Special Monthly Compensation

Topics:
Overview
Categories L through O
Housebound Benefits (Category S)
Even More Money (Category K)
Aid and Attendance (Category R)
Category Q
Rating the Appropriate Category (IMPORTANT!)

 

Note: All Special Monthly Compensation applies ONLY TO VA Disability, not DoD.

The VA should automatically give you Special Monthly Compensation if you qualify for it. You do not have to apply. If, however, you feel that you qualify and you are not receiving, contact your local VA office.

 


Overview

Extra VA Disability is given for some especially serious disabilities. The basic idea is that the VA wants to give additional disability pay in cases where the disability is so severe that the regular ratings just don’t cut it. For example, the loss of one hand and a foot is more serious than just the lost of one hand.

Note: All Special Monthly Compensation Rates are given instead of the standard VA Disability Rates, except for Category K. Category K is given in addition to your standard disability pay. All Special Monthly Compensation is tax-free.

There are different categories that determine the type and amount of Special Monthly Compensation. Each one has different requirements for the kind of conditions that qualify for Special Monthly Compensation under that category.

VERY IMPORTANT! For a condition to qualify under any category, it must be determined by the VA to be service-connected.

Any VASRD rating requirements for each category noted below can only be fulfilled by a VA Disability Rating, not DoD. So, if the DoD rates a condition at 100%, but the VA only rates it at 60%, then 60% is the only rating that can be used to qualify for a category. The majority of categories do not have VASRD rating requirements.

If the VA did not give Special Monthly Compensation in a case that qualifies, the veteran can request for his case to be reviewed, and Special Monthly Compensation will then be given dating back to the original VA Rating Decision.

Once you know what category of Special Monthly Compensation you qualify for, you can find the exact monetary amount you’ll receive for that category on our Special Monthly Compensation Rates page.

Before we discuss the different categories and conditions that qualify for Special Monthly Compensation, here are a few important definitions:

– Loss of use means that the body part cannot function any better than it would if it were amputated and a prosthetic device used. Basically, if the hand cannot grasp objects or if the foot cannot push off or balance, it would be considered loss of use. If a leg is shortened by 3 ½ inches or more, it is also considered to be loss of use of that foot.
– Aid and attendance means that the condition is so severe that it requires regular (not necessarily constant) supervision by another person. This person could be a family member, home nurse, or nursing home facility. Hospitalization does NOT qualify as aid and attendance. If a condition qualifies for aid and attendance, it is not rated at all on the VASRD, but is rated entirely on the Aid and Attendance section below.
– Permanently bedridden means that the condition is so severe that the individual cannot get out of bed. This does not include periods of bed rest prescribed by a physician since the individual could still actually get out of bed. If an individual is permanently bedridden, then they qualify for rating as Aid and Attendance, but unlike Aid and Attendance, the rating continues even if they are hospitalized.

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Categories L through O

A few guidelines before jumping into the categories:

1.) Only one Special Monthly Compensation rating can be given for Categories L through O. Category L is the lowest Special Monthly Compensation, and Category O is the highest. Pick the highest category that best fits the conditions. (Remember to check Category K, below, because even if your condition doesn’t qualify under Categories L through O, you might still qualify under K. Category K also gives ADDITIONAL money for conditions that qualify under L through O, so make sure to check it out.)

2.) Once the proper category is determined, if there are additional conditions rated by the VA that are not taken into consideration under that category that are equal to a 50% rating without the conditions already listed in the category, then the category is moved up to the next ½ category. For example, let’s say an individual has both feet amputated (100% rating), arthritis in the wrist (30%), and asthma (30%). The amputated feet qualify for Special Monthly Compensation under Category L. The arthritis and asthma do not qualify for Special Monthly Compensation, but since together they equal a 50% rating (see the VA Math section to make sure you are adding the ratings together correctly—a 30% rating and a 30% rating equal a 50% rating, not a 60%), the Category L for the feet is pushed up to a Category L ½ (an L ½ would move up to M, etc.). The highest category for this principle is Category O. Nothing can be pushed up higher than O, so if it already qualifies for a Category O, then it cannot be raised further.

3.) Instead of a 50% rating, if the non-Special Monthly Compensation conditions together equal a 100% rating, then the category is moved up an entire step instead of a ½ step. So, if the arthritis and asthma equaled a 100% rating together, the Category L would move up to a Category M (or L ½ to M ½, etc.). Again, the highest category for this principle is Category O.

4.) If the conditions that qualify for Special Monthly Compensation are caused by a disease, then that disease cannot count as the 50% or 100% rating to increase the Special Monthly Compensation category.

5.) If three extremities (two legs and one arm, or one leg and two arms) qualify for Special Monthly Compensation, then the category for only two extremities is raised to the next ½ category. So, if a veteran has both feet amputated (Category L) and one hand amputation, then it would be rated under Category L ½.

6.) If separate conditions qualify for ratings under two or more different categories between L and N ½, then only one Special Monthly Compensation is given under Category O. A single condition can only be used to qualify under ONE category. For example, let’s say that a veteran has both feet (below the knee) amputated, Category L, and both hands (below the elbow) amputated, Category M. There isn’t a category that lists amputation of all four extremities (if it did, it would have to be rated there instead of Category O), so since these conditions qualify under two different categories, one Special Monthly Compensation is given under Category O.

One last thing to know: If it says “amputation of the knee”, it doesn’t necessarily mean that knee itself has to be removed. Basically, the requirement is that the amputation is at such a place that the use of the knee is impossible. So, technically, the leg could be amputated below the knee, but as long as the knee cannot be used at all, it qualifies as “amputation of the knee”. This goes for any joint.

On to the categories.

Category L:

The following conditions qualify for a rating under Category L:

Amputation of both feet (below the knee)
Loss of use of both feet (below the knee)
Amputation of one foot (below the knee) and the loss of use of the other foot
Amputation of one hand (below the elbow) and one foot (below the knee)
Loss of use of one hand (below the elbow) and one foot (below the knee)
Amputation of one foot (below the knee) and the loss of use of one hand
Amputation of one hand (below the elbow) and the loss of use of one foot
Blindness in both eyes
Permanently bedridden
In regular need of another person to help dress, clean, feed himself, and use the restroom (aid and attendance)

Category L ½:

The following conditions qualify for a rating under Category L ½:

Amputation of one foot and amputation of the other knee
Loss of use of one foot and amputation of the other knee
Amputation of one foot and loss of use of the other knee
Loss of use of one foot and loss of use of the other knee
Amputation of one foot and amputation of one elbow
Amputation of one foot and loss of use of one elbow
Loss of use of one foot and amputation of one elbow
Loss of use of one foot and loss of use of one elbow
Amputation of one knee and amputation of one hand
Amputation of one knee and loss of use of one hand
Loss of use of one knee and amputation of one hand
Loss of use of one knee and loss of use of one hand
Blindness in one eye and total blindness in the other eye with only the ability to perceive light
Blindness in both eyes and loss of use of one foot (rated by the VASRD less than 50%)

Category M:

The following conditions qualify for a rating under Category M:

Amputation of both hands (below the elbow)
Loss of use of both hands
Amputation of one hand (below the elbow) and the loss of use of one hand
Amputation of both knees
Loss of use of both knees
Amputation of one elbow and one knee
Loss of use of one elbow and one knee
Amputation of one foot and amputation of one leg so close to the hip that it is impossible to wear a prosthesis
Loss of use of one foot and amputation of one leg so close to the hip that it is impossible to wear a prosthesis
Amputation of one foot and amputation of one arm so close to the shoulder that it is impossible to wear a prosthesis
Loss of use of one foot and amputation of one arm so close to the shoulder that it is impossible to wear a prosthesis
Amputation of one foot and loss of use of one arm at the shoulder
Loss of use of one foot and loss of use of one arm at the shoulder
Amputation of one hand and amputation of one leg so close to the hip that it is impossible to wear a prosthesis
Loss of use of one hand and amputation of one leg so close to the hip that it is impossible to wear a prosthesis
Total blindness in both eyes with only the ability to perceive light
Blindness in both eyes that requires the veteran to have someone help with his basic needs (eating, using the restroom, dressing, etc.)
Blindness in one eye and the physical loss of the other eye
Blindness in one eye and total blindness without the ability to perceive light in the other eye
Blindness in one eye and total blindness in the other eye with only the ability to perceive light and total deafness in one ear
Blindness in both eyes and deafness in both ears (rated by the VASRD 30% or more)
Blindness in both eyes and amputation of one hand
Blindness in both eyes and loss of use of one hand
Blindness in both eyes and amputation of one foot
Blindness in both eyes and loss of use of one foot (rated by the VASRD at 50% or more)
Blindness in one eye and total blindness in the other eye with only the ability to perceive light and the loss of use of one foot (rated by the VASRD at less than 50%)

Category M ½:

The following conditions qualify for a rating under Category M ½:

Amputation of one knee and amputation of one leg so close to the hip that it is impossible to wear a prosthesis
Loss of use of one knee and amputation of one leg so close to the hip that it is impossible to wear a prosthesis
Amputation of one knee and amputation of one arm so close to the shoulder that it is impossible to wear a prosthesis
Loss of use of one knee and amputation of one arm so close to the shoulder that it is impossible to wear a prosthesis
Amputation of one elbow and amputation of one leg so close to the hip that it is impossible to wear a prosthesis
Loss of use of one elbow and amputation of one leg so close to the hip that it is impossible to wear a prosthesis
Amputation of one hand and amputation of one elbow
Amputation of one hand and loss of use of one elbow
Loss of use of one hand and amputation of one elbow
Loss of use of one hand and loss of use of one elbow
Total blindness with only the ability to perceive light in one eye and the physical loss of the other eye
Total blindness with only the ability to perceive light in one eye and total blindness without the ability to perceive light in the other eye
Blindness in both eyes and total deafness in one ear
Blindness in one eye and the physical loss of the other eye and total deafness in one ear
Blindness in one eye and total blindness without the ability to perceive light in the other eye and total deafness in one ear
Blindness in one eye and total blindness in the other eye with only the ability to perceive light and deafness in both ears (rated by the VASRD 30% or more)
Total blindness in both eyes with only the ability to perceive light and the loss of use of one foot (rated by the VASRD less than 50%)
Blindness in both eyes that requires the veteran to have someone help with his basic needs and the loss of use of one foot (rated by the VASRD less than 50%)
Blindness in one eye and total blindness in the other eye with only the ability to perceive light and the amputation of one foot
Blindness in one eye and total blindness in the other eye with only the ability to perceive light and the loss of use of one foot (rated by the VASRD at 50% or more)
Blindness in one eye and total blindness in the other eye with only the ability to perceive light and the amputation of one hand
Blindness in one eye and total blindness in the other eye with the only ability to perceive light and the loss of use of one hand

Category N:

The following conditions qualify for a rating under Category N:

Amputation of both elbows
Loss of use of both elbows
Amputation of both legs so close to the hip that it is impossible to wear a prosthesis
Amputation of one arm and one leg so close to the shoulder or hip that it is impossible to wear a prosthesis on either
Amputation of one hand and amputation of one arm so close to the shoulder that it is impossible to wear a prosthesis
Loss of use of one hand and amputation of one arm so close to the shoulder that it is impossible to wear a prosthesis
Physical loss of both eyes
Total blindness without the ability to see light
Total blindness with only the ability to perceive light in one eye and the physical loss of the other eye and deafness in both ears (rated at 10 or 20% by the VASRD)
Total blindness with only the ability to perceive light in one eye and total blindness without the ability to perceive light in the other eye and deafness in both ears (rated at 10 or 20% by the VASRD)
Total blindness in both eyes with only the ability to perceive light and deafness in both ears (rated by the VASRD 30% or more)
Blindness in both eyes to such a degree that the veteran has to have someone help with his basic needs and deafness in both ears (rated by the VASRD 30% or more)
Blindness in one eye and the physical loss of the other eye and deafness in both ears (rated by the VASRD 30% or more)
Blindness in one eye and total blindness without the ability to perceive light in the other eye and deafness in both ears (rated by the VASRD 30% or more)
Total blindness in both eyes with only the ability to perceive light and the amputation of one hand
Total blindness in both eyes with only the ability to perceive light and the loss of use of one hand
Blindness in both eyes that requires the veteran to have someone help with his basic needs and the amputation of one hand
Blindness in both eyes that requires the veteran to have someone help with his basic needs and the loss of use of one hand
Total blindness in both eyes with only the ability to perceive light and the amputation of one foot
Total blindness in both eyes with only the ability to perceive light and the loss of use of one foot (rated by the VASRD 50% or more)
Blindness in both eyes that requires the veteran to have someone help with his basic needs and the amputation of one foot
Blindness in both eyes that requires the veteran to have someone help with his basic needs and the loss of use of one foot (rated by the VASRD 50% or more)
Total blindness with only the ability to perceive light in one eye and the physical loss of the other eye and the loss of use of one foot (rated by the VASRD at less than 50%)
Total blindness with only the ability to perceive light in one eye and total blindness without the ability to perceive light in the other eye and the loss of use of one foot (rated by the VASRD at less than 50%)

Category N ½:

The following conditions qualify for a rating under Category N ½:

Amputation of one elbow and amputation of one arm so close to the shoulder that it is impossible to wear a prosthesis
Loss of use of one elbow and amputation of one arm so close to the shoulder that it is impossible to wear a prosthesis
Total blindness with only the ability to perceive light in one eye and the physical loss of the other eye and deafness in both ears (rated by the VASRD 30% or more)
Total blindness with only the ability to perceive light in one eye and total blindness without the ability to perceive light in the other eye and deafness in both ears (rated by the VASRD 30% or more)
Physical loss of both eyes and the loss of use of one foot (rated by the VASRD less than 50%)
Total blindness without the ability to see light and the loss of use of one foot (rated by the VASRD less than 50%)
Total blindness with only the ability to perceive light in one eye and the physical loss of the other eye and the amputation of one foot
Total blindness with only the ability to perceive light in one eye and the physical loss of the other eye and the loss of use of one foot (rated by the VASRD at 50% or more)
Total blindness with only the ability to perceive light in one eye and total blindness without the ability to perceive light in the other eye and the amputation of one foot
Total blindness with only the ability to perceive light in one eye and total blindness without the ability to perceive light in the other eye and the loss of use of one foot (rated by the VASRD at 50% or more)
Total blindness with only the ability to perceive light in one eye and the physical loss of the other eye and the amputation of one hand
Total blindness with only the ability to perceive light in one eye and the physical loss of the other eye and the loss of use of one hand
Total blindness with only the ability to perceive light in one eye and total blindness without the ability to perceive light in the other eye and the amputation of one hand
Total blindness with only the ability to perceive light in one eye and total blindness without the ability to perceive light in the other eye and the loss of use of one hand

Category O:

The following conditions qualify for a rating under Category O:

Amputation of both arms so close to the shoulder that it is impossible to wear a prosthesis
Hearing loss in both ears (only one ear has to be caused by military service) that is rated 60% or more by the VASRD, and blindness in both eyes
Hearing loss in both ears (only one ear has to be caused by military service) that is rated 40% or more, and blindness in both eyes with only the ability to perceive light
Total deafness in one ear, and blindness in both eyes with only the ability to perceive light
Complete paralysis of both legs with the inability to control urination and defecation
Physical loss of both eyes and deafness in both ears (rated by the VASRD 30% or more)
Total blindness without the ability to see light and deafness in both ears (rated by the VASRD 30% or more)
Physical loss of both eyes and the amputation of one foot
Physical loss of both eyes and the loss of use of one foot (rated by the VASRD 50% or more)
Total blindness without the ability to see light and the amputation of one foot
Total blindness without the ability to see light and the loss of use of one foot (rated by the VASRD 50% or more)
Physical loss of both eyes and the amputation of one hand
Physical loss of both eyes and the loss of use of one hand
Total blindness without the ability to see light and the amputation of one hand
Total blindness without the ability to see light and the loss of use of one hand

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Housebound Benefits (Category S)

Special Monthly Compensation under Category S is given if the veteran has at least one condition rated 100% and one or both of the following:

The veteran is completely and permanently housebound becuase of his service-connected conditions, meaning that the veteran cannot leave his area of abode (this can include his own home, a hospital ward, or a care facility) at all, and this is expected to be the case for the rest of his life.

-OR-

The veteran has another condition rated 60% that is unrelated to the 100% condition (They affect different body system, or are a different type of disability, etc. For example, they can’t both affect the arm.)

This Special Monthly Compensation is given INSTEAD of Special Monthly Compensation under Categories L through O.

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Even More Money (Category K)

Category K gives extra Special Monthly Compensation based solely on the loss of (amputation or removal) or loss of use of a body part or function. This is in addition to:

– Regular VA Disability compensation, even if you do not qualify for any other type of Special Monthly Compensation. The total amount of compensation received, however, cannot be more than the amount of compensation given for Category L.
– Special Monthly Compensation under Categories L through N 1/2, as long as it doesn’t add up to be more than the amount given under Category O. Category O is the top limit for these categories.
– Category S
– Category R, but only if the condition that qualifies for Category K is not the same condition that qualifies for Category R. If Category K is added to Category R, the total Special Monthly Compensation cannot be more than the highest amount given for Category R1.

Category K can be given even if the condition does not qualify for any other Special Monthly Compensation. A single amount is given for EACH body part that is lost or cannot function, so in theory, you could add up as many Category K amounts as you have qualifying conditions as long as the total Special Monthly Compensation does not exceed the limits noted above.

The following body parts can be rated under this category:

Amputation of a hand
Amputation of a foot
Loss of use of a hand
Loss of use of a foot
Physical loss of one eye
Total blindness in one eye to such a degree that the individual only has the ability to perceive light or less
Physical loss of a creative organ, including ovaries, uterus, testicles, etc. If the loss of the creative organ was caused by an operation that was not performed by the DoD or VA or a referred physician, it does not qualify for rating unless the surgery was performed to correct a service-connected condition. For one testicle to qualify it must be one of the following: 1.) 1/3 the size of the other testicle, 2.) ½ or less the size of the other testicle and significantly harder or softer than the other, or 3.) tests prove that it is no longer producing sperm.
Loss of use of a creative organ
Inability to speak without the help of a prosthesis because of damage to the muscles or nerves that control the voice
Complete deafness in both ears (must be both in this case, not just one). The VA rating for this condition must be 100% to qualify.
Loss of use of BOTH buttocks (For “loss of use” in this case, the veteran must be unable to rise to his feet and remained balanced without using his arms or assistance, and the condition is rated at least 50% under VASRD code 5317.)
Loss of 25% or more of breast tissue in one or both breasts combined, or after radiation treatment to the breast tissues

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Aid and Attendance (Category R)

Category R is given to veterans who qualify for Special Monthly Compensation under Category O, or under Categories N ½ and K together, and who requires the help of another person (aid and attendance) every day. If the veteran's condition does not qualify under these categories, even if aid and attendance is required, he does not qualify for Category R.

Additionally, a veteran only qualifies for Category R if he requires the help of another person every day to perform the following tasks:

– Dressing and undressing
– Cleaning and grooming
– Feeding
– Using the restroom
– Adjusting prosthetic or orthopedic appliances frequently. A veteran only qualifies for this if he is unable to adjust an appliance that most people could adjust on their own. 

Another person does not need to be with the veteran at all times for him to qualify. He just has to be unable to perform the majority of the above activities without help every day.

A veteran can also qualify if:

– His disability, physical or mental, requires that another person regularly care for him to keep him from harming himself or others, intentionally or accidentally.
– He is bedridden. This means that his condition is severe enough that it requires him to always be in bed. He does not qualify if he chooses to remain in bed or if a physician prescribes him to a period of bed rest. It is also not enough for the veteran to just have to be in bed. To qualify for this special monthly compensation, he must also need the regular aid and attendance of another person.

Category R compensation is NOT given if the individual is hospitalized or in a care institution, only if they are being cared for at home. This is becuase the VA will already be covering the costs of hospitalization if a veteran is hospitalized for a service-connected condition. When the veteran is not hospitalized, however, this extra compensation helps support their need for daily care.

Note: There are two different things that the VA refers to as "Aid and Attendance." Please note that the Aid and Attendance discussed here is only for veterans with service-connected disabilities. The VA also gives Aid and Attendance to veterans who receive pensions. That Aid and Attendance is similar, but does have significant differences than the one described here.

Additional Category K Special Monthly Compensation can be given, but ONLY if it is based on a different condition than the one that qualifies him for Category R. For example, if the veteran has extremely severe dementia that qualifies him for aid and attendance under Category R, and he had one leg amputated, then the amputated leg does qualify for additional Special Monthly Compensation under Category K since it was not needed to qualify him for Category R.

There are two different levels under Category R: Category R1 and Category R2.

Category R1: For this category, the veteran must have to have someone helping him every day to perform the above tasks, but that person does not have to be a professional. They can be a family member, friend, etc.

Category R2: For this category, the person helping the veteran must be a licensed medical professional or someone working on behalf of a licensed medical professional. In addition, the VA must judge that the veteran would have to be hospitalized, put in a nursing home, or otherwise institutionalized if he did not have this professional-level care at home.

Note: The amounts shown in the Special Monthly Compensation Rates table for Categories R1 and R2 are the total amount the veteran receives each month if he qualifies for Category R. He does not also receive standard disability compensation or compensation for other categories (except Category K).

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Category Q

Category Q was repealed quite a while ago and is no longer being given to veterans.

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Rating the Appropriate Category

It is important to understand how all these categories work together.

A condition can only be categorized under ONE of the categories between L and O.

If a condition qualifies under Category S, then it is categorized just under S, and not under Categories L through O.

Category K can be given in addition to any category except Category R unless the condition that qualifies for Category K is not used to qualify for Category R. You can’t use the same condition to qualify for both Category K and Category R.

Category R is unique. It completely replaces any other rating for any condition. If you qualify for Category R, then you will only receive compensation for that category, and won’t receive any other disability pay from the VA, including the normal VASRD disability rating pay. The only thing you can receive in addition to Category R is Category K for entirely separate conditions.

That’s the entire Special Monthly Compensation system. Again, once you know what category you fall under, you can find the exact amount you should be receiving on our Special Monthly Compensation Rates page.

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