SMC-L is awarded when you need regular aid and attendance from another person because of your service-connected disabilities. This level provides a significant monthly payment increase above the standard 100 percent rate. The criteria for SMC-L aid and attendance focus on your functional abilities. You may qualify if you are blind or so nearly blind as to need guidance from another person, if you are a patient in a nursing home due to physical or mental incapacity, or if you need help with basic daily activities such as dressing, bathing, feeding yourself, or attending to the needs of nature. You do not need to require help with all daily activities. Needing regular assistance with any of these functions can be sufficient if your service-connected conditions are the cause. The need for aid and attendance must be based on your service-connected disabilities, not on non-service-connected conditions. However, if your service-connected conditions interact with other conditions to create the need for assistance, that can still qualify. To apply, submit medical evidence documenting what assistance you need and why. A detailed statement from your treating physician that specifically addresses your limitations and care needs is very helpful. VA may also order a specific aid and attendance examination. If you are currently paying for home care or assisted living due to your service-connected disabilities, SMC-L can help offset those costs.
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).