Aid and Attendance is widely assumed to belong to surviving spouses and low income pension cases. The compensation side version is the one veterans miss: under 38 CFR 3.350, a veteran whose service connected conditions require another person's daily help, or who meets the housebound criteria, can be paid above the 100 percent rate through SMC, with no income test involved.
Two programs, one shared name
The phrases Aid and Attendance and Housebound appear in two different VA systems, and the veteran's own compensation side is often overlooked:
- On the disability compensation side, these are forms of Special Monthly Compensation (SMC) under 38 CFR 3.350.
- On the pension side (for low-income wartime veterans), they are increased pension amounts under 38 CFR 3.351.
Housebound (SMC-S)
A veteran qualifies for SMC-S (housebound) when they have a single service connected disability rated 100 percent and either:
- additional service connected disabilities that independently combine to 60 percent or more, or
- are substantially confined to the home or immediate premises because of service connected disability.
SMC-S pays more than the standard 100 percent rate.
Aid and Attendance (SMC-L and above)
A veteran qualifies for Aid and Attendance when service connected disabilities make them need the regular aid of another person for everyday functions, such as bathing, dressing, eating, managing medication, or protecting themselves from daily hazards. This raises compensation to SMC-L or a higher level, depending on the losses involved. Being bedridden or a patient in a nursing home because of disability are common qualifying facts.
Why it is missed
Many veterans assume Aid and Attendance is only for surviving spouses or for pension. The compensation-side SMC versions can substantially increase a veteran's own monthly pay and are frequently overlooked, especially as service connected conditions worsen with age.
How to raise it
- A statement from a physician (often VA Form 21-2680) describing the need for aid and attendance or housebound status is the central piece of evidence.
- Ask VA to consider SMC whenever a service connected condition reaches the 100 percent level or you begin needing daily help.
Regulatory basis
- 38 CFR 3.350, Special monthly compensation ratings (compensation side)
- 38 CFR 3.351, Aid and attendance and housebound criteria (pension side)
Related on this site
- TDIU: Total Disability Based on Individual Unemployability, Explained
- Permanent and Total (P&T) Education
- Individual Unemployability (IU/TDIU)
Common questions
Is Aid and Attendance only for surviving spouses?
No. The same phrases appear in two VA systems. On the pension side they raise a low income survivor's or veteran's pension, but on the compensation side they are forms of Special Monthly Compensation under 38 CFR 3.350 that increase a disabled veteran's own monthly pay. The compensation side versions are the ones most often overlooked.
What is SMC-S, the housebound rate?
A veteran qualifies for SMC-S with a single service connected disability rated 100 percent plus additional service connected disabilities that independently combine to 60 percent or more, or by being substantially confined to the home because of service connected disability. SMC-S pays more than the standard 100 percent rate.
When does a veteran qualify for Aid and Attendance compensation?
When service connected disabilities create a need for the regular aid of another person with everyday functions such as bathing, dressing, eating, managing medication, or protection from daily hazards. That raises compensation to SMC-L or a higher level. Being bedridden or a nursing home patient because of disability are common qualifying facts.
How do I raise SMC with VA?
A physician's statement describing the need, often on VA Form 21-2680, is the central piece of evidence. Ask VA to consider SMC whenever a service connected condition reaches the 100 percent level or you begin needing daily help.