Citation Nr: A25035233 Decision Date: 04/16/25 Archive Date: 04/16/25 DOCKET NO. 220819-268754 DATE: April 16, 2025 ORDER Entitlement to special monthly compensation (SMC) based on aid and attendance (A&A) is granted. FINDING OF FACT For the period on appeal, the Veteran's service-connected PTSD has resulted in functional impairments that necessitated the regular aid and attendance of another person. CONCLUSION OF LAW The criteria for establishing entitlement to SMC based on A&A have been met. 38 U.S.C. §§ 1114, 5100, 5102, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.326, 3.350, 3.351, 3.352. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from December 1971 to July 1975. In the August 2022 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the July 2022 Supplemental Statement of the Case (SSOC). 38 C.F.R. § 20.301. If evidence was submitted after the AOJ issued the July 2022 SSOC, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.301, 20.801. If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the Veteran's claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. Legal Criteria - SMC A&A SMC based on the need for aid and attendance of another is payable when the Veteran, due to a service-connected disability, has suffered the anatomical loss or loss of use of both feet or one hand and one foot, or is blind in both eyes, or is permanently bedridden or so helpless as to be in need of regular aid and attendance. See 38 U.S.C. § 1114(l); 38 C.F.R. § 3.350(b). In this case, the Veteran did not lose use of both feet or one hand and one foot and he was not blind in both eyes due to service-connected disabilities. As such, whether SMC based on A&A is warranted is determined by whether he is permanently bedridden or so helpless as to be in need of regular aid and attendance. As directed by 38 C.F.R. § 3.352(a), the following criteria are to be considered for determining whether a claimant is in need of the regular aid and attendance of another person: (1) the inability of the claimant to dress himself or herself or to keep himself or herself ordinarily clean and presentable; (2) frequent need of adjustment of any special prosthetic or orthopedic appliance which, by reason of the particular disability, cannot be done without aid (not to include the adjustment of appliances which normal persons would be unable to adjust without aid, such as supports, belts, lacing at the back, etc.); (3) the inability of the claimant to feed himself or herself through the loss of coordination of the upper extremities or through extreme weakness; (4) the inability to attend to the wants of nature; or, (5) a physical or mental incapacity that requires care and assistance on a regular basis to protect the claimant from the hazards or dangers incident to his or her daily environment. "Bedridden," which is a proper basis for the determination, is defined as that condition which, through its essential character, actually requires that the claimant remain in bed. The fact that 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. 38 C.F.R. §§ 3.350 (b)(4), 3.352(a). It is not required that all of the disabling conditions enumerated in 38 C.F.R. § 3.352(a) be found to exist before a favorable rating may be made. The particular personal functions which the Veteran 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 Veteran is so helpless as to need regular aid and attendance not that there is a constant need for aid and attendance. See Turco v. Brown, 9 Vet. App. 222, 224 (1996) (holding that at least one factor listed in § 3.352(a) must be present to grant special monthly compensation based on the need for aid and attendance). Furthermore, the performance of the necessary aid and attendance service by a relative of the beneficiary or other member of his or her household will not prevent the granting of the additional allowance. 38 C.F.R. § 3.352(c). Analysis The Veteran asserts that his service-connected PTSD is so disabling that he requires the regular aid and attendance of another person. For the reasons explained below, the Board agrees. The AOJ obtained a VA Examination for Housebound Status or Permanent Need for Regular Aid and Attendance in May 2022. In this report, the examiner indicated that the Veteran is unable to prepare his own meals, needs assistance with bathing and tending to other hygiene needs, requires medication management, and needs assistance due to forgetfulness, memory issues, and frequent flashbacks from his PTSD. Further, the examiner noted that the Veteran does have the ability to leave his home for necessary life functions with the assistance of his wife, children, or grandchildren. As noted in 38 C.F.R. § 3.352, it is not required that a veteran be found unable to perform all activities of daily living to warrant entitlement to aid and attendance benefits. Rather, it is only necessary that the evidence establish a veteran is so helpless as to need regular aid and attendance. Based on the foregoing, the Board finds the Veteran's PTSD is sufficiently disabling to warrant entitlement to aid and attendance benefits in accordance with 38 C.F.R. § 3.350(b)(3). Accordingly, the Board finds that special monthly compensation for aid and assistance is warranted. T. REYNOLDS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Nestander, Jessica S. 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.