Special Monthly Compensation (SMC)

Every VA SMC Level Explained (K through T)

Special Monthly Compensation (SMC) is extra VA disability compensation paid when a service-connected condition causes severe functional loss (like loss of use of a hand/foot), extreme sensory loss (certain blindness/deafness patterns), or a need for regular Aid & Attendance (A&A). This guide covers every SMC level, how VA assigns it, and how to claim it when it’s missed.

Updated for the current SMC rate year shown on VA.gov • Built for veterans, caregivers, and VSOs
SMC deep-dive

SMC is often “inferred.” Don’t leave money on the table.

VA can (and should) award SMC when the evidence supports it, even if you didn’t know to ask. But SMC is frequently missed—especially SMC-K, Housebound (factual), and Aid & Attendance pathways.

Jump to the overview
Start here

What SMC is (and what it isn’t)

SMC is not a separate “rating.” It’s a higher payment level authorized by law for veterans whose service-connected conditions cause losses or care needs that the normal rating schedule doesn’t fully capture.

SMC pays for function & care needs Examples: loss of use of a limb, blindness patterns, the need for regular help with activities of daily living.
SMC can apply even below 100% Some SMC (like SMC-K) can be added at many rating levels.
SMC is often “inferred” VA should grant it when the record supports it, but it’s frequently missed.
SMC is driven by the codesheet Your rating decision’s codesheet typically shows the SMC “pay code” and effective dates.
Pro tip: Always download and review your Rating Decision + Codesheet. If SMC is missing and the evidence was already in the file, a Higher-Level Review may fix it quickly.
Official links

Fast links (rates, rules, and forms)

Use these official links to verify current payments, read the governing rules, and file or appeal.

Rates (official)

Rules (official)

Common forms (official)

KnowVA / M21-1 (VBA manual): Special Monthly Compensation (SMC) section
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The process

How VA assigns SMC

SMC is decided by VA raters using the evidence in your file and the legal rules in 38 CFR § 3.350 (and, for A&A factors, 38 CFR § 3.352). In many cases, VA should award SMC as an inferred issue—meaning it’s granted when the evidence shows you qualify, even if your claim didn’t say “SMC” by name.

Where to find SMC on your decision

  • Codesheet / rating codes: often lists SMC pay code(s) and effective dates.
  • Narrative section: may explain why SMC was granted or denied.
  • Exam results: A&A exams, limb function findings, vision/hearing results.

Effective dates & back pay (common reality)

  • SMC effective dates usually track the underlying entitlement date—often tied to the date of claim, increase, or medical evidence.
  • If SMC was missed, correcting it can create substantial back pay.
  • If the evidence already existed, an HLR can be a strong option. If you need new evidence (like a properly completed 21-2680), a Supplemental Claim is often better.
Heads up: SMC can get complex at higher levels (especially P/O/R/T). If you’re in upper-level SMC territory, it’s smart to work with an accredited VSO/rep and anchor your argument in the CFR + your medical evidence.
The ladder

The SMC ladder in plain English

SMC letters represent different “lanes” of entitlement. Some are core statutory levels (L-O), while others are special mechanisms (K, P, R, S, T) that add or modify payments. Use this as your mental map, then check the detailed sections below.

K Add-on for specific anatomical loss or loss of use (creative organ, one hand/foot, etc.).
S Housebound: either “statutory” (100% + separate 60%) or “factual” confinement.
L → M → N → O Core levels for catastrophic losses and/or A&A with specific thresholds.
P Intermediate / “next higher” steps between the core levels when combinations warrant it.
R1 / R2 “Special A&A” on top of very high SMC (O or max P), including “higher level of care” needs.
T TBI-specific pathway tied to A&A and higher level of care.
Gold rule: At higher levels VA cannot “double count” the same disability to build multiple SMC entitlements. Upper-level SMC often turns on “separate and distinct” functional losses and anti-pyramiding rules.
SMC-K

SMC-K: the add-on most commonly missed

SMC-K is a special payment variation that VA can add to many basic rates. It commonly applies to loss (or loss of use) of a creative organ, but it also covers certain limb and sensory losses. Official rules are in 38 CFR § 3.350(a).

Common SMC-K triggers (examples)

  • Loss/loss of use of one hand or one foot
  • Loss of use of a creative organ (commonly ED when tied to service-connected disability/medication)
  • Blindness of one eye with only light perception
  • Complete organic aphonia (loss of voice)
  • Certain deafness patterns (see CFR for specifics)
Pro tip: SMC-K is often supported by routine C&P findings, medication history, or specialist notes. If you have ED secondary to a service-connected condition or meds, ask VA to consider SMC-K explicitly.

Practical example

You’re rated 70% PTSD and take medications that cause ED. If VA grants ED secondary, SMC-K is often warranted as an additional monthly amount.

SMC-S

SMC-S: Housebound (two different legal paths)

SMC-S can be granted in two ways: statutory housebound (the rating math path) or factual housebound (confinement due to service-connected disabilities). The governing rule is 38 CFR § 3.350(i).

1) Statutory housebound (“100% + 60%”)

  • You have one service-connected disability rated total (100%), and
  • You have additional service-connected disability(ies) independently ratable at 60% or more, separate and distinct.

2) Factual housebound (“substantially confined”)

  • You are substantially confined to your home (or immediate premises) due to service-connected disabilities, and
  • It’s reasonably certain the confinement will continue for life.
Example: A veteran with severe service-connected cardiopulmonary disease and mobility limitations who only leaves home for medical care may qualify under the factual path even without meeting the 60% math test.
SMC-L

SMC-L: Aid & Attendance (A&A) or qualifying losses

SMC-L is where many veterans first encounter “serious” SMC. It may apply due to certain limb/vision losses, being permanently bedridden, or needing regular Aid & Attendance. See 38 CFR § 3.350(b).

Common SMC-L pathways

  • Loss/loss of use of both feet
  • Loss/loss of use of one hand and one foot
  • Blindness in both eyes at qualifying acuity thresholds
  • Permanently bedridden
  • Regular Aid & Attendance (needs help with personal functions/safety)

A&A: what VA actually looks at

A&A determinations are fact-driven under 38 CFR § 3.352. Key factors include dressing, bathing/cleanliness, feeding, toileting, prosthetic adjustment needs, and needing help to avoid hazards/dangers.

Evidence that wins A&A: a detailed VA Form 21-2680 plus caregiver statements that describe frequency (daily/weekly), what help is required, and safety risk (falls, medication management, wandering, etc.).
SMC-M / SMC-N

SMC-M and SMC-N: higher losses (hands, arms, legs, vision)

SMC-M and SMC-N are triggered by more severe anatomical loss or loss of use patterns (and certain blindness thresholds). The “full list” is long—use 38 CFR § 3.350(c) and (d) for the exact criteria.

SMC-M: common examples

  • Loss/loss of use of both hands
  • Loss/loss of use of both legs at a level preventing natural knee action with prosthesis
  • Blindness in both eyes with only light perception
  • Blindness + A&A under specific circumstances

SMC-N: common examples

  • Loss/loss of use of both arms at a level preventing natural elbow action with prosthesis
  • Anatomical loss of both legs so near the hip as to prevent prosthesis use
  • Blindness in both eyes without light perception
Practical note: “Loss of use” is a medical-functional finding, not just a diagnosis. VA looks at whether no effective function remains other than what an amputation stump with prosthesis would provide.
SMC-O

SMC-O: the top statutory level (before R)

SMC-O can be reached through extremely severe anatomical loss patterns or through certain combinations of L-N rates. See 38 CFR § 3.350(e).

Two big ways SMC-O happens

  • Single catastrophic criterion (for example, specific loss patterns listed in the regulation), or
  • Combination pathway: entitlement to two or more of the rates L through N, without counting the same condition twice.
Upper-level SMC warning: “No double counting” and “separate and distinct” requirements are where many claims get denied. Build your record around distinct functional losses, distinct body systems, and clear medical separation of causes.
SMC-P

SMC-P: intermediate steps and “next higher” rates

SMC-P is a mechanism that moves you to an intermediate step (like “L ½”) or to the next higher statutory level based on qualifying combinations. See 38 CFR § 3.350(f).

Why SMC-P exists

  • Some combinations are more severe than L but don’t perfectly match M
  • Some combinations justify a “next higher” level under detailed rules
  • VA uses intermediate steps to match compensation to severity more accurately
Keep it simple: If you’re at L, M, N, or O and you have additional qualifying losses, you may be in “P territory.” This is where an accredited rep and careful CFR-based argument can matter.
SMC-R1 / R2

SMC-R: “Special Aid & Attendance” on top of high SMC

SMC-R is for veterans who already qualify for very high SMC (typically SMC-O or the maximum rate under SMC-P) and who also require Aid & Attendance. See 38 CFR § 3.350(h) and the A&A criteria in 38 CFR § 3.352.

R1 vs R2 (the practical difference)

  • R1: you need regular A&A on top of the high SMC prerequisite.
  • R2: you need a higher level of care (daily personal health-care services in the home) such that without it you would need institutional care.
R2 proof checklist: document the daily skilled care tasks (wound care, catheter care, medication administration, etc.), show licensure or supervision structure, and include a statement that without this care institutionalization would be required.
SMC-T

SMC-T: TBI residuals + higher level of care

SMC-T is a specialized pathway for veterans whose service-connected residuals of traumatic brain injury (TBI) require regular A&A and also require a higher level of care such that, without it, institutional care would be necessary. See 38 CFR § 3.350(j) and the “higher level of care” discussion in 38 CFR § 3.352.

What makes or breaks SMC-T

  • Clear medical linkage: the A&A need must be due to service-connected TBI residuals.
  • Clear care evidence: daily personal health-care services + supervision/licensure details.
  • Clear “but for” statement: without that care, institutionalization would be required.
Common denial reason: the record shows help is needed, but it’s not clearly tied to service-connected TBI residuals (or it doesn’t meet the “higher level of care” threshold). Tight medical documentation is everything here.
Evidence

Evidence checklists (what to gather)

Loss of use / anatomical loss

  • C&P exam findings describing remaining function (grip, balance, propulsion, etc.)
  • Specialist notes (orthopedics, neurology, PM&R, ophthalmology, audiology)
  • Assistive device history (AFOs, braces, wheelchair, prosthetics)
  • Photos can help for amputations/prosthetics, but medical documentation is primary

Aid & Attendance (SMC-L and up)

  • VA Form 21-2680 completed thoroughly
  • Caregiver statement: who helps you, what tasks, how often, and what happens if you’re alone
  • Fall history, wandering risks, medication management needs
  • Home health notes (if applicable)

Higher level of care (R2 / T)

  • Daily skilled personal health-care services documented
  • Provider licensure or supervision structure
  • Statement that without care institutionalization would be required
Use the CFR as your checklist: For A&A, mirror the factors in 38 CFR § 3.352 and show specific examples (not just “needs help”).
How to apply

How to claim SMC (and how to fix it when VA misses it)

1

Identify the SMC pathway

Match your situation to the most likely SMC lane: K (add-on), S (housebound), L (A&A), higher levels (M/N/O/P), or R/T.

2

File the right claim type

3

If A&A / Housebound: complete VA Form 21-2680

Have your treating provider complete the form as thoroughly as possible. If you can’t get it completed, file anyway and request VA schedule an exam.

4

Write a one-paragraph “SMC request”

In your statement, ask VA to consider SMC under 38 CFR § 3.350 (and § 3.352 for A&A). Include concrete examples: “needs help bathing daily,” “falls weekly,” “cannot manage meds,” etc.

5

Track, respond, and appeal if needed

If VA denies, read the reason and respond with targeted evidence. For complex upper-level SMC, consider an accredited rep early.

Avoid these

Common mistakes that delay or reduce SMC

  1. Never checking the codesheet. SMC pay codes and effective dates are often only obvious there.
  2. Vague A&A evidence. “Needs help” isn’t enough—document tasks, frequency, and hazards.
  3. Assuming 100% automatically includes SMC. It doesn’t. SMC is a separate analysis.
  4. Confusing statutory vs factual housebound. These are two different tests.
  5. Trying R2/T without “higher level of care” proof. Skilled care documentation and supervision details matter.
FAQ

Frequently asked questions

Do I have to “apply” for SMC?

Often VA should award SMC automatically when the evidence supports it. In reality, many veterans still need to raise it (especially SMC-K, A&A, factual housebound, and upper-level pathways) so VA develops the right evidence.

Can SMC be paid with less than 100%?

Yes. For example, SMC-K can be payable in addition to many compensation levels. Some other SMC pathways can apply even if you’re not at 100% schedular—what matters is the qualifying loss/need.

What’s the single best form for A&A?

VA Form 21-2680 is the standard. Pair it with a caregiver statement and medical records that describe falls, supervision needs, medication management, and other hazards.

Where do I verify the payment amounts?

Use the official VA SMC rates page: VA.gov SMC rates . Rates vary based on dependents and change each year.

What if VA denied because “not service-connected”?

SMC generally requires that the underlying cause is service-connected (or that the housebound/A&A need is due to service-connected disabilities). If the condition isn’t service-connected yet, you may need to win service connection first (direct, secondary, or aggravation).

Sources

Sources & further reading

Reminder: The CFR controls. The M21-1/KnowVA and community guides are useful for understanding how VA develops and rates claims, but if there’s a conflict, anchor your argument in the regulation and your evidence.