What are Commonly Recognized Types of VA Compensation Claims?
We provide a list of 18 commonly recognized types of claims for veterans Disability Compensation and a brief explanation about each one of these types of claims. This is our own list and not based on anything from the Department of Veterans Affairs. Other websites may use a different dichotomy for common types of claims.
1. Specific Chronic Conditions Presumed Service-Connected with a Time Limit
The veteran must have 90 continuous days or more of service. Having one or more of these 41 chronic diseases or disorders is considered to have been caused by service if they manifest themselves to a degree of disability of 10% or more within one year after discharge. Manifesting does not necessarily mean medical diagnosis, only that evidence shows the existence. There are some exceptions to the one year rule which are: Hansen's Disease (leprosy) must have appeared within three years after separation. Tuberculosis must have appeared within three years after separation. Multiple sclerosis must have appeared within seven years after separation.
Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig's Disease can appear any time after separation from service. Because service connection is presumed, it is not required to produce evidence for service connection – only evidence of the manifestation of the disorder or disease. A claim for ALS is automatically granted at any time application is made.
2. Prisoner of War - Chronic Conditions, Service-Connected with No Time Limit
This list of chronic conditions is considered presumptive service-connected for veterans who are former prisoners of war. The veteran must have 90 continuous days or more of service. There are 20 diseases or disorders considered service-connected for a prisoner of war depending on the length of imprisonment and manifested any time after separation to a disabling degree of 10% or more. Manifesting does not necessarily mean medical diagnosis, only that evidence shows the existence. Because service connection is presumed, it is not required to produce evidence for service connection – only evidence of the manifestation of the disorder or disease. Evidence must be provided that shows the claimant was a prisoner of war for the prescribed amount of imprisonment.
3. Ionizing Radiation - Chronic Conditions Presumed Service-Connected
Careful attention is paid to whether the veteran was actually exposed to radiation to a degree to cause a number of conditions which are mostly cancers. Exposure is generally assumed to be related to nuclear detonations or experiments of which there is a specific list and the veteran must prove he was involved at the time. Manifestation of these diseases or disorders can occur generally any time after a certain prescribed period of time, depending on the condition. Manifesting does not necessarily mean medical diagnosis, only that evidence shows the existence.
Because service connection is presumed, it is not required to produce evidence for service connection – only evidence of the manifestation of the disorder or disease. That said, the claimant must provide evidence of being in the defined locations where the claimant was presumably exposed to ionizing radiation and in sufficient doses to result in one of the chronic conditions on the list. This might prove a difficult task.
4. Agent Orange - Chronic Conditions, Service-Connected with No Time Limit
The veteran must have 90 continuous days or more of service. Herbicides were used in Vietnam to defoliate trees in order to remove cover for the enemy. During the manufacturing process, significance amounts of harmful contaminants called dioxins were produced. Different blends of herbicides were used but the most common was one called "Agent Orange." Being on the ground in Vietnam, during the war or on the inland waterways is sufficient for presumption for service connection. Harmful exposure other than the automatic "boots on the ground" for Vietnam is generally considered to be inhalation and not topical.
Exposure also occurred on air bases in Thailand, the demilitarized zone in Korea , on certain ships offshore from Vietnam and for aircrews up through 1987 flying C-123 aircraft that were used for dispersal. In addition, numerous storage, spraying operations, testing and loading sites – outside the country and inside the US – could have resulted in exposure.
The claimant must prove that he or she was exposed to Agent Orange. Proving that the claimant was in Vietnam or in any other locations where VA recognizes there was exposure to Agent Orange is relatively easy, based on service records. Being exposed to Agent Orange under other circumstances might be a difficult task. There are 14 illnesses or diseases presumed by VA to be service-connected for Agent Orange veterans:
- AL amyloidosis,
- chloracne or other acne Form disease similar to chloracne,
- porphyria cutanea tarda,
- soft-tissue sarcoma (other than osteosarcoma, chondrosarcoma,
- Kaposi's sarcoma or mesothelioma),
- Hodgkin's disease,
- multiple myeloma,
- respiratory cancers (lung, bronchus, larynx, trachea), • non-Hodgkin's lymphoma,
- prostate cancer,
- acute and subacute peripheral neuropathy,
- diabetes mellitus (Type 2),
- all chronic B-cell leukemias (including, but not limited to, hairy-cell leukemia and chronic lymphocytic leukemia),
- Parkinson's disease, and
- ischemic heart disease.
5. Disability Caused by Illness, Combat or Injury Incurred in the Service
This type of disability is not presumed to be service-connected. Evidence must be produced to show that it was service-connected. Proving service connection adds an additional degree of difficulty over those conditions that are presumed. Generally, evidence of the illness or injury should be contained in service medical records of the claimant. If no medical evidence is available, service connection can still be established through other means such as lay testimony or historical reports from individuals who observed the injury or illness of the claimant. There is no time frame for making a claim. However, lay testimony by itself is not enough to establish service connection. There must be other corroborating evidence. There is an exception if service connection is claimed as a result of combat. Lay testimony can be sufficient to establish service connection for combat related injuries or conditions.
Sometimes, the injury or illness does not manifest as chronically disabling for many years after separation. Medical evidence soon after separation of the existence of the illness or injury and prior to manifestation of disability is often necessary in establishing service connection and what VA calls continuity of the disabling condition. These types of claims are very common for any age of veteran, be it a young veteran or a veteran who is aged. For some other types of claims involving direct service connection, continuity of symptoms must be established but not necessarily manifest early on. Some disabling conditions may not show up for years.
Also remember that for these direct service-connected claims, especially where there is scanty evidence of the incurrence of an illness or injury in the service, current disabling conditions that could be attributed to combat or being a prisoner of war are usually accepted based on the testimony of the claimant alone with no other corroborating evidence. For peacetime service or noncombatant service, testimony of the claimant or other witnesses is not enough without other supporting physical evidence such as service treatment records or personnel records or credible buddy statements where inference can be drawn that the in-service incurrence took place.
6. Secondary Service Connection or Aggravation of an Existing Condition
Service connection can be granted under 38 CFR 3.310 when disabilities are proximately due to or the result of a service-connected condition or the increase in severity of a non-service-connected disability. This increase in severity of a non-service-connected disability has to be attributable to aggravation by a service-connected disability and not due to the natural progress of that non-service-connected disability.
7. Exposure to Hazards, Chemicals and Harmful Environmental Conditions
The veteran may have been exposed to any one or more of the following during active duty:
- Harmful sounds from guns, equipment and machinery used during military service
- Vietnam Era veterans who are at risk for hepatitis C
- Depleted uranium used in military tank armor and some bullets
- (Qarmat Ali) Hexavalent chromium in contaminated sodium dichromate dust; water treatment plant in 2003
- Camp Lejeune Water Supplies
- Burn Pits – Open-air pit waste disposal at military sites
- (Gulf War) Substances used to repel or destroy pests such as insects and pathogens
- PCBs – Polychlorinated biphenyls used as coolant and insulating fluid
- Industrial Solvents – Usually a liquid used to dissolve, degrease, clean, strip paint, etc.
- Exposure during military service to the airborne hazards listed below could potentially cause certain health problems in Veterans, depending on a number of other factors.
- Atsugi Waste Incinerator Atsugi, Japan: Combustion waste disposal that burned industrial and medical waste
- Oil Well Fire, Smoke (Gulf War)
- Oil or gas wells that caught on fire and burned during the 1990-1991 Gulf War
- Sand, Dust and Particulates Tiny airborne matter that can cause respiratory and other health problems
- Sulfur Fire (Al Mishraq, Iraq)
- Responding to concerns of many returning Veterans, VA will continue to study the health risks of pollution in Iraq and Afghanistan, including burn pit smoke, and establish a burn pit registry for eligible
- Asbestos Mineral – fiber used in older buildings and an older ships; if inhaled deeply into the lungs can cause health problems
- Vibration – Periodic back and forth movement that if severe, can cause health conditions
- Lead Metal that can be toxic for certain uses
- Noise – Harmful sounds from guns, equipment, airplanes, combat vehicles and machinery that is often experienced during military service
- Exposure to extreme heat or extreme cold
- Heavy equipment including armored vests that may cause deterioration of bodily joints
- Herbicide Tests and Storage
- Radiation – Dental technicians, nuclear weapons technicians, and others with routine and usually safe exposure
- CARC Paint – Chemical Agent Resistant Coating (CARC) used on military vehicles to resist corrosion and chemical agents
- Fuels (Petroleum, Oils, Lubricants) – Fuels such as diesel and JP-8 used to operate vehicles in the military
- Use of biological toxins or infectious agents with intent to kill or incapacitate
- Nerve Agents – Toxic chemicals that attack the body's nervous system
- Mustard Gas – Odorless, poisonous gas used during World War I, II, and military tests in the 1940s
- Project 112/Project SHAD – Military tests of chemical/biological warfare materials conducted in the 1960s to early 1970s
- Edgewood/Aberdeen Experiments – Classified medical studies of low-dose chemical agents conducted from 1955-1975
- Agent Orange and other herbicides used in Vietnam. Agent Orange and other herbicides used in Vietnam were tested or stored elsewhere, including some military bases in the United States.
The key to this type of application is demonstrating that "you were in the right place at the right time" so to speak. The more likely the nexus between your current condition and the exposure, the more likely the inference that it occurred in service. Conditions caused by these types of exposure may not manifest until many years after getting out of the service. Trying to show evidence of the continuity of symptoms, as in other claims, is more difficult with one of these claims. The crucial issue in establishing service connection is that the chronic condition that you currently have is known to be caused by the particular exposure that you incurred in service. You definitely must have an opinion letter from your treating physicians as to the probability of this link to service connection.
This is likely going to be one of those claims based on reasonable doubt. VA will not be able to prove beyond a 50-50 probability that you did not incur the current disability because of an exposure in service, and as such must use the principle of reasonable doubt to award you the benefit.
Proving you were at an assignment where you were exposed to the hazard, the chemicals or the environment is crucial. There also has to be some sort of evidence that the level of exposure was sufficient enough to cause injury, disease or disorder. Or this must be self-evident because of the assignment. In addition you may have to provide medical literature that corroborates whatever is wrong with you now, could have been caused by the exposure. For example, certain cancers are known to be caused to by exposure to CARC Paint or to solvents and so forth.
If enough evidence is produced to show that there is a reasonable assumption or inference that the current disability is service-connected, then a strong opinion letter from a private physician might sway VA to make a favorable decision. Relying on a VA scheduled opinion exam will likely not get you the benefit. Careful medical literature research and collaboration with a medical specialist is typically the best way to win one of these claims.
From the 1950s through the 1980s, people living or working at the U.S. Marine Corps Base Camp Lejeune, North Carolina, were potentially exposed to drinking water contaminated with industrial solvents, benzene, and other chemicals.
VA has established a presumptive service connection for Veterans, Reservists, and National Guard members exposed to contaminants in the water supply at Camp Lejeune from August 1, 1953 through December 31, 1987 who later developed one of the following eight diseases:
- Adult leukemia
- Aplastic anemia and other myelodysplastic syndromes
- Bladder cancer
- Kidney cancer
- Liver cancer
- Multiple myeloma
- Non-Hodgkin's lymphoma
- Parkinson's disease
8. PTSD - Posttraumatic Stress Disorder
Posttraumatic Stress Disorder is a mental disorder classified as an "anxiety" by VA. It is a mental health problem that can occur after someone goes through a traumatic event like war, assault, or disaster. Most people have some stress reactions after a trauma. If the reactions don't go away over time or disrupt your life, you may have PTSD. Because PTSD can affect a person's ability to make an income, it is considered a disabling condition subject to Compensation if it is severe enough to be rated. Oftentimes, these are difficult claims to approve, because PTSD cannot be quantifiably measured like other conditions. It requires special evaluations from psychiatrists and employment assessment specialists. In addition, the service connection is sometimes difficult to establish when PTSD is not caused by engaging in combat. For many sufferers this is the case.
PTSD is becoming a very common claim for disability with applications soaring in the last 10 or so years. This condition also leads to the inability to work and as such many PTSD claims are combined with individual unemployability claims.
9. Hearing Loss with or without Tinnitus
Tinnitus and hearing loss are the #1 and #2 most commonly awarded conditions for Compensation. Tinnitus, by itself, connected to service is ratable at 10% disability. Tinnitus is a ringing or rushing or other sound only perceived by the individual and not by anyone else. Most people describe it as extremely high-pitched. Depending on the degree, it can be very disconcerting and interfere with normal functioning.
Generally, service-connected tinnitus should be persistent – meaning it is present most of the time. This establishes it as chronic. Establishing service connection for tinnitus by itself is generally not that difficult. This is because there is no definitive test for this condition and VA must accept the word of the person that it exists.
Tinnitus at 10% – as a combined rating – is often awarded in combination with noise induced hearing loss which is typically rated at 0%. This is because tinnitus is a common symptom of noise induced hearing loss. The hearing loss is much easier to establish as a service connection because the condition can be recognized through testing and because it is well-known that certain noise exposure conditions will cause it. For most cases of hearing loss, you must have the tinnitus or you will only get a 0% rating. With the tinnitus you get 10% as a combined rating.
As long as duty can be established where the claimant was exposed sufficiently to loud noise or sudden air pressure changes resulting in hearing loss, these types of claims are not that difficult to generate an award. If the hearing loss by itself is severe enough, it could result in a combined or single rating of 20%, 30% or even 100%.
Establishing a duty assignment in the service that is consistent with producing noise induced hearing loss and enough exposure over time is often important to winning one of these claims. Your personnel records or other evidence should show that you had such assignments in the service.
10. PTIU - Permanent and Total Disability Due to Individual Unemployability
This is a rating increase for someone already on claim to produce the equivalent of 100% disabled, even though the existing underlying rating remains the same. However, Individual Unemployability pays out at the 100% rate.
The veteran must currently be service connected for a single disability evaluated at least 60 percent disabling or service connected for multiple disabilities evaluated at least 70 percent disabling, with one of the multiple disabilities rated at least 40 percent disabling. There are circumstances where the requirement for a single 60 or 40 percent disability may be met by a combination of disabilities that can be considered a single disability. There is no age test for this rating. This means a retired 85-year-old who meets the criteria could just as well be considered unemployable as a younger person.
Unemployability means the inability of a veteran to secure or follow a substantially gainful occupation. A finding of unemployability cannot be made if the evidence shows that the veteran is engaged in, or is capable of being engaged in, a substantially gainful occupation. However, a finding could be made if the evidence shows marginal employment. Marginal employment is defined in terms of a veteran's earned annual income.
For a voluntarily-retired individual, not producing earned income, this alternative test for marginal employment would not be appropriate and the test of "capable of being engaged in a substantially gainful occupation" would have to be the test. This marginal employment income should generally not exceed the government's established poverty threshold for one person. Exceeding this threshold may indicate a substantially gainful occupation, as noted by the Court of Appeals for Veteran's Claims (CAVC) in Faust v. West, 13 Vet. App. 342 (2000), where a substantially gainful occupation was defined as "one that provides annual income that exceeds the poverty threshold for one person."
In addition to the income criterion, evidence showing that employment is marginal rather than substantially gainful may also exist on a "facts found" basis. Examples of this marginal status include employment in the protected environment of a family business or sheltered workshop. Such fact-based marginal employment is consistent with a finding of unemployability.
11. Sleep Apnea
Sleep apnea claims have become more prevalent in the last few the years. This is probably due to the fact that sleep apnea is often a secondary service connected condition to PTSD. If this is your case, go to the claim category for secondary service connection and follow those instructions. Secondary service connection for sleep apnea doesn't just have to be PTSD. It could be any number of conditions that are already service-connected for which the veteran is on claim and that would also aggravate or directly cause the difficulty breathing asleep.
If this is a claim for direct service connection, it may be difficult to establish. Sleep apnea by itself is not a disease, but it is a cluster of symptoms that revolve around several underlying causes which prevent a person from breathing properly, particularly at night. Sleep apnea in service may be just simply a condition that is developed and that has been reported and treated in service and contained in service treatment records.
Lacking any medical records from service, the applicant can possibly use lay statements to establish incurrence in service, however VA will typically not accept lay statements for sleep apnea from the veteran who is the claimant. This is because VA thinks, and perhaps rightly so, that because sleep apnea occurs while one is asleep, the veteran cannot possibly describe his or her symptoms that are supposed to be observable, because the veteran is asleep. Lay statements must be from other individuals who witnessed veteran's sleep apnea episodes in service. But this is not all, there must be some sort of corroborating evidence – lacking medical evidence – that can back up the lay statements. These might be personnel records of some kind that show reassignment due to lack of sleep or inattention or something like that.
12. Gulf War Disorders - Service Connection Is Presumed with a Time Limit
Of the 700,000 servicemembers deployed to the Gulf War in 1990 and 1991, 36.5 percent were experiencing some symptoms of Gulf War illness in 2005, according to a previous NAS study. The federal government spent more than $500 million on research related to Gulf War veterans from 1994 to 2014, but there have been few findings about Gulf War illness and specific chemical agents that could be causing it, according to the NAS study from February.
Veterans may receive Disability Compensation for chronic disabilities resulting from undiagnosed illnesses and/or medically unexplained chronic multi-symptom illnesses defined by a cluster of signs or symptoms. A disability is chronic if it has existed at least 6 months.
The undiagnosed illnesses must have appeared either during active service in the Southwest Asia Theater of Operations during the Gulf War period of Aug. 2, 1990, to July 31, 1991, or to a degree of at least 10 percent at any time since then through Dec. 31, 2021. This theater of operations includes Iraq, Kuwait, Saudi Arabia, the neutral zone between Iraq and Saudi Arabia, Bahrain, Qatar, the United Arab Emirates, Oman, the Gulf of Aden, the Gulf of Oman, the Persian Gulf, the Arabian Sea, the Red Sea, and the airspace above these locations.
Because service connection is presumed, it is not required to produce evidence for service connection – only evidence of the manifestation of the disorder or disease. That said, the claimant must provide evidence of being in the service in the particular theater of operation. Disability has to become manifest to 10% or more from the time of active duty and no later than December 31, 2021. Examples of symptoms of an undiagnosed illness and medically unexplained chronic multi-symptom illness defined by a cluster of signs and symptoms include:
- chronic fatigue syndrome,
- irritable bowel syndrome,
- signs or symptoms involving the skin,
- skin disorders,
- muscle pain,
- joint pain,
- neurological signs or symptoms,
- neuropsychological signs or symptoms,
- signs or symptoms involving the respiratory system (upper or lower),
- sleep disturbances,
- gastrointestinal signs or symptoms,
- cardiovascular signs or symptoms,
- abnormal weight loss, and
- menstrual disorders.
If no previous claim has been made or if a previous claim was made but there was no chronic disability for an award, it may be possible to submit a new claim or reopen the previous claim as long as this is done within one year of any correspondence with VA. It is important to note that the condition had to have manifest itself at 10% or more prior to December 31, 2016. You would have to provide concrete medical evidence of the manifestation of symptoms prior to December 31, 2016 to even proceed. Otherwise, don't bother to make a claim.
13. Request for Reevaluation or Change for an Existing Benefit
Changes to an existing benefit represent about 63% of all claims pending for approval. Veterans already on claim are getting older and in many cases their disabilities are increasing in severity. If they have legitimate medical or work-related evidence of an increase in disability, there is a possibility for an increased rating and more monthly income.
It can also work in the opposite direction. Sometimes, a request for reevaluation of a rating can result in downgrading that rating or even reevaluating whether a service connection exists. We have heard of veterans not only losing the rating but losing the service connection and the entire award. You should always be careful in requesting a change that you have a legitimate increase in disability and that a reevaluation won't reduce your existing award. If you have been service-connected for at least 10 years, that service connection is protected and VA cannot take it away from you. If you have had the same rating for at least 20 years, that rating is protected and VA can only increase it but not decrease it.
Some veterans have developed secondary conditions, meaning that their primary disability has resulted in conditions that are caused by the primary disability. For example, service-connected diabetes can result in cardiovascular disease which would be a new condition but would be considered secondary to the diabetes and therefore service-connected. If the cardiovascular disease results in disability with a rating, the VA will combine those ratings to produce a new larger rating. Combined ratings are not additive. For example a 40% rating for diabetes and a 20% rating for cardiovascular disease results in a 50% combined rating not a 60% additive rating.
If you have developed a disability that has been aggravated or caused by a service-connected disability, do not continue in this section. Instead, go to the section above that is devoted to this type of claim "#6 Secondary Service Connection or Aggravation of an Existing Condition."
Also please note that if your disability has worsened or you have developed new disabilities to the point that you are severely disabled and could qualify under "Special Monthly Compensation," (SMC) go ahead and go to that section below for this type of application instead of going to claim for secondary disability.
If enough evidence is produced to show that there is a reasonable assumption or inference that the current disability is worsened, then a strong opinion letter from a physician might sway VA.
14. Section 1151 Claim
This non-service-connected disability benefit is named after the section in Title 38 United States Code where it is found. If a non-service-connected disabling condition is caused by or aggravated by VA examination, hospital care, medical or surgical treatment, Vocational Rehabilitation, or (beginning November 1, 2000) a program of Compensated Work Therapy under 38 USC 1718, then Compensation is payable for that condition as though the condition was service-connected.
Remember, however, that even though Compensation will be paid, the condition is in fact NOT service-connected, and should not be called such. Because of this, ancillary benefits beyond Compensation are limited in Section 1151 cases: in general, they are restricted to the applicable priority medical care; a clothing allowance (where applicable); and, where the qualifying level of compensable disability is present, an automobile and appropriate special adaptive equipment under 38 USC, Chapter 39 and special adapted housing under 38 USC, Chapter 21.
Compensation for disabilities under Section 1151 may be combined with Compensation for any service-connected conditions the veteran may also have. If the veteran is awarded any amount from a judicial award, settlement, or compromise for the same condition(s) for which compensation under Section 1151 has been (or will be) authorized, the Compensation otherwise payable for such condition(s) must be withheld until the full amount of the award, settlement, or compromise has been recovered. [38 USC 1151; 38 CFR §§ 3.358, 3.361–3.363, 3.800] Such recovery does not affect entitlement to any Compensation payable for service-connected disabilities, however.
These types of claims are not common because the burden of proof is so high. In order to meet the qualifications of 38 U.S.C. 1151, the proximate cause of additional disability or death must be
- carelessness, negligence, lack of proper skill, error in judgment, or similar instance of fault on the part of VA in furnishing the hospital care, medical or surgical treatment, or examination
- an event not reasonably foreseeable, or
- the provision of
- training and rehabilitation by VA or one of its service providers as part of an approved rehabilitation program under 38 U.S.C. Chapter 31, or
- a CWT program.
Even if you succeed in getting one division of VA to blame the other division of VA for doing wrong, you still have to demonstrate the exact nature of your disability before and after the treatment. Evidence for this claim must be some sort of hardcopy evidence from hospital or clinical or organizational records. You would have a difficult time establishing an award based on personal testimony or testimony of witnesses. This is not to say it can't be done.
For example, if you had a knee operation for joint replacement and they did it on your good knee instead of your bad knee, this is pretty easy to establish. Or if you have a mastectomy and they removed the wrong breast, that's pretty simple to prove. Or if they operated on you and left a surgical instrument inside – pretty straightforward. It's the errors or negligence involving treatment protocols or surgical procedures and what was right and what was wrong for the particular condition that might be difficult to prove.
VA will consider as an informal claim for benefits under 38 U.S.C. 1151, any statement showing an intent to file a claim for benefits resulting from
- hospital, medical or surgical treatment by VA
- examination by VA, or
- pursuit of a course of vocational rehabilitation.
Note: If an individual or his or her representative files an in formal claim, VA send him or her the appropriate application form.
You should seek help with representation for such a claim. Likely it will require an attorney who specializes in these types of medical malpractice claims for veterans. Perhaps a service organization has experience with these claims as well.
15. Tropical Diseases – Service Connection Is Presumed with a Time Limit
The veteran must have 90 continuous days or more of service. The disorder or disease must manifest disability to a degree of 10% or more within one year from date of separation or at the end of the standard incubation period. Disorders or diseases caused by treatment may also be considered service-connected. Because service connection is presumed, it is not required to produce evidence for service connection – only evidence of the manifestation of the disorder or disease. Manifesting does not necessarily mean medical diagnosis, only that evidence shows the existence.
- Blackwater fever.
- Leishmaniasis, including kala-azar.
- Oroya fever.
- Yellow fever.
Qualifying periods of service for the following infectious diseases include active military, naval, or air service in the Southwest Asia theater of operations during the Gulf War period of August 2, 1990, to July 30, 1991, or active military, naval, or air service on or after September 19, 2001, in Afghanistan.
- Campylobacter jejuni,
- Coxiella burnetti (Q fever),
- Mycobacterium tuberculosis,
- Nontyphoid Salmonella,
- Visceral leishmaniasis, and
- West Nile virus.
16. Special Monthly Compensation (SMC)
The majority of service-connected disabilities are defined by a percentage ranging from 0 to 100 percent to reflect the severity of the condition(s) and the disabling effects they have on the veteran. These percentages are explicitly defined by Federal Regulations under the Schedule for Rating Disabilities and are assigned a monetary Compensation award based on the vocational limitations that these injuries or disorders cause and subsequently the effect they may have on monetary earnings.
Some injuries and disorders are more severe in nature and result in several additional debilitating residual conditions that can have additional adverse affects on an individual's socioeconomic state. To better assist with meeting the specialized needs of these individuals, additional benefits are available under Special Monthly Compensation (SMC) ratings provided under Title 38 of U.S.C. 1114. These ratings are in addition to the numerical ratings established under the standard rating schedule and are identified by letters such as SMC (k), SMC (l), SMC (m), SMC (n), SMC (o), SMC(p), SMC (r), SMC (s) and the recently added SMC (t). These alphabetical titles are named after the subsections of the Code of Federal Regulations that outline the required eligibility requirements for each level of SMC.
SMC provides additional monetary Compensation awards and where applicable can establish entitlement to additional ancillary benefits such as the VA's Specially Adapted Housing Grant and the Automobile and Adaptive Equipment Grants.
The basic elements of Special Monthly Compensation Ratings include anatomical (or physical) loss or the loss of use of limbs, hands, feet and/or reproductive organs; aphonia; deafness; blindness; loss of bowel and bladder control; being permanently housebound; and a need for regular aid and attendance with activities of daily living or a higher level of care–all of which must be a result of the veteran's service-connected disabilities.
Most veterans suffering these disabilities are fully aware of the possibility of receiving SMC where it is appropriate and have long since applied. One never knows, however, if someone fell through the cracks and never bothered to apply.
17. Specific Ancillary Benefits, Allowances and Grants
Even though many disabled veterans are aware of these special allowances, it doesn't hurt to reiterate what is available. Perhaps the veteran is in need at this point and never bothered to apply previously. This is a reminder of these benefits. We provide no further instructions other than for the veteran to get in touch with an appropriate service officer for application where applicable. Here is a list of these special allowances.
- Housing Grants SAH Grant, Eligibility for up to $77,307:
- SHA Grant, Eligibility for up to $15,462
- Temporary Residence Adaptation (TRA)
- Supplemental Financing
- Automobile Allowance
- Clothing Allowance
- Medal of Honor Pension
18. HISA Grants (Home Improvement and Structural Alterations)
These are total lifetime amount grants of either $2,000 or $6,800 to any veteran who qualifies for modifying the home for disability. They are awarded through the local regional medical center prosthetics department. The veteran must be enrolled in VA health care and receive a prescription from the health care provider for this grant. The grant money comes from the veteran's local regional medical center budget.
Total lifetime amount HISA benefit up to $6,800 may be provided for veterans and service members who have a service connected condition rated 50% or more service connected.
Lifetime benefit up to $2,000 may be provided for Veterans who have a non-service connected condition.
The veteran must be registered with VA health care. In order to receive a HISA grant, the Veteran must first have a prescription from a VA physician in the VA health care system. This must include:
- The diagnosis with medical justification
- The Veteran's name, address, SSN, and phone number(s).
Please refer to the table of contents in the top right column of this page for more topics on VA Disability Compensation.
TABLE OF CONTENTS
- What is Compensation
- Eligibility for Compensation
- Entitlement for Compensation
- Income Rating Levels
- Presumptive Service-Connected
- Direct Service-Connected
- Secondary Service-Connected
- Common Compensation Claims
- Claims Taking Too Long
- Shorten Claim Decisions
- Options for Bad Decisions
- Claimant Dies before Decision
- Determining Disability Ratings
- Examples of Claims
- Aid & Attendance Allowance
- Other Benefits for Claimants
This 2023 Edition provides detailed instructions on how to submit claims for benefits through the Department of Veterans Affairs new intake center and uses the successful "Fully Developed Claim Process" for faster and better decisions. View the Book...
- About Accreditation & Fees
- Accreditation Study Materials
- CLE to Maintain VA Accreditation
- Correcting Your Military Discharge
- Find Home Care / Assisted Living
- Find Hospice Care
- Find Medical Alert
- Help finding a LTC Facility
- Help with Care Management
- Help with Elder Law
- Help with Estate Planning
- Help with Disputes / Mediation
- Help with Financial Planning
- Help with Medicaid Planning
- Help with Tax Planning
- Informal Claims / Effective Dates
- Service Connected Disabilities
- State VA Nursing Homes
- VA Aid and Attendance Benefit
- VA Burial Benefits
- VA Healthcare System
- VA Help - Surviving Spouse
- VA Home Renovation Grants
- VA Long Term Care Benefits
- VA Pays Family for Eldercare
- VA Regional Offices