SMC-L: Aid & Attendance for Service-Connected Veterans
Who qualifies for SMC-L
- Anatomical loss or loss of use of both feet.
- Anatomical loss or loss of use of one hand and one foot.
- Blindness in both eyes with visual acuity of 5/200 or worse.
- Permanent bedridden status due to service-connected disability.
- So helpless from service-connected disability that the needs the regular of another person.
How VA defines 'regular aid & attendance'
38 CFR § 3.352(a) lists the factors VA weighs: inability to dress or undress without assistance, inability to keep ordinarily clean and presentable, inability to feed oneself, inability to attend to the wants of nature, frequent need of adjustment of a special prosthetic or orthopedic appliance, incapacity (physical or mental) requiring care or assistance on a regular basis to protect against hazards or dangers of the daily environment.
Not all of those factors must be present — VA weighs whether the 's condition leaves them 'so helpless as to be in need of regular .' A condition causing inability to protect oneself from daily-environment hazards is enough.
Evidence VA needs
- — Examination for Housebound Status or Permanent Need for Regular — completed by the 's treating physician.
- Clinical notes describing ADL dependence (bathing, dressing, eating, toileting, transferring).
- Caregiver or spouse statement describing the daily care provided.
- Discharge summaries from any hospitalization or skilled nursing stay related to the service-connected condition.
- Hospice or palliative-care documentation, if applicable.
How to request SMC-L
- Have the treating provider complete in full.
- Submit it on a (new or amended) requesting consideration based on .
- Include a written description of daily care needs, signed by the caregiver.
- If a recent did not consider A&A, file a with the 21-2680 and care documentation.
Where these claims break down
- ×Submitting only the 21-526EZ without VA Form 21-2680 — VA will likely deny for lack of medical evidence.
- ×Confusing SMC-L (service-connected) with the A&A pension enhancement (needs-based, non-service-connected).
- ×Not raising SMC-L on terminal or hospice cases where the veteran clearly meets the criteria.
Frequently Asked Questions
Useful Tools & Topics
Have questions about your specific case?
Every veteran's facts are different. A free initial consultation with a VA-Accredited Claims Agent can tell you whether your matter is a fit for representation — and what the right next step looks like either way.
Disclaimer: This page is for educational purposes only and does not constitute legal advice. Oakridge Claims is a private business and is not affiliated with, endorsed by, or operated by the U.S. Department of Veterans Affairs. No guarantees of outcomes are made. Each claim is decided on its individual facts.
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