Citation Nr: 21011511 Decision Date: 03/02/21 Archive Date: 03/02/21 DOCKET NO. 14-06 506 DATE: March 2, 2021 ORDER Special monthly compensation (SMC) based on the need for regular aid and attendance is denied. FINDING OF FACT The Veteran is not in need of regular aid and attendance due to service-connected disabilities. CONCLUSION OF LAW The criteria for SMC based on the need for the regular aid and attendance are not met. 38 U.S.C. § 1114; 38 C.F.R. §§ 3.350, 3.352.   REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active duty service from September 1979 to June 1992, from October 2001 to November 2003, and from September 2005 to April 2009, with additional service in the Army Reserve. This matter is before the Board of Veterans’ Appeals (Board) on appeal from an October 2013 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded the matter in May 2018 and September 2020. SMC - Aid and Attendance A. Law Increased compensation at the aid and attendance rate is payable when a veteran is helpless or so nearly helpless as the result of service-connected disability that he requires the regular aid and attendance of another person. 38 U.S.C. § 1114(l); 38 C.F.R. § 3.350(b). To establish a need for regular aid and attendance, the veteran must, as a result of service-connected disability, (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. Id. Determinations as to need for aid and attendance must be based on actual requirements of personal assistance from others. In making such determinations, consideration is given to such conditions as the following: the inability of the claimant to dress or undress himself or to keep himself ordinarily clean and presentable; the frequent need of the adjustment of any special prosthetic or orthopedic appliance which by reason of the particular disability cannot be done without aid; the inability of the claimant to feed himself through loss of coordination of the upper extremities or through extreme weakness; the 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 daily environment. 38 C.F.R. § 3.352(a). Establishing that a Veteran is "bedridden" would be a proper basis for the aid and attendance determination and is defined as that condition which, through its essential character, actually requires that the claimant remain in bed. The fact that the 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 above be found to exist before a favorable rating may be made. The particular personal functions that the claimant is unable to perform should be considered in connection with his condition as a whole. It is only necessary that the evidence establish that the claimant 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 on an opinion that the claimant's condition is such as would require him to be in bed. They must be based on the actual requirement of personal assistance from others. 38 C.F.R. § 3.352(a). The performance of the necessary aid and attendance service by a relative of the claimant or other member of his or her household will not prevent the granting of the additional allowance. 38 C.F.R. § 3.352(c). A claimant is entitled to the benefit of the doubt when there is an approximate balance of positive and negative evidence on any issue material to the claim. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990) (when the evidence supports the claim or is in relative equipoise, the claim will be granted). B. Analysis The Board finds that the criteria for SMC based on the need for aid and attendance have not been met. A VA aid and attendance examination was conducted in November 2020. The November 2020 VA examination revealed that the Veteran lives alone and is able to do “everything himself without assistance.” He does not need assistance in bathing and tending to other hygiene needs. The examination report additionally states that he does not require the use of aids such as canes, braces, crutches, or the assistance of another person for locomotion. Moreover, the examination report reflects that the Veteran is competent to manage his finances. The examiner noted that the Veteran's posture and appearance were within normal limits. The examiner further noted that the Veteran is able to perform self-care, and ambulate or travel beyond the premises of the home. Lastly, the Veteran reported that he leaves the home as needed for activities such as grocery shopping, medical appointments, church gatherings, etc., and that he typically leaves his home twice daily. The VA treatment records do not show that the Veteran is unable to care for himself or is in need of regular aid and attendance as defined in section 3.352. The Veteran is not a patient in a nursing home, and does not have service-connected vision impairment. In sum, the record shows that the Veteran does not need regular assistance of others to accomplish activities of daily living such as dressing and undressing himself, feeding himself, or attending to the wants of nature. He is able to leave his home at will. Accordingly, the criteria for SMC based on the need for aid and attendance are not met. See 38 U.S.C. § 1114; 38 C.F.R. §§ 3.350, 3.352 Because the preponderance of the evidence is against the claim, the benefit-of-the-doubt doctrine does not apply. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). J. Rutkin Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. R. Montalvo, 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.