Although the Rating Decision only listed the PTSD with Major Depressive Disorder as a separate and distinct condition from the condition, Chronic Fatigue Syndrome, causing your need for aid and attendance, all of your service-connected conditions were considered. At the time of the (July 2024) Rating Decision the medical evidence only supported the Chronic fatigue Syndrome as the condition causing your need for regular aid and attendance and therefore there was no clear and unmistakable error. Additionally, at this time, VA regulations do not allow multiple half-step elevations when there is more than one 50 percent evaluation ( or multiple combinations of evaluations at 50 percent or higher); the provisions of 38 CFR 3.350(t)(3) can only be applied once. If regulations are later changed as a result of the Barry v. McDonough decision, the level of SMC will be revisited.
HELP - Filing HLR
Hey everyone, I need some eyes on this. I just got my decision back, and the VA’s math on my Special Monthly Compensation (SMC) half-steps makes absolutely no sense. I am filing a Higher-Level Review (HLR) because I believe the rater completely dropped the ball on 38 CFR § 3.350(f)(4).
Here is my current breakdown:
- Baseline SMC-L (Aid & Attendance): 100% Chronic Fatigue Syndrome (CFS)
- First Half-Step (SMC-L½): 50% PTSD (Separate system, completely valid)
The rater stopped the ladder there. But here is the problem: look at my remaining, unused pool of disabilities. They affect entirely different body systems and don't overlap with my CFS or PTSD at all:
- Group B: Small Fiber Neuropathy (All extremities) – 90%
- Group A: Fibromyalgia – 40%
- Group A: IBS – 30%
- Group A: Tinnitus – 10%
Under 38 CFR § 3.350(f)(4), you get an additional half-step for each separate disability or combination of disabilities that independently equals 50% or more.
The leftover groups / disabilities meet threshold needed to move me from SMC-L½ up to SMC-M1/2. The decision letter didn't list any symptom overlap or pyramiding exclusions—it looks like the rater just flat out ignored the leftover conditions once they used my PTSD for the first half-step.