on next page.) In sum, and in consideration of the evidence, the Board finds that prior to May 22, 2019 the Veteran did not have a single service-connected disability rated as 100 percent and additional service-connected disability or disabilities independently ratable at 60 percent, and he is not shown by the facts to be substantially confined as a direct result of service-connected disabilities to his dwelling and the immediate premises. As such, the preponderance of the evidence is against the claim for SMC housebound, the benefit-of-the-doubt doctrine is not applicable, and therefore SMC on a housebound basis is not warranted. Michael A. Pappas Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Nettey, Associate 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.