Citation Nr: 21042553 Decision Date: 07/13/21 Archive Date: 07/13/21 DOCKET NO. 14-11 654 DATE: July 13, 2021 ORDER Prior to January 13, 2020, excluding the period from April 27, 2012 to August 1, 2012, entitlement to special monthly compensation (SMC) under 38 U.S.C. § 1114 (s) is denied. From January 13, 2020, entitlement to SMC under 38 U.S.C. § 1114 (s) is granted. FINDINGS OF FACT 1. Prior to January 13, 2020, the Veteran was not substantially confined to his house nor did he have a single service-connected disability ratable at 100 percent along with other unrelated disabilities that combined to at least 60 percent (excluding the period from April 27, 2012 to August 1, 2012). 2. From January 13, 2020, the Veteran had a TDIU based on his service-connected acquired psychiatric disability and other unrelated disabilities that combine to at least 60 percent. CONCLUSIONS OF LAW 1. Prior to January 13, 2020, the criteria for entitlement to SMC under 38 U.S.C. § 1114 (s) (excluding the period from April 27, 2012 to August 1, 2012), have not been met. 38 U.S.C. §§ 1114, 5107; 38 C.F.R. § 3.350. 2. From January 13, 2020, the criteria for entitlement to SMC under 38 U.S.C. § 1114 (s) have been met. 38 U.S.C. §§ 1114, 5107; 38 C.F.R. § 3.350. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from March 1975 to February 1979 and April 1980 to February 1983. The Veteran requested a hearing before the Board. The requested hearing was conducted in August 2017 by the undersigned Veterans Law Judge. A transcript is associated with the claims file. In April 2021, the Board remanded this claim for additional development. The RO granted entitlement to SMC based on housebound criteria in a January 2021 rating decision, effective May 1, 2020. As such, the issue on appeal has been limited to the period prior to May 1, 2020. Additionally, the Board notes that the Veteran was previously awarded entitlement to SMC under 38 U.S.C. § 1114(s) from April 27, 2012 to August 1, 2012; this period of time has been excluded from the period on appeal. Entitlement to SMC under 38 U.S.C. § 1114(s), prior to May 1, 2020. The Board has a "well-established" duty to maximize a claimant's benefits. See Buie v. Shinseki, 24 Vet. App. 242, 250 (2011). This duty to maximize benefits requires VA to assess all a claimant's disabilities to determine whether any combination of disabilities establishes entitlement to special monthly compensation (SMC) under 38 U.S.C. § 1114. See Bradley v. Peake, 22 Vet. App. 280, 294 (2008) (SMC "benefits are to be accorded when a Veteran becomes eligible without need for a separate claim"). Special monthly compensation 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). Subsection 1114(s) requires that a disabled Veteran whose disability level is determined by the ratings schedule must have at least one disability that is rated at 100 percent in order to qualify for the SMC provided by the statute. A total disability rating based on individual unemployability (TDIU) may satisfy the requirement for a single disability rated total, if awarded on the basis of a single disability. See Bradley v. Peake, 22 Vet. App. 280 (2008); Buie v. Shinseki, 24 Vet. App. 242, 250 (2011). In this case, in an April 2021 decision, the Board determined that the Veteran is entitled to a TDIU based on his acquired psychiatric disability alone, effective December 23, 2011. The TDIU based on the Veteran's acquired psychiatric disability satisfies the requirement for a single disability rated total. Therefore, to qualify for SMC, the Veteran must have additional separate and distinct service-connected disabilities rated at least 60 percent disabling when combined or be permanently housebound by reason of service-connected disability or disabilities. As noted, the RO granted entitlement to SMC based on housebound criteria in a January 2021 rating decision, effective May 1, 2020. In addition to his acquired psychiatric disability, the Veteran is service connected for the following disabilities prior to May 1, 2020: right shoulder disability rated as 20 percent disabling, right hip disability rated as 10 percent disabling from August 2012 and as 20 percent disabling from January 2020, right knee disability rated as 10 percent disabling, right thigh disability rated as 10 percent disabling, lumbar spine disability rated as 10 percent disabling, right hip limitation of flexion disability rated as 10 percent disabling from January 2020, and right shoulder scar and left hip disability, both rated as noncompensable. Based on these disabilities, other than his acquired psychiatric disability, the Veteran's combined rating is 50 percent, prior to January 13, 2020, and 60 percent, thereafter. Of note, the Veteran's right hip disability was granted an increase to 20 percent disabling, effective January 13, 2020, and he was also granted a separate 10 percent rating for limitation of flexion of the right hip, effective January 13, 2020, resulting in a 60 percent combined rating as of that date. See 38 C.F.R. § 4.25 (combined ratings table). Therefore, the Board finds that the criteria for entitlement to SMC are met, effective January 13, 2020. Unfortunately, prior to January 13, 2020, the Veteran does not meet the criteria for SMC, excluding the period he already received SMC from April 27, 2012 to August 1, 2012. There is no evidence, lay or medical, that the Veteran was permanently housebound by reason of service-connected disabilities, prior to January 13, 2020 and as stated, although the Veteran's TDIU based on his acquired psychiatric disability satisfies the requirement for a single disability rated total, he does not have separate and distinct additional disabilities that are rated at least 60 percent disabling when combined, prior to January 13, 2020. His combined rating prior to January 13, 2020, other than his acquired psychiatric disability, is 50 percent. As such, the Board concludes that the criteria for entitlement to SMC pursuant to 38 U.S.C. § 1114 (s), prior to January 13, 2020 (excluding April 27, 2012 to August 1, 2012) have not been met and, to this extent, the Veteran's claim is therefore denied. 38 U.S.C. § 1114 (l); 38 C.F.R. § 3.350 (i). In conclusion, entitlement to SMC pursuant to 38 U.S.C. § 1114 (s) is granted, effective January 13, 2020; entitlement to SMC prior to January 13, 2020 is denied. (continued on next page) TANYA SMITH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. Andersen, 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.