Above SMC-L, there are progressively higher compensation levels for veterans with the most severe combinations of disabilities. These levels provide substantial monthly payments reflecting the extreme impact of these conditions. SMC-L and one-half (L½) is awarded when you qualify for SMC-L and also have additional disability rated at 50 percent or more that is independent of the condition qualifying you for aid and attendance. SMC-M applies to combinations including loss or loss of use of multiple extremities. SMC-N covers more severe combinations, such as loss of use of both arms or being bedridden. SMC-O and above apply to the most severe cases involving multiple amputations, blindness combined with loss of limbs, or paraplegia with loss of use of additional extremities. SMC-R provides the two highest rates in the compensation system. SMC-R1 applies when you need regular aid and attendance plus a higher level of care. SMC-R2 applies when you need a higher level of aid and attendance on a daily basis. SMC-T was created specifically for veterans with service-connected traumatic brain injury who need assistance in their residences. Each level has precise qualifying criteria, and the monthly rates increase significantly at each step. If you have extremely severe service-connected disabilities, review whether a higher SMC level applies to your situation.
Note: This article references sections of the VA's M21-1 Adjudication Procedures Manual. The VA periodically reorganizes the M21-1 and section numbers may have changed since this article was written. For the most current section references, visit the VA's public M21-1 Web Automated Reference Material System (WARMS).