Special Monthly Compensation (SMC)

What VA looks for: Loss or loss of use: SMC(k)

1. 1A service-connected condition behind the lossSMC pays for losses and impairments that come from service-connected conditions only. The condition is shown on your rating decision, or is claimed at the same time.
2. 2A listed loss, or loss of useLoss of use of a hand or foot means no useful function is left beyond what an amputation with a good prosthesis would give, judged by grasping and handling for a hand, or balance and walking for a foot. The rater decides loss of use from an exam that describes the function you have left.

Source: M21-1 VIII.iv.4.A (opens in new tab); 38 CFR 3.350(a) (opens in new tab)

Which kind of claim is this?

• Loss or loss of use: SMC(k)

  VA adds SMC(k) to the regular monthly rate for each listed loss or loss of use caused by a service-connected condition, up to three SMC(k) awards: one hand, one foot, both buttocks, a reproductive organ, sight in one eye with only light perception left, hearing in both ears with no air and bone conduction, the ability to speak, or 25 percent or more of breast tissue (or breast tissue treated with radiation). Loss of use of a reproductive organ includes loss of erectile function caused by a service-connected disease such as diabetes, and a diagnosis of female sexual arousal disorder. SMC(k) can be paid with any rating from 0% to 100%, and adds to other SMC levels except SMC(o), (q), and (r).

  Source: 38 CFR 3.350(a) (opens in new tab); M21-1 VIII.iv.4.A (opens in new tab); VA.gov: special monthly compensation rates (opens in new tab)

• Severe losses and aid and attendance: SMC(l) through (o)

  SMC(l) covers loss or loss of use of both feet, or of one hand and one foot, blindness in both eyes at 5/200 or less, being permanently bedridden, or needing the regular aid and attendance of another person. SMC(m), (n), and (o) cover more severe losses and combinations, such as both hands, both legs at higher levels, or blindness with no light perception. Half steps between the levels cover other combinations.

  1. 1The losses the level namesEach level lists the losses, loss of use, or blindness it covers. For the top level built from two separate losses, each one is counted only once.
  2. 2Needing help from another person with daily livingVA looks at whether you need help to dress, keep clean, eat, use the toilet, or adjust a prosthetic, or need someone to protect you from everyday hazards. Not all of these have to apply, and the need must be regular, though it does not have to be constant. The decision rests on the help you actually need. VA generally looks for one service-connected condition rated 100% as the cause or part of the cause, though no law requires it. Ratings for the effects of one disease, or for a condition and the conditions it caused, that combine to 100% count as one condition here.
  3. 3Being permanently bedriddenA condition that by its nature requires you to stay in bed. Bed rest a doctor prescribes to help you recover does not count.

  Source: 38 CFR 3.350(b) (opens in new tab); 38 CFR 3.350 (opens in new tab); 38 CFR 3.352(a) (opens in new tab); M21-1 VIII.iv.4.A (opens in new tab); VA.gov: special monthly compensation rates (opens in new tab)

• Higher-level care and brain injury: SMC(r) and (t)

  At the maximum SMC rate (SMC(o), or the same maximum reached under SMC(p)), or at the rate halfway between SMC(n) and (o) plus SMC(k), VA adds an aid and attendance allowance, SMC(r)(1), when you need regular aid and attendance. A higher allowance, SMC(r)(2), covers daily personal health care from a licensed provider, or someone a licensed provider supervises, without which you would need a hospital, nursing home, or other residential care.

  1. 1For SMC(r): the maximum SMC rate, or halfway between SMC(n) and (o) plus SMC(k)The SMC(r) allowances add to the maximum SMC rate, or to the rate halfway between SMC(n) and (o) plus SMC(k). SMC(t) does not need this level. Your rating decision shows the SMC level you have now.
  2. 2Daily health care from a licensed providerFor SMC(r)(2), care such as physical therapy, injections, catheter care, or sterile dressing changes, given at home each day by a licensed provider or by someone a licensed provider supervises and checks in with at least once a month. A family member who gives the care must be licensed or supervised the same way.
  3. 3Aid and attendance needed for brain injury residualsFor SMC(t), the need for regular aid and attendance comes from service-connected traumatic brain injury residuals, and without that help you would need a hospital, nursing home, or other residential care.

  Source: 38 CFR 3.350(h) (opens in new tab); 38 CFR 3.350(j) (opens in new tab); 38 CFR 3.352(b) (opens in new tab); M21-1 VIII.iv.4.A (opens in new tab); VA.gov: special monthly compensation rates (opens in new tab)

• Housebound: SMC(s)

  SMC(s) starts with one service-connected condition rated 100%. On top of that, VA looks for either other service-connected conditions rated 60% or more on their own, separate from the first and in a different part of the body or body system, or being permanently housebound: confined to your home and its grounds (or a ward, if you live in an institution) by service-connected conditions, in a way that is reasonably certain to last for life.

  1. 1One service-connected condition rated 100%A single condition rated 100%. Several conditions that combine to 100% do not count. Individual Unemployability granted for one condition does count.
  2. 2Other conditions rated 60% or moreOne of two routes: other service-connected conditions rated 60% or more on their own, separate from the 100% condition and involving a different part of the body or body system.
  3. 3Confined to your home by service-connected conditionsThe other route: your service-connected conditions keep you at home and its grounds, and the confinement is expected to last for life. Leaving home for medical care does not by itself count against it.

  Source: 38 CFR 3.350(i) (opens in new tab); M21-1 VIII.iv.4.A (opens in new tab); VA.gov: special monthly compensation rates (opens in new tab); VA Form 21-526EZ (opens in new tab)

• Your spouse needs aid and attendance

  VA pays added compensation when your spouse needs the regular aid and attendance of another person, once your combined rating is 30% or more. The 21-526EZ lists this with Special Monthly Compensation.

  1. 1A combined rating of 30% or moreAdded compensation for a spouse starts at a combined rating of 30%.
  2. 2A spouse who needs regular helpYour spouse is blind or nearly blind (5/200 or less in both eyes, or a visual field of 5 degrees or less), is a nursing home patient because of mental or physical incapacity, or needs help from another person with daily living.

  Source: 38 CFR 3.351(c) (opens in new tab); 38 CFR 3.352(a) (opens in new tab); VA Form 21-526EZ (opens in new tab); VA.gov: special monthly compensation rates (opens in new tab); VA.gov: add dependents to your disability benefits (opens in new tab)

What to gather, and what it shows VA

Records and statements go to VA. BeneVets never asks you to upload or type them here.

Steps, in order

1. Get free help from a VSO

   Free help: an accredited VSO can file this with you. Find one near you in the BeneVets VSO directory at Find an accredited VSO near you. SMC levels and combinations are detailed, and a representative can check which ones your record fits.

   Source: VA.gov: accredited representatives (opens in new tab)

2. Check your current ratings

   Read your latest rating decision for each service-connected condition, its rating, and any SMC level. If you have no rating yet, the compensation chapter covers the first claim.

   Source: M21-1 VIII.iv.4.A (opens in new tab); VA.gov: download VA benefit letters (opens in new tab)

3. Write down what changed, on paper

   On paper, note each loss or loss of use, the daily tasks you need help with, who helps, and how often you leave home. Keep it with your papers; BeneVets does not ask for it.

4. Ask a provider to complete VA Form 21-2680

   For aid and attendance or housebound SMC, ask a VA or private medical provider to complete VA Form 21-2680. It goes to VA with your claim.

   Source: VA Form 21-2680 (opens in new tab); VA Form 21-526EZ (opens in new tab); M21-1 VIII.iv.4.A (opens in new tab)

5. Add nursing home information if it applies

   If you or your spouse lives in a nursing home, ask a nursing home official to complete VA Form 21-0779 for VA.

   Source: VA Form 21-0779 (opens in new tab); VA Form 21-526EZ (opens in new tab)

6. Handle private medical records

   For each private provider or home health agency, send copies of the records to VA, or complete VA Form 21-4142 and VA Form 21-4142a so VA can request them.

   Source: 38 CFR 3.159(c)(1) (opens in new tab); VA Form 21-4142 (opens in new tab); VA Form 21-4142a (opens in new tab)

7. Ask for statements about daily help

   Ask family members or caregivers who help you whether they will complete VA Form 21-10210. Your own account goes on VA Form 21-4138.

   Source: M21-1 V.ii.1.B (opens in new tab); VA Form 21-10210 (opens in new tab); VA Form 21-4138 (opens in new tab)

8. List your spouse

   For added compensation for a spouse who needs aid and attendance, your spouse goes on VA Form 21-686c, sent with your claim.

   Source: VA Form 21-686c (opens in new tab); VA Form 21-526EZ (opens in new tab); VA.gov: add dependents to your disability benefits (opens in new tab)

9. File your claim

   File VA Form 21-526EZ and include the supporting forms that apply: VA Form 21-2680, or VA Form 21-0779 for a nursing home stay. The BeneVets fill flow can prefill identity, contact, and service fields; the rest is completed on VA's form.

   Source: VA Form 21-526EZ (opens in new tab); M21-1 VIII.iv.4.A (opens in new tab)

10. Go to any exam VA schedules

    VA asks for an exam only when it needs more information to decide. The 21-526EZ treats SMC as a claim for increased benefits, and when someone misses the exam for a claim for increase without good cause, such as illness or a hospital stay, VA denies the claim.

    Source: 38 CFR 3.159(c)(4) (opens in new tab); 38 CFR 3.655(b) (opens in new tab); VA Form 21-526EZ (opens in new tab); VA.gov: VA claim exam (opens in new tab)

11. Track your claim

    Track the claim on VA.gov and answer any VA request for more evidence.

    Source: M21-1 III.i.2.D (opens in new tab); VA.gov: how to file a VA disability claim (opens in new tab)

12. Read the SMC part of the decision

    The decision lists any SMC level right after the combined rating, and explains any SMC you claimed that VA did not grant. Each issue has its own review option: a Supplemental Claim (VA Form 20-0995), a Higher-Level Review (VA Form 20-0996), or a Board Appeal (VA Form 10182).

    Source: M21-1 VIII.iv.4.A (opens in new tab); VA.gov: decision reviews and appeals (opens in new tab); VA Form 20-0995 (opens in new tab); VA Form 20-0996 (opens in new tab); VA Form 10182 (opens in new tab)

Good to know