Citation Nr: 21028500 Decision Date: 05/11/21 Archive Date: 05/11/21 DOCKET NO. 11-05 626 DATE: May 11, 2021 REMANDED Entitlement to special monthly compensation (SMC) based on the need of aid and attendance of another person is remanded. REASONS FOR REMAND The Veteran had active military service from February 1991 to May 1991. This matter comes to the Board of Veterans' Appeals (Board) from a March 2010 rating decision from the Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ), which, in pertinent part, granted service connection for a lumbar spine disability, and assigned a disability rating of 20 percent, effective June 10, 2009. The Board granted an increased rating of 40 percent, effective May 5, 2017. See December 2020 Board decision. The Veteran testified before the undersigned Veterans Law Judge at a Board video conference hearing in August 2012. A transcript of the hearing testimony is of record. The Veteran's case has been remanded on several occasions on several issues on appeal. In December 2020, the Board, in pertinent part, found that the evidence showed the issue of SMC based on need for aid and attendance had been raised by the record as part of the increased rating claim for the lumbar spine disability. See 38 C.F.R. § 3.350; Akles v. Derwinski, 1 Vet. App. 118 (1991) (the issue of entitlement to SMC is part and parcel of a claim for increased compensation and does not require submission of a separate claim). The Board then remanded this remaining issue on appeal for additional development. The case is now returned for appellate review. For the reasons below, the case must be remanded again. 1. Entitlement to special monthly compensation (SMC) based on the need of aid and attendance of another person is remanded. The Board remanded the claim in December 2020 finding that the issue of entitlement to SMC based on the need of aid and attendance had been raised by a November 2019 VA examination for the lumbar spine, which noted that the Veteran reported that her daughters took care of her, including with respect to driving, bathing, dressing, cooking and shopping. The record shows that the Veteran submitted a VA-Form 21-2680 Examination for Housebound Status or Permanent Need for Regular Aid and Attendance in August 2020 showing that she needed assistance with bathing due to surgical areas and was not able to prepare her own meals due to limited mobility due to surgeries. It was further noted that the Veteran was unable to elevate her arms and stand straight up. It was noted that the examination took place at a private hospital in Dallas, Texas, but the form was not signed by a doctor. The Veteran also submitted medical records noting that she had a double mastectomy associated with a breast cancer diagnosis and that she had a home health nurse as a result of the surgery, in addition to several reconstruction surgeries. Of note, the AOJ denied service connection for breast cancer (and breast surgery) in January 2021. Thus, the Veteran's breast cancer (and resultant surgeries) is not service connected. However, the Veteran submitted a statement in February 2021 that she recently fell and hit her head causing her back to be exacerbated. She further noted that she had a home health care provider that assisted her 36 hours per week including assisting with showering, bathing, dressing grooming, housekeeping, meal preparation, personal care, and grocery shopping. The Veteran is service connected for a lumbar spine disability, migraine headaches, and residuals of traumatic brain injury (TBI). On remand, the Veteran should be provided with the requisite VA examination to determine whether she is in need of aid and attendance of another person due to service-connected disabilities. The matters are REMANDED for the following action: 1. Obtain the Veteran's VA treatment records for the period from February 2021 to present. 2. Ask the Veteran to submit a supplemental statement from the physician who filled out the VA-Form 21-2680 Examination for Housebound Status or Permanent Need for Regular Aid and Attendance in August 2020 to determine whether her need for aid and attendance is due to service-connected disability. 3. Schedule the Veteran for an examination by an appropriate clinician to determine whether the Veteran has the need for aid and attendance of another person due to her service-connected lumbar spine disability, either separately, or in combination with her other service-connected disabilities, including radiculopathy of the bilateral lower extremities, cervical spine disability, migraine headaches, posttraumatic stress disorder, and residuals of TBI. S. L. Kennedy Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Sarah B. Richmond, 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.