Mid-1970s Army veteran • Progressive neurologic decline • Frequent falls
The Challenge
VA initially denied A&A stating that "The overall evidence does not show a single service-connected disability is the sole or partial cause of the need for A&A OR that a totally disability service-connected conditions results in the need for assistance."
What Existed Before
- Service connection for orthopedic + mental health/neurological conditions
- Documented falls.
- PCP notes describing “supervision needed with medications”
The record lacked functional analysis showing how service-connected disabilities impacted ADLs and safety.
Our Contribution
- Created structured ADL/IADL breakdown
- Linked fall risk to SC balance disorder
- Explained cognitive fatigue related to SC neurological condition
- Added timeline of progressive deterioration.
Key Takeaway
After the updated assessment and supporting documentation were submitted, the veteran later received a favorable VA decision granting SMC-L (Aid & Attendance). Individual outcomes always depend on the full body of evidence.
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