Citation Nr: 25008749 Decision Date: 07/02/25 Archive Date: 07/02/25 DOCKET NO. 18-21 528 DATE: July 2, 2025 ORDER Entitlement to special monthly compensation (SMC) based on the need for aid and attendance at the housebound rate is denied. FINDING OF FACT The Veteran, without providing good cause, failed to report for a VA examination scheduled in April 2025 in conjunction with his claim for SMC based on the need for aid and attendance at the housebound rate. CONCLUSION OF LAW SMC based on the need for aid and attendance at the housebound rate is denied on the basis of the Veteran's failure to report for a VA medical examination. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 3.655. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the U.S. Air Force from April 1968 to April 1972. This matter comes to the Board of Veterans' Appeals (Board) from an appeal of an August 2017 rating decision from the Department of Veterans Affairs (VA) Regional Office (RO). By way of background, the issue of entitlement to SMC was raised in an August 2022 Board decision that remanded the matter for development of that issue. A May 2023 supplemental statement of the case (SSOC) denied the claim based on the Veteran's failure to appear for a scheduled examination. In an August 2023 decision, after finding good cause for failing to appear at a scheduled examination because the Veteran's address had changed, the Board remanded the claim to obtain a VA examination. In a February 2024 SSOC the claim was denied again based on the Veteran's failure to appear for a scheduled examination. In May 2024, the Board determined that there had not been substantial compliance with the Board's prior remand directives and remanded the case again to the agency of original jurisdiction (AOJ). In a November 2024 SSOC, the AOJ denied the claim based on the Veteran's failure to appear for a scheduled examination. In February 2025, the Board again determined that there had not been substantial compliance with the Board's prior remand directives because it did not appear that an examination for SMC was scheduled. Therefore, the Board remanded the case for the AOJ to complete this development. The matter has now returned to the Board for appellate review. The Board finds there has been substantial compliance with the remand. See Stegall v. West, 11 Vet. App. 268 (1998). Entitlement to special monthly compensation (SMC) based on the need for aid and attendance at the housebound rate The Veteran seeks an award of SMC based on the need for aid and attendance at the housebound rate due to his service-connected disabilities. Under 38 C.F.R. § 3.655 (b), when a claimant fails to report for an examination scheduled in conjunction with a claim for increase without good cause, the claim shall be denied. Examples of good cause include, but are not limited to, the illness or hospitalization of the claimant or the death of an immediate family member. 38 C.F.R. § 3.655 (a). A claim for SMC is considered a claim for an "increase" in rating pursuant to 38 C.F.R. § 3.655 as it requests a higher rate of compensation benefits for symptomatology associated with service-connected disabilities in addition to the compensation received for the disability ratings assigned thereto under the Rating Schedule. See also 38 C.F.R. § 3.350 (SMC "ratings"). Historically, the Veteran filed a Fully Developed Claim, VA Form 21-526EZ in March 2017 seeking an award of SMC for aid and attendance. In an April 2017 rating decision, the AOJ denied the Veteran's claim finding that the criteria to grant SMC had not been met. The Veteran did not appeal this decision, and no new and material evidence was received within one year of the decision. The April 2017 rating decision is final. 38 U.S.C. § 7105 (c) (2012); 38 C.F.R. § 3.104, 20.302, 20.1103 (2016). In June 2017, the Veteran filed a VA Form 21-8940 Veterans Application for Increased Compensation Based on Unemployability. In an August 2017 rating decision, the Veteran's claim for a total disability evaluation based on individual unemployability (TDIU) was denied. The Veteran appealed this decision in a November 2017 Notice of Disagreement. In a February 2018 statement of the case, the AOJ denied the Veteran's claim. In April 2019, the Veteran appealed to the Board and requested a hearing. In October 2021, a Board hearing was held with the undersigned Veterans Law Judge at which the Veteran testified in support of his claim for a TDIU. An August 2022 Board decision granted the Veteran's claim for a TDIU and in the same decision raised the issue of SMC based on the need for regular aid and attendance or by reason of being housebound due to the Veteran's service-connected disabilities. Consequently, the Board remanded the issue of entitlement to SMC to obtain a VA examination in the same decision. As discussed above, the Veteran's claim for SMC has been remanded multiple times to obtain a VA aid and attendance examination. This examination was necessary to establish entitlement of the nature of the benefit sought, as the aid and attendance regulations require specific information about the combined nature of the disabilities involved and their impact on daily life. Most recently, in February 2025, the Board remanded the claims to obtain a VA examination to address permanent need for regular aid and attendance due to his service-connected disabilities. The Board notes that a claim for a TDIU is considered a claim for increase. See Rice v. Shinseki, 22 Vet. App. 447, 452 (2009). As the Veteran's claim for SMC is derived from his claim for a TDIU, the Board finds that it stems from a claim for increase for purposes of applying the provisions of 38 C.F.R. § 3.655 (b). In February 2025, the RO scheduled the Veteran for a VA examination with respect to his SMC claim. Specifically, the RO created an Exam Scheduling Request which reflected the Veteran's last known address. In April 2025, an Appointment Notification, detailing the time and place of the scheduled VA examination, was sent to the Veteran. However, an Exam Scheduling Request Contention in April 2025 reveals that the examination was cancelled at the claimant's request. A review of the claims file shows Veteran did not provide any explanation as to his failure to report. An April 2025 SSOC notified the Veteran that the RO had requested a VA examination to evaluate his disabilities; and failure to report for an examination in conjunction with a claim for increase, "the claim shall be denied." Thus, the record demonstrates that the Veteran was made aware of the consequences for his failure to report for an examination under 38 C.F.R. § 3.655. Further, the record does not reflect that the Veteran attempted to reschedule the examination or was unable to do so. In addition, neither the Veteran nor his prior representative provided any good cause for his failure to report to the examination. See Appellate Brief June 2025. As the Veteran failed to report for VA examination scheduled in conjunction with his claim for increase without good cause, the claim must be denied under 38 C.F.R. § 3.655. Accordingly, the Veteran's claim for SMC based on the need for regular aid and attendance at the housebound rate is denied as a matter of law. See Sabonis v. Brown, 6 Vet. App. 426 (1994). Emily Tamlyn Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. Scanlan, 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.