Citation Nr: 21011018 Decision Date: 02/26/21 Archive Date: 02/26/21 DOCKET NO. 18-52 216 DATE: February 26, 2021 ORDER Basic entitlement to special monthly pension based on the need for regular aid and attendance or housebound status is denied. FINDING OF FACT The appellant is not in need of regular aid and attendance of another person and she is not housebound. CONCLUSION OF LAW The criteria for special monthly pension based on the need of regular aid and attendance or housebound status have not been met. 38 U.S.C. §§ 1502 (b), 1503; 38 C.F.R. §§ 3.23, 3.351, 3.352, 3.271, 3.272. REASONS AND BASES FOR FINDING AND CONCLUSION The matter comes on appeal before an August 2018 rating decision which denied the appellant’s claim for entitlement to special monthly pension based on the need for regular aid and attendance or housebound status. The appellant perfected her appeal in November 2018. While the Board dismissed a claim for special monthly compensation in April 2019, the claim for special monthly pension remained on appeal. Basic entitlement to special monthly pension based on the need for regular aid and attendance or housebound status Special monthly pension is payable to individuals who are permanently bedridden or helpless or so nearly helpless as to be in need of the regular aid and attendance of another person under the criteria set forth in 38 C.F.R. § 3.352(a). 38 U.S.C. §§ 1502(b), 1521; 38 C.F.R. § 3.351 (a), (b). To establish a need for regular aid and attendance, a veteran must (1) be blind or 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; (2) be a patient in a nursing home because of mental or physical incapacity; or (3) show a factual need for aid and attendance. 38 U.S.C. § 1502(b); 38 C.F.R. §§ 3.351(c). The following factors will be accorded consideration in determining the need for regular aid and attendance: inability of a claimant to dress or undress herself, or to keep herself 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 adjustments of appliances which normal persons would be unable to adjust without aid, such as supports, belts, lacing at the back, etc.); inability of a claimant to feed herself through loss of coordination of upper extremities or through extreme weakness; inability to attend to the wants of nature; or incapacity, either 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. 38 C.F.R. § 3.352 (a). A finding that the claimant is “bedridden” will provide a proper basis for the determination. Bedridden will be that condition which, through its essential character, requires that the Veteran remain in bed. The fact that a claimant has voluntarily taken to bed or that a physician has prescribed rest in bed for the greater or lesser part of the day to promote convalescence or cure will not suffice. 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. Id. A surviving spouse that does not meet the requirements for increased pension based on need for aid and attendance, will nonetheless be awarded a higher rate of death pension if they are permanently housebound by reason of disability. The “permanently housebound” requirement is met when the surviving spouse is substantially confined to his or her home (ward or clinical areas, if institutionalized) or immediate premises by reason of disability or disabilities which it is reasonably certain will remain throughout the surviving spouse’s lifetime. See 38 C.F.R. § 3.351(f). The appellant contends in an October 2018 substantive appeal to the denial of special monthly pension that she is 76 years old and very ill. In support of her appeal, she submitted an April 2018 Examination for Housebound Status or Permanent Need for Regular Aid and Attendance completed by her physician. The examination report shows that the appellant’s disabilities consist of limitations due to trigger fingers (a condition due to inflammation of the tendons that flex the fingers) and hypertension. The examination shows, however, that the appellant was able to feed herself and prepare her own meals. She did not need assistance with bathing or tending to other hygiene needs. She was not legally blind and did not require nursing care. There were no restrictions of the lower extremities, spine, or neck. There was no other pathology such as loss of bowel or bladder control, dizziness, loss of memory, or poor balance which affected the appellant’s ability to perform self-care, ambulate, or travel beyond the premises of the home. There were no limitations to the appellant’s ability to leave the home or immediate premises. The evidence of record does not show that the appellant is blind or so nearly blind as to have corrected visual acuity of 5/200 or less, in both eyes. The record does not indicate that the appellant is a patient in a nursing home because of mental or physical incapacity. The record does not show that she is bedridden. She is not permanently housebound. The April 2018 examination shows that the appellant was not substantially confined to her home by reason of disability. While the appellant has limitations in the fingers of the hands, the appellant has not presented evidence showing that disability prevents her from bathing herself, dressing herself, ambulating, or feeding herself due to a loss of coordination in the upper extremities or weakness. The Board finds that the current evidence of record does not establish that the appellant has a factual need for aid and attendance of another person, and she is not shown to require care or assistance on a regular basis to protect her from hazards or dangers incident to her daily environment. Accordingly, the Board finds that the weight of the evidence is against the claim for special monthly pension based on the need for regular aid and attendance of another person or housebound status. K. Parakkal Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Christine C. Kung 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.