Citation Nr: 21009199 Decision Date: 02/19/21 Archive Date: 02/19/21 DOCKET NO. 16-53 353 DATE: February 19, 2021 ORDER Entitlement to special monthly compensation (SMC) based on aid and attendance is granted. FINDING OF FACT Due to his service-connected disabilities, the Veteran is so helpless as to be in need of regular aid and attendance of another person. CONCLUSION OF LAW The criteria for SMC based on the need for regular aid and attendance have been met. 38 U.S.C. §§ 1114, 1154, 5107; 38 C.F.R. §§ 3.102, 3.350, 3.351, 3.352. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from August 1968 to June1970, including combat service in the Republic of Vietnam and his decorations include the Combat Infantryman Badge. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a rating decision that was issued by the Department of Veterans Affairs (VA) Regional Office (RO). In March 2019, the Veteran, his wife and his daughter appeared at a hearing before the undersigned Veterans Law Judge. This case was previously before the Board in August 2019 and remanded for additional development. SMC The Veteran raised the issue of entitlement to SMC based on the need for the aid and attendance of another person at his March 2019 BVA hearing. The Veteran testified that his service-connected disabilities render him in need for aid and attendance in his daily care, including taking medications, showering, toileting, tying shoes, putting socks, getting dressed, staying alone and others. See BVA hearing transcript (March 2019). Moreover, in May 2011, the Veteran received an independent living needs assessment where he stated his constant need for assistance in his daily care by his wife and family. Also, he stated his inability to control his daily living activities and not been able to do anything including his hobbies. The VA examiner concluded that due to his service-connected disabilities he has a low amount of independence and needs assistance for his daily care. Also, the examiner recommended grab bars and seat in the shower, toilet raisers, wheelchair, shoehorn, incline stair lift and continue medical treatment. See Independent living needs assessment Veterans Transition Services (VTS) Publication D1 (May 2011). Additionally, his wife and daughter provided testimony in his hearing of the severity of his need for assistance due to not been able to take care of himself in his daily living activities. See BVA hearing transcript (March 2019). Special monthly compensation is payable at a specified rate if the veteran, as the result of service-connected disability, is in need of regular aid and attendance. Need for aid and attendance means helplessness or is so nearly helpless as to require the regular aid and attendance of another person. A veteran will be considered to be in need of regular aid and attendance if he or she is blind or is so nearly blind as to have corrected visual acuity of 5/200 or less, in both eyes, or concentric contraction of the visual field to 5 degrees or less; if the veteran is a patient in a nursing home because of mental or physical incapacity; or if the evidence 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). See 38 U.S.C. § 1114(l); 38 C.F.R. § 3.351(b). The following will be accorded consideration in determining the need for regular aid and attendance: inability of claimant to dress or undress himself, or to keep himself ordinarily clean and presentable; frequent need of adjustment of any 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 aid, such as supports, belts, lacing at the back, etc.); inability of claimant to feed himself through loss of coordination of upper extremities or through extreme weakness; inability to attend to the wants of nature; or incapacity, physical or mental, which requires care or assistance on a regular basis to protect the claimant from hazards or dangers incident to his or her daily environment. “Bedridden” will be a proper basis for the determination. See 38 C.F.R. § 3.352(a). A veteran will be found to be bedridden if the condition actually requires that he remain in bed, but not if he voluntarily stays in bed or if a physician merely recommends bed rest. It is not required that all of the disabling conditions enumerated in this paragraph be found to exist before a favorable rating may be made. The particular personal functions that the veteran is unable to perform should be considered in connection with his or her condition as a whole. 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. Determinations that the veteran is so helpless, as to be in need of regular aid and attendance will not be based solely upon an opinion that the claimant’s condition is such as would require him or her to be in bed. They must be based on the actual requirement of personal assistance from others. Id. Furthermore, the performance of the necessary aid and attendance service by a relative of the beneficiary or other member of his or her household will not prevent the granting of the additional allowance. See 38 C.F.R. § 3.352 (c). The Board finds that SMC for aid and attendance is warranted. The Board acknowledges that on October 2020 a VA examiner stated that the Veteran is independent in all his ADLs and all his self-grooming activities. See VA medical examination (October 2020). However, the same examiner noted that his significant other assist him in mostly all daily activities. Additionally, the examiner noted that the Veteran’s suffers from dizziness and peripheral neuropathy that causes imbalances and problems ambulating. Moreover, his significant other provided another credible statement noting that she is the Veteran’s full-time companion and caregiver for everyday activities that include meal preparation, grocery shopping, medication set up and health logs, housekeeping, laundry, bathing and others. See Buddy statement (September 2019). Indeed, the medical and lay evidence shows that the Veteran needs assistance from his family to manage his medications, grocery shopping, and other normal daily living activities. Although a veteran need not show all of the disabling conditions identified in 38 C.F.R. § 3.352(a) to establish entitlement to aid and attendance, the Court has held that it is logical to infer there is a threshold requirement that “at least one of the enumerated factors be present.” See Turco v. Brown, 9 Vet. App. 222, 224 (1996). Accordingly, the Board finds that, with resolution of all reasonable doubt in the Veteran’s favor, the criteria are satisfied to award special monthly compensation based on the need aid and attendance of another person. (Continued on the next page)   As the manifestations of the Veteran's service-connected disabilities meet the pertinent requirements, as demonstrated by the noted medical reports and consistent lay statements, SMC based on the aid and attendance of another person is warranted. STEVEN D. REISS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Alvarado- 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.