--- title: "Part VIII, Subpart iv, Chapter 4, Section B History of Special Monthly Compensation (SMC)" document: "M-21-1" section: "Part VIII, Subpart iv, Chapter 4, Section B" canonical: "https://veteranai.co/va-regulations/m21-1/viii.iv.4.b-history-of-special-monthly-compensation-smc" source: "https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000177481/M21-1-Part-VIII-Subpart-iv-Chapter-4-Section-B-History-of-Special-Monthly-Compensation-SMC" updated: "2026-09-07T14:37:39.990180Z" --- May 12, 2015 ### VIII.iv.4.B.1.a. Purpose of This Section This section has been designed for use by the rating activity when reviewing prior rating decisions for accuracy in the awarding of special monthly compensation (SMC).Prior rating decisions addressing the issue of entitlement to SMC may appear to be erroneous based upon current criteria, when, in fact, they were totally correct based upon the criteria in effect at the time of the prior rating decision. ### VIII.iv.4.B.1.b. Content of This Section This section * contains only an overview of the history of SMC, not all of the historical aspects involving the payment of SMC * provides a breakdown for each of the levels of SMC, and * does not address the limited number of cases in which the criteria for SMC that were in effect before July 1, 1933, would be at issue. **Note:** Where appropriate, cross-references have been made to other levels of SMC where there are, or were, restrictions in the simultaneous payment of SMC at one or more levels. ### VIII.iv.4.B.1.c. Compensation Service Assistance in Resolving Difficult SMC Cases If there is any question as to which level of SMC is appropriate in a given case, submit the claims folder to Compensation Service for an advisory opinion._**Reference**_ : For more information on requesting advisory opinions, see [M21-1, Part X, Subpart v, 1.A](). ### VIII.iv.4.B.1.d. Overview of the History of SMC Changes From July 1, 1933, PL 73-2, to the Present The table below describes the history of changes affecting the payment of SMC since the enactment of _Public Law (PL) 73-2_ , on July 1, 1933, to the present.**Important:** Prior to July 1, 1933, SMC at various levels was payable under the provisions of the _World War Veterans’ Act of 1924_.**Legend:** * The letters K through T indicate subsections of [38 U.S.C. 1114](). * IA indicates the initial authority for the subsection. * A indicates that the subsection was amended. * D indicates that the subsection was deleted. * C-R indicates that the subsection was changed and the change involves restriction of payment. | **Public Law**| **Effective Date**| **K**| **L**| **M**| **N**| **O**| **P**| **Q**| **R**| **S**| **T** _PL 73-2_| 07/01/1933| IA| IA| IA| IA| IA| | | | | _PL 79-182_| 10/01/1945| A| A| A| A| A| IA| | | | _PL 82-427_| 08/01/1952| A| | | | | | IA| | | _PL 84-969_| 10/01/1956| A| | | | | | | | | _PL 85-652_| 09/01/1958| | | A| | | | | | | _PL 85-782_| 10/01/1958| | | | | C-R| C-R| | IA| | _PL 86-663_| 09/01/1960| C-R| | | | | | | | IA| _PL 88-20_| 07/011963| A| | | | | | | | | _PL 88-22_| 07/01/1963| A| | | | | | | | | _PL 89-311_| 12/01/1965| | | | | A| A| | | | _PL 90-77_| 10/01/1967| C-R| | | | | C-R| | | C-R| _PL 90-493_| 08/19/1968| | | | | | | D| | | _PL 95-479_| 10/01/1978| | | | | | A| | A| | IA _PL 96-128_| 10/01/1979| | | | | | | | A| | _PL 97-66_| 10/01/1981| | A| A| A| A| A| | | | _PL 97-306_| 10/01/1982| | | | A| | A| | | | _PL 98-223_| 10/01/1983| | | | | A| A| | | | _PL 99-576_| 10/28/1986| | | | | | | | | | D _PL 106-419_| 11/01/2000| A| | | | | | | | | _PL 107-330_| 12/06/2002| A| | | | | | | | | _PL 110-157_| 12/26/2007| | | | | A| | | | | _PL 111-275_| 10/01/2011| | | | | | | | | | A ## 2. SMC Under 38 U.S.C. 1114(k) This topic contains information on SMC under 38 U.S.C. 1114(k), including information on SMC under * _PL 73-2_ * _PL 79-182_ * _PL 82-427_ * _PL 84-969_ * _PL 86-663_ * _PL 88-20_ * _PL 88-22_ * _PL 90-77_ * _PL 106-419_, and * _PL 107-330_. December 13, 2005 ### VIII.iv.4.B.2.a. SMC Under PL 73-2 _PL 73-2_ , effective July 1, 1933, provided for payment of SMC for the anatomical loss or loss of use (L/LOU) of only * one foot * one hand, or * one eye. **Notes:** SMC under [38 U.S.C. 1114(k)]() was * payable in addition to the basic rate of compensation payable for disability ratings of 10 percent through 100 percent * payable for only one disability meeting the criteria under [38 U.S.C. 1114(k)](), even though multiple disabilities meeting the criteria may have existed, and * ** _not_** payable in addition to SMC under [38 U.S.C. 1114(l)]() through [38 U.S.C. 1114(n)](). **Example:** A Veteran with loss of one foot, plus the loss of one eye, would have been entitled to compensation based on the disability evaluation assigned, plus SMC under [38 U.S.C. 1114(k)]() for _either_ loss of the foot _or_ loss of the eye, but not both. ### VIII.iv.4.B.2.b. SMC Under PL 79-182 _PL 79-182_ , effective October 1, 1945 * clarified the standard for blindness of one eye as having light perception only (LPO), and * provided for the payment of SMC under [38 U.S.C. 1114(k)](), in addition to SMC under [38 U.S.C. 1114(l) through (n)](), for each L/LOU under [38 U.S.C. 1114(k)](). **Note:** The prohibition against the payment of SMC for more than one disability meeting the criteria under [38 U.S.C. 1114(k)]() was continued. ### VIII.iv.4.B.2.c. SMC Under PL 82-427 _PL 82-427_ , effective August 1, 1952, provided for the payment of SMC under [38 U.S.C. 1114(k)]() for anatomical L/LOU of a creative organ. ### VIII.iv.4.B.2.d. SMC Under PL 84-969 _PL 84-969_ , effective October 1, 1956, provided for the payment of SMC under [38 U.S.C. 1114(k)]() for anatomical L/LOU of both buttocks. ### VIII.iv.4.B.2.e. SMC Under PL 86-663 _PL 86-663_ , effective September 1, 1960, created a new level of SMC under [38 U.S.C. 1114(s)](). SMC under [38 U.S.C. 1114(k)]() was not payable in addition to SMC under [38 U.S.C. 1114(s)]().**Note:** If the additional 60-percent disability establishing entitlement at the “s” level included entitlement under [38 U.S.C. 1114(k)](), payment was to be made at the 100 percent + “k” level, as this was a greater benefit than the 100 percent + “s” level. ### VIII.iv.4.B.2.f. SMC Under PL 88-20 _PL 88-20_ , effective July 1, 1963, provided for the payment of SMC under [38 U.S.C. 1114(k)]() for deafness in both ears, with absence of air and bone conduction. ### VIII.iv.4.B.2.g. SMC Under PL 88-22 _PL 88-22_ , effective July 1, 1963, provided for the payment of SMC under [38 U.S.C. 1114(k)]() for organic aphonia with constant inability to communicate by speech. ### VIII.iv.4.B.2.h. SMC Under PL 90-77 _PL 90-77_ , effective October 1, 1967 * provided for the payment of SMC * for each disability that met the criteria under [38 U.S.C. 1114(k)](), and * under both [38 U.S.C. 1114(s)]() and [38 U.S.C. 1114(k)](), and * removed the prohibition against using an additional disability, ratable as 50 percent disabling, to justify awarding an intermediate rate under [38 U.S.C. 1114(p)](), when the same disability had been used as the basis for establishing entitlement to SMC under [38 U.S.C. 1114(k)](). **References:** For more information on awarding entitlement to SMC * based on anatomical loss, see _PL 79-182_ , and * for additional disabilities, see _PL 86-663_. ### VIII.iv.4.B.2.i. SMC Under PL 106-419 _PL 106-419_ , effective November 1, 2000, amended the criteria for payment to include a woman Veteran’s anatomical loss of one or both breasts, including loss by mastectomy. ### VIII.iv.4.B.2.j. SMC Under PL 107-330 _PL 107-330_ , effective December 6, 2002, clarified that loss of one or both breasts includes * loss of 25 percent or more of breast tissue from a single breast or both breasts in combination, and * receipt of radiation treatment of breast tissue. ## 3. SMC Under 38 U.S.C. 1114(l) This topic contains information on SMC under 38 U.S.C. 1114(l), including information on SMC under * _PL 73-2_ * _PL 79-182_, and * _PL 97-66_. December 13, 2005 ### VIII.iv.4.B.3.a. SMC Under PL 73-2 _PL 73-2_ , effective July 1, 1933, provided for the payment of SMC under [38 U.S.C. 1114(l)]() for * the anatomical L/LOU of * both hands or both feet, or * one hand and one foot, or * being so helpless as to be in need of regular aid and attendance (A&A). **Note:** Since _PL 73-2_ did not provide for the payment of intermediate levels of SMC, the level of L/LOU had no effect on the level of SMC payable.**Example:** Amputation of one arm above the elbow and amputation below the elbow of the other arm would establish entitlement to SMC under [38 U.S.C. 1114(l)](). ### VIII.iv.4.B.3.b. SMC Under PL 79-182 _PL 79-182_ , effective October 1, 1945, provided for the payment of SMC under [38 U.S.C. 1114(l)]() if the Veteran was * blind in both eyes, with visual acuity of 5/200 (1.5/60) or less, or * permanently bedridden. **Notes:** * Concentric contraction of the field of vision beyond 10 degrees was considered equivalent to visual acuity of 5/200 (1.5/60) until July 6, 1950, the effective date of a change to the 1945 rating schedule. Under the revised rating schedule, concentric contraction of the field of vision beyond five degrees was considered equivalent to visual acuity of 5/200 (1.5/60). * _PL 79-182_ provided for payment of SMC at intermediate levels. **Reference:** For more information on payment of SMC at intermediate levels, see * [38 U.S.C. 1114(p)](), and * M21-1, Part VIII, Subpart iv, 4.B.7. ### VIII.iv.4.B.3.c. SMC Under PL 97-66 _PL 97-66_ , effective October 1, 1981, removed L/LOU of both hands as a condition warranting entitlement to SMC under [38 U.S.C. 1114(l)](). **Rationale:** Effective October 1, 1981, the L/LOU of both hands became one of the criteria for entitlement to SMC under [38 U.S.C. 1114(m)](). **Reference:** For more information on [38 U.S.C. 1114(m)](), see M21-1, Part VIII, Subpart iv, 4.B.4. ## 4. SMC Under 38 U.S.C. 1114(m) This topic contains information on SMC under 38 U.S.C. 1114(m), including information on SMC under * _PL 73-2_ * _PL 79-182_ * _PL 85-652_, and * _PL 97-66_. December 13, 2005 ### VIII.iv.4.B.4.a. SMC Under PL 73-2 _PL 73-2_ , effective July 1, 1933, established the criteria for payment of [38 U.S.C. 1114(m)]() as * the L/LOU of three extremities, or * blindness in both eyes, having LPO. ### VIII.iv.4.B.4.b. SMC Under PL 79-182 _PL 79-182_ , effective October 1, 1945, provided for payment of SMC under [38 U.S.C. 1114(m)]() if the evidence showed * L/LOU of two extremities at a level, or with complications, preventing natural elbow or knee action with prosthesis in place, or * blindness in both eyes, leaving the Veteran so helpless as to require A&A. ### VIII.iv.4.B.4.c. SMC Under PL 85-652 _PL 85-652_ , effective September 1, 1958, reinstated blindness in both eyes, having LPO, as a condition warranting entitlement to SMC under [38 U.S.C. 1114(m)](). ### VIII.iv.4.B.4.d. SMC Under PL 97-66 _PL 97-66_ , effective October 1, 1981, elevated the level of SMC for * L/LOU of both hands from [38 U.S.C. 1114(l)]() to [38 U.S.C. 1114(m)](), and * L/LOU of both arms at levels, or with complications, preventing natural elbow action with prosthesis in place from [38 U.S.C. 1114(m)]() to [38 U.S.C. 1114(n)](). ## 5. SMC Under 38 U.S.C. 1114(n) This topic contains information on SMC under 38 U.S.C. 1114(n), including information on SMC under * _PL 73-2_ * _PL 79-182_ * _PL 97-66_, and * _PL 97-306_. December 13, 2005 ### VIII.iv.4.B.5.a. SMC Under PL 73-2 _PL 73-2_ , effective July 1, 1933, provided for payment of SMC under [38 U.S.C. 1114(n)]() for blindness in both eyes, having LPO, **_plus_** the L/LOU of one extremity. ### VIII.iv.4.B.5.b. SMC Under PL 79-182 _PL 79-182_ , effective October 1, 1945, provided for payment of SMC under [38 U.S.C. 1114(n)]() if the evidence showed anatomical loss of * two extremities so near the shoulder or hip as to prevent the use of a prosthetic appliance, or * both eyes, or total blindness of both eyes, having no light perception, accompanied by * phthisis bulbi * evisceration, or * other obvious deformity or disfigurement. ### VIII.iv.4.B.5.c. SMC Under PL 97-66 _PL 97-66_ , effective October 1, 1981, elevated the level of SMC for * L/LOU of both arms at levels, or with complications, preventing natural elbow action with a prosthesis in place from [38 U.S.C. 1114(m)]() to [38 U.S.C. 1114(n)](), and * anatomical loss of both arms so near the shoulder as to prevent the use of a prosthetic appliance from [38 U.S.C. 1114(n)]() to [38 U.S.C. 1114(o)](). ### VIII.iv.4.B.5.d. SMC Under PL 97-306 _PL 97-306_ , effective October 1, 1982 * added blindness without light perception in both eyes as a condition warranting entitlement to SMC, and * removed the requirement that blindness must be accompanied by * phthisis bulbi * evisceration, or * other obvious deformity or disfigurement. **Reference:** For more information on SMC for anatomical loss or blindness, see _PL 79-182_. ## 6. SMC Under 38 U.S.C. 1114(o) This topic contains information on SMC under 38 U.S.C. 1114(o), including information on SMC under * _PL 73-2_ * _PL 79-182_ * _PL 85-782_ * _PL 89-311_ * _PL 97-66_ * _PL 98-223_, and * _PL 110-157._ September 8, 2009 ### VIII.iv.4.B.6.a. SMC Under PL 73-2 _PL 73-2_ , effective July 1, 1933, established the criterion for payment of SMC under [38 U.S.C. 1114(o)]() for two or more conditions warranting entitlement to SMC under [38 U.S.C. 1114(l) through (n)]().**Important:** No condition could be considered twice. ### VIII.iv.4.B.6.b. SMC Under PL 79-182 _PL 79-182_ , effective October 1, 1945, provided for payment of SMC under [38 U.S.C. 1114(o)]() for * bilateral blindness, with visual acuity of 5/200 (1.5/60) or less, in combination with bilateral total deafness, and/or * transverse myelitis, with loss of use of both legs and loss of anal and bladder control. ### VIII.iv.4.B.6.c. SMC Under PL 85-782 _PL 85-782_ , effective October 1, 1958, created a new level of SMC under [38 U.S.C. 1114(r)]().**References:** For more information on * SMC under [38 U.S.C. 1114(r)](), see M21-1, Part VIII, Subpart iv, 4.B.9, and * determining the maximum rate payable under [38 U.S.C. 1114(p)](), see M21-1, Part VIII, Subpart iv, 4.B.12. ### VIII.iv.4.B.6.d. SMC Under PL 89-311 _PL 89-311_ , effective December 1, 1965, amended the criteria under [38 U.S.C. 1114(o)]() (_PL 85-782_) to read: bilateral deafness, with the hearing impairment in one or both ears service-connected (SC), rated at 60 percent, or more, plus SC total blindness with 5/200 (1.5/60) visual acuity, or less. ### VIII.iv.4.B.6.e. SMC Under PL 97-66 _PL 97-66_ , effective October 1, 1981, elevated the level of SMC for anatomical loss of both arms so near the shoulder as to prevent the use of prosthetic appliances from [38 U.S.C. 1114(n)]() to [38 U.S.C. 1114(o)](). ### VIII.iv.4.B.6.f. SMC Under PL 98-223 _PL 98-223_ , effective October 1, 1983, provided for payment of SMC under [38 U.S.C. 1114(o)]() to include bilateral blindness, having LPO or less, with * SC total deafness in one ear, or * bilateral hearing loss, rated 40 percent or more disabling, with SC hearing impairment in at least one ear. ### VIII.iv.4.B.6.g. SMC Under PL 110-157 _PL 110-157_ , effective December 26, 2007, amended the visual impairment criteria for entitlement under [38 U.S.C. 1114(o)]() to provide for payment of SMC for * total SC blindness with 20/200 visual acuity or less, combined with * bilateral deafness rated at 60 percent or more (and the hearing loss in either ear is SC). ## 7. SMC Under 38 U.S.C. 1114(p) This topic contains information on SMC under 38 U.S.C. 1114(p), including information on SMC under * _PL 79-182_ * _PL 85-782_ * _PL 89-311_ * _PL 90-77_ * _PL 95-479_ * _PL 97-66_ * _PL 97-306 _for bilateral blindness with * L/LOU of one hand or one foot, and * no light perception in one eye, and * _PL 98-22_. September 13, 2018 ### VIII.iv.4.B.7.a. SMC Under PL 79-182 _PL 79-182_ , effective October 1, 1945, established intermediate steps of SMC for a level of disability that exceeded the requirements for entitlement to any of the levels of SMC under [38 U.S.C. 1114(l) through (n)]().The table below lists the criteria set forth in _PL 79-182_ for establishing entitlement to each intermediate step of SMC.| **Intermediate Step**| **Criteria** l½| * L/LOU of * one hand or one foot, and * another extremity at a level or with complications preventing natural elbow or knee action with prosthesis in place, or * blindness of one eye with 5/200 (1.5/60) visual acuity or less, and blindness of the other eye having LPO. m| * the anatomical * L/LOU of one hand or one foot, and * loss of another extremity so near the shoulder or hip as to prevent the use of a prosthetic appliance, or * blindness of one eye, having 5/200 (1.5/60) visual acuity or less, and anatomical loss, or blindness, having no light perception, accompanied by phthisis bulbi, evisceration, or other obvious deformity or disfigurement of the other eye. m½| * the anatomical * L/LOU of one extremity at a level or with complications preventing natural elbow or knee action with prosthesis in place, and * loss of another extremity so near the shoulder or hip as to prevent the use of a prosthetic appliance, or * blindness of one eye, having light perception, and anatomical loss, or blindness, having no light perception accompanied by phthisis bulbi, evisceration, or other obvious deformity or disfigurement of the other eye. additional ½ step| an additional SC disability or combination of disabilities independently rated 50 percent or more disabling.**Note:** Subsequently published regulatory guidance clarified that the 50 percent allowed under _PL 79-182_ refers to a single permanent disability or combination of disabilities. additional full step| an additional SC disability independently rated 100-percent disabling. ### VIII.iv.4.B.7.b. SMC Under PL 85-782 _PL 85-782_ , effective October 10, 1958, established a level of SMC under [38 U.S.C. 1114(r)]().**Note:** One way to establish basic entitlement to SMC under [38 U.S.C. 1114(r)]() was for the Veteran to be entitled to the maximum rate under [38 U.S.C. 1114(p)]().**Reference:** For more information on the history of decisions regarding determination of the maximum rate under [38 U.S.C. 1114(p)](), see M21-1, Part VIII, Subpart iv, 4.B.12. ### VIII.iv.4.B.7.c. SMC Under PL 89-311 _PL 89-311_ , effective December 1, 1965, provided for the payment of SMC under [38 U.S.C. 1114(p)]() to include * blindness plus bilateral deafness, which established entitlement to an additional full step of SMC if the evidence showed * SC blindness with 5/200 (1.5/60) visual acuity, or less, and * bilateral deafness, rated at least 40-percent disabling, with SC hearing impairment in at least one ear, and * blindness plus total deafness in one ear, which established entitlement to an additional half step of SMC if the Veteran had * SC blindness with 5/200 (1.5/60) visual acuity, or less, and * SC total deafness in one ear. ### VIII.iv.4.B.7.d. SMC Under PL 90-77 _PL 90-77_ , effective October 1, 1967 * amended the criterion restricting concurrent payment under [38 U.S.C. 1114(k)]() and [38 U.S.C. 1114(s)](), and * deleted the prohibition against using an additional disability, rated at least 50-percent disabling, to award entitlement to an additional half step of SMC under [38 U.S.C. 1114(p)]() when the same disability had been used to establish entitlement to SMC under [38 U.S.C. 1114(k)](). **Reference:** For more information on [38 U.S.C. 1114(s)](), see M21-1, Part VIII, Subpart iv, 4.B.10. ### VIII.iv.4.B.7.e. SMC Under PL 95-479 _PL 95-479_ , effective October 1, 1978, authorized an additional half step of SMC for L/LOU of three extremities. ### VIII.iv.4.B.7.f. SMC Under PL 97-66 _PL 97-66_ , effective October 1, 1981 * increased by one full step the levels of SMC payable for bilateral L/LOU of both upper extremities, and * established levels of SMC under [38 U.S.C. 1114(p)]() for the varying levels of L/LOU of the upper extremities. The table below lists the criteria set forth in _PL 97-66_ for establishing entitlement to SMC at the three levels shown.| **SMC level**| **Criteria** m½| * L/LOU of one hand, and * L/LOU of one arm at a level, or with complications, preventing natural elbow action with prosthesis in place. **Note:** Level “m½” was previously designated “l½.” n| * L/LOU of one hand, and * loss of one arm so near the shoulder as to prevent the use of a prosthetic appliance. **Note:** Level “n” was previously designated “m.” n½| * L/LOU of one arm at a level or with complications preventing natural elbow action with prosthesis in place, and * loss of one arm so near the shoulder as to prevent the use of a prosthetic appliance. **Note:** Level “n½” was previously designated “m½.” ### VIII.iv.4.B.7.g. SMC Under PL 97-306 for Bilateral Blindness With L/LOU of One Hand or One Foot _PL 97-306_ , effective October 1, 1982, provided for the payment of an additional half step or a full step of SMC for blindness with L/LOU of one hand or one foot.The table below lists the criteria set forth in _PL 97-306_ for establishing entitlement to an additional half or full step of SMC.| **The Veteran is entitled to …**| **If the medical evidence shows …** a full step of SMC| * bilateral blindness, with visual acuity of 5/200 (1.5/60) or less, and * L/LOU of one hand. a full step of SMC| * bilateral blindness, with visual acuity of 5/200 (1.5/60), or less, and * L/LOU of one foot which, by itself, or in combination with another compensable disability, is 50 percent or more disabling. a half step of SMC| * bilateral blindness, with visual acuity of 5/200 (1.5/60) or less, and * L/LOU of one foot, which is * less than 50-percent disabling, and * the only compensable disability, other than bilateral blindness. **Note:** _PL 97-306_ also removed the previous requirement that blindness with no light perception be accompanied by phthisis bulbi, evisceration, or other obvious deformity or disfigurement. **Reference:** For more information on SMC for additional disabilities rated 50-percent and 100-percent disabling, see [M21-1, Part VIII, Subpart iv, 4.A.6](). ### VIII.iv.4.B.7.h. SMC Under PL 97-306 for Bilateral Blindness With No Light Perception in One Eye The Veteran is entitled to increased levels of SMC for bilateral blindness with no light perception in one eye.**Note:** _PL 97-306_ changed the level of SMC that may be awarded for blindness by equating blindness with no light perception to enucleation of the eye.**Example:** The appropriate level of SMC for bilateral blindness with no light perception in one eye may be calculated as follows: * 5/200 (1.5/60) & NLP = “m,” and * LPO & NLP = “m½.” ### VIII.iv.4.B.7.i. SMC Under PL 98-223 _PL 98-223_ , effective October 1, 1983, authorized an additional * full step of SMC for * SC blindness, with visual acuity of 5/200 (1.5/60) or less, in combination with * bilateral deafness, rated at least 30-percent disabling (with SC hearing impairment in one or both ears), and * half step of SMC for * SC blindness, having LPO or less, with * bilateral deafness, rated 10 or 20-percent disabling (with SC hearing impairment in one or both ears). **Notes:** * Prior to enactment of _PL 98-223_ , hearing impairment rated 40-percent disabling was required for entitlement to a full step of SMC. * Veterans with bilateral blindness, having better than LPO in either eye, plus SC total deafness in one ear, remain entitled to an additional half step of SMC. * Veterans with bilateral blindness, having LPO or less, plus SC total deafness in one ear, are entitled to SMC under [38 U.S.C. 1114(o)](). **Reference:** For more information on SMC under [38 U.S.C. 1114(o)](), see M21-1, Part VIII, Subpart iv, 4.B.6. ## 8. SMC Under 38 U.S.C. 1114(q) This topic contains information on SMC under 38 U.S.C. 1114(q), including information on SMC under * _PL 82-427_, and * _PL 90-493_. May 15, 2017 ### VIII.iv.4.B.8.a. SMC Under PL 82-427 _PL 82-427_ , effective August 1, 1952, established a minimum level of SMC for Veterans whose tuberculosis was completely arrested.**Notes:** * The minimum rate of SMC payable under this law was $67.00. * When entitlement to SMC (q) is established based on arrested tuberculosis, the benefit cannot be combined with or added to any other disability compensation. **Reference:** For more information on determining inactivity (complete arrest) of tuberculosis, see [38 CFR 3.375](). ### VIII.iv.4.B.8.b. SMC Under PL 90-493 _PL 90-493_ , effective August 19, 1968, repealed [38 U.S.C. 1114(q)]() except for those Veterans who on August 19, 1968, were receiving or entitled to receive disability compensation for tuberculosis. ## 9. SMC Under 38 U.S.C. 1114(r) This topic contains information on SMC under 38 U.S.C. 1114(r), including information on SMC under * _PL 85-782_ * _PL 95-479_, and * _PL 96-128_. December 13, 2005 ### VIII.iv.4.B.9.a. SMC Under PL 85-782 _PL 85-782_ , effective October 1, 1958, established a new level of SMC under [38 U.S.C. 1114(r)](). Entitlement was awarded if the Veteran was * entitled to the maximum rate under either * [38 U.S.C. 1114(o)](), or * [38 U.S.C. 1114(p)](), and * in need of regular A&A. **Notes:** * Payment of SMC under [38 U.S.C. 1114(r)]() while hospitalized at government expense was prohibited. * If the need for A&A was one of the bases for establishing entitlement under either [38 U.S.C. 1114(o)]() or [38 U.S.C. 1114(p)](), the additional benefit under [38 U.S.C. 1114(r)]() was still payable. ### VIII.iv.4.B.9.b. SMC Under PL 95-479 _PL 95-479_ , effective October 1, 1978 * added a new subsection, [38 U.S.C. 1114(r)(2)]() * redesignated the existing [38 U.S.C. 1114(r)]() as [38 U.S.C. 1114(r)(1)](), and * provided for the payment of SMC under [38 U.S.C. 1114(r)(2)]() if a Veteran in receipt of SMC under [38 U.S.C. 1114(r)(1)]() was entitled to a higher level of care. **Note:** Entitlement under [38 U.S.C. 1114(r)(2)]() while hospitalized at government expense was prohibited. ### VIII.iv.4.B.9.c. SMC Under PL 96-128 _PL 96-128_ , effective October 1, 1979, expanded the field of eligible Veterans under both [38 U.S.C. 1114(r)(1)]() and [38 U.S.C. 1114(r)(2)]() to include Veterans rated 100-percent disabled, who are also entitled to SMC at a level of “n½+k,” and are in need of * regular A&A under [38 U.S.C. 1114(r)(1)](), and * a higher level of care under [38 U.S.C. 1114(r)(2)](). ## 10. SMC Under 38 U.S.C. 1114(s) This topic contains information on SMC under 38 U.S.C. 1114(s), including information on SMC under * _PL 86-663_, and * _PL 90-77_. December 13, 2005 ### VIII.iv.4.B.10.a. SMC Under PL 86-663 _PL 86-663_ , effective September 1, 1960, established a new level of SMC under [38 U.S.C. 1114(s)](). Entitlement existed if the Veteran had an SC disability rated 100-percent disabling and * an additional SC disability or disabilities, independently ratable as 60 percent or more disabling, or * was permanently housebound by reason of the SC disability or disabilities. **Notes:** * If the Veteran was entitled to SMC under [38 U.S.C. 1114(k)]() by virtue of the disability ratable as 60-percent disabling, the Veteran was to be paid basic disability compensation for the disability considered 100-percent disabling plus SMC under [38 U.S.C. 1114(k)](), since the combined rate was a greater benefit than paying basic disability compensation for the disability rated 100-percent disabling plus SMC under [38 U.S.C. 1114(s)](). * SMC under [38 U.S.C. 1114(k)]() was not payable in addition to SMC under [38 U.S.C. 1114(s)](). ### VIII.iv.4.B.10.b. SMC Under PL 90-77 _PL 90-77_ , effective October 1, 1967, allowed for the payment of SMC under [38 U.S.C. 1114(k)]() in addition to SMC under [38 U.S.C. 1114(s)](). ## 11. SMC Under 38 U.S.C. 1114(t) This topic contains information on SMC under 38 U.S.C. 1114(t), including information on SMC under * _PL 95-479_ * _PL 99-576_, and * _PL 111-275_. May 12, 2015 ### VIII.iv.4.B.11.a. SMC Under PL 95-479 _PL 95-479_ , effective October 1, 1978, established a new level of SMC under [38 U.S.C. 1114(t)](). Entitlement was awarded if the Veteran * was rated less than 100-percent disabled and was entitled to SMC under [38 U.S.C. 1114(k)]() for the L/LOU of an extremity rated 40 percent or more disabling, and * had L/LOU of a paired extremity as a result of a non-service-connected (NSC) disability, not the result of the Veteran's own willful misconduct, that would be rated, if SC, at least 40-percent disabling. **Note:** [38 CFR 3.383]() and [38 U.S.C. 1160]() allow for the rating of an NSC paired organ or extremity as if SC. ### VIII.iv.4.B.11.b. SMC Under PL 99-576 _PL 99-576_ , effective October 28, 1986, repealed [38 U.S.C. 1114(t)](). ### VIII.iv.4.B.11.c. SMC Under PL 111-275 _PL 111-275_ , effective October 1, 2011, authorized a new level of SMC under [38 U.S.C. 1114(t),]() which is payable at the rate equal to SMC under [38 U.S.C. 1114(r)(2)](), to Veterans who need regular A&A for residuals of TBI, but * are not eligible for SMC under [38 U.S.C. 1114(r)(2)](), and * would require hospitalization, nursing home care, or other residential institutional care in the absence of regular A&A. **Note:** The SMC (t) rate authorized by _PL 111-275_ is not the same as the historical SMC (t) rate that was discontinued in 1986. The SMC (t) rate authorized by _PL 111-275_ cannot be rated or awarded using the historical code.**Reference:** For more information on [38 U.S.C. 1114(t),]() see [M21-1, Part VIII, Subpart iv, 4.A.11](). ## 12. Maximum Allowable Rates Under 38 U.S.C. 1114(p) This topic contains information on maximum allowable rates, including * determining the maximum rate under 38 U.S.C. 1114(p) for the purpose of determining entitlement to SMC under 38 U.S.C. 1114(r) * history of decisions affecting determinations of the maximum allowable rate under 38 U.S.C. 1114(p) * consequences of the decision of General Counsel (GC) Opinion 9-63 in 1977 * determining entitlement to SMC under 38 U.S.C. 1114(r) after 1977, and * disabilities warranting consideration under 38 U.S.C. 1114(o) or (p), as well as 38 U.S.C. 1114(r). December 13, 2005 ### VIII.iv.4.B.12.a. Determining the Maximum Rate Under 38 U.S.C. 1114(p) for the Purpose of Determining Entitlement to SMC Under 38 U.S.C. 1114(r) _PL 85-782_ , effective October 1, 1958, created a level of SMC under [38 U.S.C. 1114(r)](). One of the ways to establish basic entitlement under [38 U.S.C. 1114(r)]() was for the Veteran to be entitled to the maximum rate under [38 U.S.C. 1114(p)](), that is, [38 U.S.C. 1114(o)]().The question arose as to what constituted the maximum rate under [38 U.S.C. 1114(p)](). For example, if a Veteran was entitled to “n½” under [38 U.S.C. 1114(p)](), this rate was less than the maximum under [38 U.S.C. 1114(o)](). However, if the Veteran also had independent entitlement to SMC under [38 U.S.C. 1114(k)](), that is, “n½ +k,” the rate payable exceeded the maximum under [38 U.S.C. 1114(p)](), that is, [38 U.S.C. 1114(o)](). **Question:** The question to be resolved then was whether the SMC payable under [38 U.S.C. 1114(k)]() could be added to the rate payable under [38 U.S.C. 1114(p)](), in this example, “n½,” to establish basic entitlement to [38 U.S.C. 1114(r)](). **Response:** For a history of the relevant decisions that have addressed the question of what constitutes the maximum rate of SMC under [38 U.S.C. 1114(p)](), see M21-1, Part VIII, Subpart iv, 4.B.12.b-d. ### VIII.iv.4.B.12.b. History of Decisions Affecting Determinations of the Maximum Allowable Rate Under 38 U.S.C. 1114(p) The table below describes the history of relevant decisions affecting determinations of the maximum rate of SMC under [38 U.S.C. 1114(p)]().| **Decision and Date**| **Opinion** _General Counsel_ _(GC) Opinion 18-59_ , dated June 18, 1959| Held that since [38 U.S.C. 1114(k)]() is not part of [38 U.S.C. 1114(p)](), the maximum rate under [38 U.S.C. 1114(p)]() was not being paid, and therefore the Veteran * did _not_ have basic eligibility to SMC under [38 U.S.C. 1114(r)](), and * should be paid SMC under [38 U.S.C. 1114(o)](). _GC Opinion 9-63_ , dated June 13, 1963| Reversed _GC opinion 18-59_ and held that any Veteran entitled to the maximum SMC rate, which is SMC under [38 U.S.C. 1114(o)](), under any provision in [38 U.S.C. 1114]() met the basic eligibility criteria for SMC under [38 U.S.C. 1114(r)]().This meant that Veterans who were entitled to SMC at the level of “n+2k,” “n+3k,” or “n½ +k,” all of which exceeded the rate of SMC under [38 U.S.C. 1114(o)](), were to be paid SMC under [38 U.S.C. 1114(r)](). Reinterpretation of _GC Opinion 9-63_ in 1977| * Determined that _GC Opinion 9-63_ did _not_ say that all Veterans entitled to the maximum rate under [38 U.S.C. 1114(o)]() were also entitled automatically to SMC under [38 U.S.C. 1114(r)](), and * held that basic eligibility to the SMC under [38 U.S.C. 1114(r)]() was established, and if the need for A&A was demonstrated, SMC under [38 U.S.C. 1114(r)]() could then be paid. ### VIII.iv.4.B.12.c. Consequences of the Decision of GC Opinion 9-63 in 1977 As a consequence of the 1977 decision, and in conjunction with the adjustment necessitated by the rate increase mandated by _PL 95-117_ , effective October 1, 1977, work items were generated for each SMC code 15 or 28, “n+3k” and “n½ +k” respectively.The affected cases were to be reviewed to determine whether the Veteran required A&A, in order to justify continued entitlement under [38 U.S.C. 1114(r)]().**Note:** A liberal interpretation was to be applied in making this determination, and no Veteran’s benefit was to be reduced below the rate payable under [38 U.S.C. 1114(r)]() without review of the Veteran’s case by Central Office. ### VIII.iv.4.B.12.d. Determining Entitlement to SMC Under 38 U.S.C. 1114(r) After 1977 After the 1977 decision, entitlement under [38 U.S.C. 1114(r)]() for any Veterans receiving SMC under [38 U.S.C. 1114(o)](), or the maximum rate under [38 U.S.C. 1114(p)](), was to be based on whether a factual need for A&A existed.**Important:** This is the criterion currently in effect. ### VIII.iv.4.B.12.e. Disabilities Warranting Consideration Under 38 U.S.C. 1114(o) or (p), as Well as 38 U.S.C. 1114(r) The need for A&A may be based on one of the same disabilities that is used to establish entitlement to SMC under either [38 U.S.C. 1114(o)]() or to the maximum rate under [38 U.S.C. 1114(p)]().**Example:** **Situation:** The Veteran is entitled to * SMC at the “n½” level, based on amputation of the left arm at the shoulder and amputation of the right arm above the elbow, and * an additional half step of SMC to the "o" level under [38 U.S.C. 1114(p)](), based on the existence of a separate disability rated 50-percent disabling. **Result:** If evidence shows the Veteran requires A&A by reason of the bilateral amputations, award entitlement to SMC under [38 U.S.C. 1114(r)](), using SMC code 55.**Note:** Because Veterans entitled to SMC at these levels are, by definition, very seriously disabled, apply a liberal interpretation of the law in determining the need for A&A.