Citation Nr: 25005147 Decision Date: 04/16/25 Archive Date: 04/16/25 DOCKET NO. 16-19 983 DATE: April 16, 2025 ORDER Entitlement to special monthly compensation (SMC) based on need for aid and attendance, for the purposes of accrued benefits, is granted. FINDING OF FACT During the period on appeal, the Veteran was in factual need of aid and attendance. CONCLUSION OF LAW The criteria for an award of special monthly compensation (SMC) based on need for aid and attendance, for purposes of accrued benefits, have been met. 38 U.S.C. §§ 1114, 5107; 38 C.F.R. §§ 3.102, 3.350, 3.352 REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the Army, on active duty from November 1967 to November 1970. His awards included the Vietnam Campaign Medal, among others. This claim comes 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). This matter was most recently before the Board in November 2024. The Board remanded the issue to obtain an adequate VA examination. The Board is now satisfied there was substantial compliance with this Remand. See Stegall v. West, 11 Vet. App. 268 (1998); Dyment v. West, 13 Vet. App. 141, 146-47 (1999). Specifically, in January 2025, an adequate addendum opinion was provided. Accordingly, the Board finds that the Remand directives were substantially complied with and, thus, there is no Stegall violation in this case. Unfortunately, the Veteran passed away in July 2017. The appellant is his surviving spouse. Lastly, the Board notes that in March and April 2025, the appellant's attorney requested additional time to develop evidence. However, as the Board grants the appeal in this decision, there is no prejudice not delaying any further. Aid and Attendance SMC based on the need for aid and attendance is warranted when a veteran: (1) is 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) is a patient in a nursing home because of mental or physical incapacity; or (3) establishes a "factual need for aid and attendance" under 38 C.F.R. § 3.352 (a). See also 38 C.F.R. § 3.351 (b), (c). The criteria considered in establishing a "factual need for aid and attendance" are: " The inability of a 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 daily environment. See 38 C.F.R. § 3.352(a). Entitlement to special monthly compensation based on the need for aid and attendance and/or housebound status, for purposes of accrued benefits The appellant asserts entitlement to SMC based on the Veteran's need for aid and attendance. After a review of the evidence, the Board determines that this benefit is warranted. Specifically, the Veteran did not use a prosthetic for any service-connected disability, which preclude any need for help with regular adjustment. However, the evidence, to include medical records, lay statements, VA examinations and an October 2024 private opinion, show that the Veteran needed his wife's assistance with daily hygiene, meal preparation, dressing, medication management, and transportation. Moreover, the January 2025 VA examiner opined that the Veteran's service-connected bilateral lower extremity neuropathy, in part, caused him to be unable to perform activities of daily living. Specifically, the VA examiner explained that his disorders caused him to be unable to dress or undress, keep ordinarily clean or presentable during the appeal period. The examiner continued, stating that he was unable to feed himself through a loss of coordination of upper extremities or through extreme weakness, and the Veteran had been unable to attend to the wants of nature. Finally, the examiner indicated that he remained in bed to protect him from hazards or dangers incident to his daily environment. While the January 2025 VA examiner indicated that the Veteran's restrictions were in part due to his nonservice-connected orthostatic hypotension and general unsteadiness, they also opined that it was due to his service-connected disabilities. Indeed, the Veteran was service connected for bilateral upper and lower extremity neuropathy and had trouble walking and feeding himself due to upper extremity weakness. In the Board's view, this is clear evidence that the Veteran was unable to ambulate, feed or dress himself without excessive help due to service-connected disabilities. The Veteran was never visually impaired enough to require aid and attendance, nor did he live in a nursing facility. However, the Veteran regularly needed his wife's aid and assistance to assist in activities of daily activity and when ambulating to protect him from the hazards of falling. Thus, the Board fids a factual need for aid and attendance. Accordingly, entitlement to SMC for aid and attendance is established, for purposes of accrued benefits. 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. B.T. KNOPE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board McDonald, Thomas K.