What is VA Special Monthly Compensation (SMC)?
101st Airborne soldiers advancing through a field - Operation Van Buren 1966
VA ratings are typically assigned from 0% up to 100%, but Congress also created special monthly compensation, which is a continuation of the rating schedule over and above 100% for Veterans who’s disabilities meet certain criteria. Special monthly compensation is confusing, and I’ll do my best to unpack it all here for you. It doesn’t help that the VA SMC alphabet soup can seem completely out of order. Like SMC-T pays the most but is alphabetically after one of the lowest SMC ratings (SMC-S). But we will get to that.
If you need help with an SMC claim or appeal, you can contact me here.
If you’re wondering what the most common medical conditions are that qualify someone for special monthly compensation, see my SMC Cheat Sheet post here.
If you’re wondering if you can qualify for special monthly compensation based on a mental health condition, see my post about that here.
SMC-K and SMC-S are standalone awards so we will cover those first.
Note: In the actual text of the regulations, the special monthly compensation letter designations are listed as lowercase letters surrounded by parentheses like (k) instead of K or SMC-K. I’ve listed it both ways for ease and speed of typing.
(All SMC payment rates listed below are for a Veteran and spouse and current as of 2026. You can find the latest published rates here.)
SMC-K
Under 38 CFR §3.350(a), SMC(k) can be awarded for:
Loss or loss of use (LOU) of one hand, or one foot, or both buttocks, or one or more creative organs
Loss of use or blindness of one eye, having only light perception
Deafness of both ears
Aphonia (loss of speech)
For women Veterans, loss of 25% or more of tissue from a single breast or both breast in combination (includes loss from partial or complete mastectomy or radiation treatment)
Now the neat thing is you can have multiple awards for SMC-K as long as the total of those awards doesn’t exceed the rate payable under SMC-L. That means you could be awarded roughly 6 SMC-K awards if you are currently at 100% or TDIU and 3 SMC-K awards if you are already at the SMC-S rate.
SMC-K can also be awarded if you are being paid at any rate between SMC-L and SMC-N, but you are going to be limited to 3 awards of SMC-K.
Each SMC-K award is worth $139.87 per month.
Smoke grenade identifies landing zone for 101st Airborne UH-1D carrying a brigade commander - Operation Cook 1967
SMC-S
Under 38 CFR 3.350(i), SMC(s) pays $4,628.12 per month and is sometimes referred to as the “housebound rating” even though there is a way to qualify for it without actually being housebound. SMC-S is paid instead of your 100% rating, not in addition to it.
The most common way to qualify for SMC-S is by having a single 100% scheduler rating or TDIU based on a singular disability, and a separate, additional 60% or more in combined ratings that are unrelated to the 100% or TDIU qualifying disability.
The other way to qualify for SMC-S is to have a 100% or TDIU rating and truly be substantially confined to your house due to your service-connected disabilities. You would need strong medical evidence like a statement from your doctor to support such a claim.
SMC-L
This is where we start to get into the interesting SMC stuff. Under 38 CFR 3.350(b), SMC(l) can be awarded based on any one of these:
Loss of, or loss of use of both feet, or;
Loss of, or loss of use of one hand and one foot, or;
Need for the aid and attendance (A&A) of another, or
Permanently bedridden, or;
5/200 visual acuity or less bilaterally qualifies for entitlement under 38 U.S.C. 1114(l). However, evaluation of 5/200 based on acuity in excess of that degree but less than 10/200 (§ 4.83 of this chapter), does not qualify. Concentric contraction of the field of vision beyond 5 degrees in both eyes is the equivalent of 5/200 visual acuity
SMC-L currently pays $5,120.42 per month. At SMC-L you can still keep up to 3 SMC-K ratings, as long as you don’t exceed the rate paid under SMC(m).
The need for aid and attendance (A&A) is one of the most common ways to qualify for SMC-L, and the criteria which explains how to qualify is listed in 38 CFR 3.352(a).
Generally, at least one condition rated at 100% that will be the basis for aid and attendance will make your life easier as far as getting it awarded, BUT it is not a requirement. The raters at your local regional office will assert that it is required, but in the regulations there is no requirement that the Veteran have a 100% rating in order to be granted A&A. This is an extra-statutory requirement that the VA has decided to create out of thin air. But that requirement doesn’t mean you can’t ultimately win, you just have to know what you’re doing and what path to take to have a shot at winning.
Multiple SMC-L awards
Something that many people don’t know (including most advocates and VBA employees) is that a Veteran can be granted two separate SMC-L awards, including two separate aid and attendance awards based on two or more separate conditions. For instance, if the evidence supported it, you could be awarded aid and attendance based solely on your severe PTSD and a separate award of aid and attendance based solely on your ischemic heart disease.
As another example, you could be awarded one SMC-L for loss of use (LOU) of your lower extremities due to severe residuals of service-connected diabetes, and then a separate award for A&A based on your severe depression.
Why does this matter? If you have two or more awards of SMC under any rate from SMC-L through SMC-N, with no condition being considered twice, that catapults you to SMC-O. If one of those awards is based on the need for A&A, that bumps you further to SMC-R1, which currently pays over $10k per month for a Veteran and spouse.
You will never win one of these cases at the regional office. They don’t understand SMC and will consider it impermissible and/or pyramiding. When it comes to the VA and SMC, they grant the least amount possible (except for maybe ALS cases). These cases are extremely complex, require careful medical documentation, and a sound legal argument. Even then it’s difficult. It’s an art form and you have to approach it tactfully and tactically.
The Barry bump clause
As a side note, once you hit SMC-L, the bump clauses under 38 CFR 3.350(f)(3) and (f)(4) come into play which launch you to higher rates of SMC. See my post about that and Barry v. McDonough here. But depending on what those other conditions/ratings are, you may be better off pursuing two SMC-L’s instead.
101st Airborne 81 mm mortar crew - Operation Harrison 1966
SMC-M
Under 38 CFR 3.350(c), SMC(m) can be awarded based on any of the following:
Anatomical loss or loss of use of both hands;
Anatomical loss or loss of use of both legs at a level, or with complications, preventing natural knee action with prosthesis in place;
Anatomical loss or loss of use of one arm at a level, or with complications, preventing natural elbow action with prosthesis in place with anatomical loss or loss of use of one leg at a level, or with complications, preventing natural knee action with prosthesis in place;
Blindness in both eyes having only light perception;
Blindness in both eyes leaving the veteran so helpless as to be in need of regular aid and attendance.
Obviously, you could also qualify for SMC-M if you have been awarded SMC-L and also qualify for at least two intermediate steps or a full step under the bump clause mentioned earlier in this post. SMC-M currently pays $5,628.14 per month
SMC-N
SMC(n) pays $6,372.23 per month and can be awarded based on any of the following:
Amputation is a prerequisite except for loss of use of both arms and blindness without light perception in both eyes. If a prosthesis cannot be worn at the present level of amputation but could be applied if there were a reamputation at a higher level, the requirements of this paragraph are not met; instead, consideration will be given to loss of natural elbow or knee action.
Anatomical loss or loss of use of both arms at a level or with complications, preventing natural elbow action with prosthesis in place;
Anatomical loss of both legs so near the hip as to prevent use of a prosthetic appliance;
Anatomical loss of one arm so near the shoulder as to prevent use of a prosthetic appliance with anatomical loss of one leg so near the hip as to prevent use of a prosthetic appliance;
Anatomical loss of both eyes or blindness without light perception in both eyes.
Note that in the first requirement it states amputation is a prerequisite for some conditions. You don’t see a lot of Veterans that qualify for SMC-M or SMC-N based on the strict reading of the law, but there are plenty who do reach SMC-M based on the Barry bump clause, and rarely some who reach SMC-N. Honestly, a Veteran that disabled would likely be better off going for two SMC-L awards in pursuit of SMC-R1/R2 which pays more.
SMC-N is also last call for SMC-K awards. Once you get above SMC-N, then those no longer apply. Uniquely, if a Veteran is at SMC-N 1/2 and also has an SMC-K, that pushes them straight to SMC-O. SMC-N regulations can be found in 38 CFR 3.350(d).
1st Infantry Division troops, M48, and M113 - Operation Buckskin 1966
SMC-O
SMC(o) pays $7,096.71 per month and is found in 38 CFR 3.350(e). As we discussed earlier, the easiest way to get to SMC-O is likely going to be to have two separate awards of any SMC rate between SMC-L and SMC-N. Again, if you at least one of those awards are based on the need for aid and attendance, that bumps you even further to SMC-R1.
You can qualify for SMC-O if you meet the following criteria:
Anatomical loss of both arms so near the shoulder as to prevent use of a prosthetic appliance;
Conditions entitling to two or more of the rates (no condition being considered twice) provided in 38 U.S.C. 1114(l) through (n);
Bilateral deafness rated at 60 percent or more disabling (and the hearing impairment in either one or both ears is service connected) in combination with service-connected blindness with bilateral visual acuity 20/200 or less.
Service-connected total deafness in one ear or bilateral deafness rated at 40 percent or more disabling (and the hearing impairment in either one of both ears is service-connected) in combination with service-connected blindness of both eyes having only light perception or less.
Paraplegia. Paralysis of both lower extremities together with loss of anal and bladder sphincter control will entitle to the maximum rate under 38 U.S.C. 1114(o), through the combination of loss of use of both legs and helplessness. The requirement of loss of anal and bladder sphincter control is met even though incontinence has been overcome under a strict regimen of rehabilitation of bowel and bladder training and other auxiliary measures.
Note: Combinations. Determinations must be based upon separate and distinct disabilities. This requires, for example, that where a veteran who had suffered the loss or loss of use of two extremities is being considered for the maximum rate on account of helplessness requiring regular aid and attendance, the latter must be based on need resulting from pathology other than that of the extremities. If the loss or loss of use of two extremities or being permanently bedridden leaves the person helpless, increase is not in order on account of this helplessness. Under no circumstances will the combination of “being permanently bedridden” and “being so helpless as to require regular aid and attendance” without separate and distinct anatomical loss, or loss of use, of two extremities, or blindness, be taken as entitling to the maximum benefit. The fact, however, that two separate and distinct entitling disabilities, such as anatomical loss, or loss of use of both hands and both feet, result from a common etiological agent, for example, one injury or rheumatoid arthritis, will not preclude maximum entitlement.
Helplessness. The maximum rate, as a result of including helplessness as one of the entitling multiple disabilities, is intended to cover, in addition to obvious losses and blindness, conditions such as the loss of use of two extremities with absolute deafness and nearly total blindness or with severe multiple injuries producing total disability outside the useless extremities, these conditions being construed as loss of use of two extremities and helplessness.
SMC-P
SMC(p) is a confusing cluster. There are a number of different pay rates in SMC-P and each has a different way to qualify. My advice is just try to avoid SMC-P all together as you’d almost assuredly be better of pursuing two SMC-L’s, which pays more. The list of qualifying criteria is lengthy and I’m not going to list it all here. If you want to review it see 38 CFR 3.350(f)(1).
SMC-R1 and SMC-R2
As I’ve already discussed earlier, the easiest was to get to SMC(r)(1) is to be awarded two separate rates between SMC-L and SMC-N, with no condition being counted twice, and one of them being for aid and attendance. If you missed that memo, scroll back up and read the section entitled “Multiple SMC-L awards.”
Two SMC-L’s is the most common, but any combination of two SMC-L’s, SMC-M’s, and SMC-N’s gives you the bump to SMC-O, and then SMC-R1 if one of is based on aid and attendance
Most of these cases require careful legwork getting conditions service-connected and/or properly rated even before the SMC pursuit begins, and then a strategic plan once you do begin to pursue SMC.
SMC-R1/R2 is considered an extension of SMC-O and 38 CFR 3.350(h) states:
Maximum compensation cases. A veteran receiving the maximum rate under 38 U.S.C. 1114 (o) or (p) who is in need of regular aid and attendance or a higher level of care is entitled to an additional allowance during periods he or she is not hospitalized at United States Government expense. (See § 3.552(b)(2) as to continuance following admission for hospitalization.) Determination of this need is subject to the criteria of § 3.352. The regular or higher level aid and attendance allowance is payable whether or not the need for regular aid and attendance or a higher level of care was a partial basis for entitlement to the maximum rate under 38 U.S.C. 1114 (o) or (p), or was based on an independent factual determination.
Entitlement to compensation at the intermediate rate between 38 U.S.C. 1114 (n) and (o) plus special monthly compensation under 38 U.S.C. 1114(k). A veteran receiving compensation at the intermediate rate between 38 U.S.C. 1114 (n) and (o) plus special monthly compensation under 38 U.S.C. 1114(k) who establishes a factual need for regular aid and attendance or a higher level of care, is also entitled to an additional allowance during periods he or she is not hospitalized at United States Government expense. (See § 3.552(b)(2) as to continuance following admission for hospitalization.) Determination of the factual need for aid and attendance is subject to the criteria of § 3.352.
Note: Amount of the allowance. The amount of the additional allowance payable to a veteran in need of regular aid and attendance is specified in 38 U.S.C. 1114(r)(1). The amount of the additional allowance payable to a veteran in need of a higher level of care is specified in 38 U.S.C. 1114(r)(2). The higher level aid and attendance allowance authorized by 38 U.S.C. 1114(r)(2) is payable in lieu of the regular aid and attendance allowance authorized by 38 U.S.C. 1114(r)(1).
Currently SMC-R1 pays $10,046.47 and SMC-R2 pays $11,491.26 per month.
To get to SMC(r)(2), you need to get to R1 first, and then require a higher level of aid and attendance. The easiest way to get this is to have your caregiver spouse or whoever be trained by a supervising medical provider to help with things like physical therapy or other care tasks. To be eligible for SMC-R2, the Veteran must be so helpless that he need to be institutionalized in a hospital or nursing home if he didn’t have the help of a caregiver.
1st Cavalry Division soldier drinking from coconut - Operation Pershing
SMC-T
SMC(t) has been discussed a lot recently because of the Laska v. McDonough decision which made the eligibility criteria a lot less restrictive then the VA construed it to be. See my post explaining that here.
Laska removed the VA’s extra-statutory requirement that a Veteran would need in-home care by a healthcare professional, and instead it can now be provided by a loved one. It's the same "regular" level of aid and attendance that you find in SMC-L.
Because of the Laska decision, the requirements for SMC(t) under 38 CFR 3.350(j) are now:
The Veteran needs regular aid and attendance (A&A) for the residuals of TBI, and
The Veteran is not eligible for a higher level of A&A under SMC(r)(2), and
The Veteran would need hospitalization, nursing home care, or other residential institutional care without in-home A&A.
SMC-T pays at the same rate as SMC-R2, so $11,491.26 per month.
Oftentimes, the VA will combine a Veteran’s rating for TBI with their service-connected mental health condition and say they can’t differentiate which conditions is causing which symptom. This does not preclude you from being eligible for SMC-T if you meet the eligibility criteria.
1st Air Cavalry Division checking a house - Operation Irving
Final Thoughts
Congress created special monthly compensation for America’s most disabled Veterans. It is not easy to qualify for, and it surely isn’t easy to get the correct rate awarded from the VA when you do. I’m a big proponent of Veterans advocating for themselves in the claims process when they are able, but I would never recommend that a Veteran try to tackle a higher level SMC claim on their own. These claims are just flat out too complex and there’s a hundred ways for you or the VA to screw it up.
If you go on most Veterans “help” sites, you will be assured that the VA will most certainly consider SMC in every case where it applies and award it without error or issue. This is hardly ever true. Or you will be told to shut up and be happy that you’re at 100%, and there’s nothing further for you. I’ve heard VSOs say the same thing. Those VSOs aren’t being malicious, they just aren’t trained in SMC and have no idea how it works. Ditto with most regional office VBA employees.
One of the wonders of SMC is that, unlike most other benefits, the effective date can be much earlier than the date of application. SMC is considered an ancillary benefit, and if the evidence shows that it should have been awarded at an earlier date, the award can be backdated to that date. Proving that and getting it awarded is no small feat, but it is possible.
I hope this helps! If you need help with a SMC claim or appeal, you can contact me here.