Housebound VA Requirements and How to Get SMC-S

What Is SMC-S?

Special Monthly Compensation Level S (SMC-S) is a VA benefit awarded to veterans who are considered housebound as a result of their service-connected conditions. This means the veteran either cannot leave their home regularly due to their disabilities or qualifies through a specific combination of VA disability ratings that presumes such confinement. 

The VA recognizes that this level of restriction places additional strain on a veteran’s daily life and compensates for that with a higher monthly payment than standard disability benefits. 

SMC-S vs. Other SMC Levels 

While all Special Monthly Compensation (SMC) levels provide extra benefits beyond the basic disability schedule, each tier targets a different level of severity or type of need. SMC-S is specifically centered on housebound status, making it distinct from other types like SMC-L, which are designed for veterans who require hands-on assistance with daily activities such as dressing or eating. 

What Is the Difference between SMC Housebound and Aid and Attendance Benefits? 

Although both SMC Housebound and Aid and Attendance are forms of Special Monthly Compensation, they are meant for different situations and levels of need. 

Housebound benefits are intended for veterans who are mostly confined to their homes because of service-connected disabilities. This doesn’t mean the veteran is entirely unable to leave the house, but rather that leaving is rare and usually limited to essential medical visits. Veterans who qualify for Housebound status may still be able to manage daily personal tasks on their own, like dressing or feeding themselves. The key factor is that their disability keeps them home most of the time. 

On the other hand, Aid and Attendance (A&A) benefits are for veterans who require help from another person to complete everyday tasks. These tasks include activities like bathing, using the restroom, eating, getting dressed, or remembering to take medication. The need can arise from either a physical condition, like paralysis, or a mental condition, such as advanced dementia or severe PTSD. 

The financial difference also matters. Aid and Attendance generally pays more than Housebound because it addresses a greater level of need and dependency. Veterans cannot receive both SMC Housebound and Aid and Attendance at the same time; they must qualify and be paid under one or the other, depending on their circumstances. 

For more information, visit our Aid and Attendance VA Benefits page. 

Can You Receive Both SMC-S and SMC-L or Other Types of SMC?  

The VA does not allow you to stack or combine multiple SMC levels for a higher payout. You can only receive one SMC level at a time, even if you meet the criteria for more than one. 

If you qualify for both SMC-S and another level, like SMC-L, the VA will review your case and award you the level that pays more. The higher rate is what you will receive, not both combined. 

This rule applies to all SMC categories. For example, if you meet the requirements for both SMC-K and SMC-S, you won’t be paid for both unless one of the benefits (like SMC-K) is classified as a separate and specific type of compensation that can be combined. SMC-K is one of the only exceptions and can sometimes be added to another SMC level because it pays for specific losses like the use of a limb or an organ. 

But in most situations, SMC-S replaces other potential SMC payments. The VA is structured to prevent duplication of benefits for overlapping needs. So, while it’s possible to qualify under several SMC rules, you’ll only receive the single highest amount that applies to your situation. 

Is SMC-S Paid in Addition to VA Compensation?  

No, SMC-S is not added on top of your standard VA disability payments. Instead, it replaces your usual monthly compensation when awarded. 

This can be confusing because some other VA benefits are added on top of regular compensation. However, SMC-S works differently. When the VA approves you for SMC-S, they stop paying your standard monthly disability rate and begin paying the higher SMC-S rate instead. 

This higher rate reflects the VA’s recognition that your situation involves more serious limitations than those covered by the basic disability rating schedule. It’s designed to provide extra support because your needs are greater either due to housebound status or because of multiple severe service-connected disabilities. 

So, while you won’t receive both regular compensation and SMC-S together, you will receive more money each month than someone who is just rated at 100% under the basic VA schedule. 

Is SMC-S Permanent? 

SMC-S is not automatically permanent. Whether it becomes permanent depends on the nature of your disabilities and how the VA classifies your condition. For SMC-S to be considered permanent, one of the following must apply: 

• The VA formally rates your condition as “permanent and total”, meaning they do not expect your condition to improve. 
• Your disabilities are static, meaning they are long-term and unlikely to get better, so there is no medical reason to expect any change that would reduce your ratings.     

If your health improves or your housebound status changes (such as becoming more mobile or no longer needing to stay home due to your disabilities) the VA can remove your SMC-S benefits. They may also reassess your case during a routine review, especially if your rating wasn’t labeled as permanent when it was first granted. 

Because SMC-S is based on specific conditions being met, any change in your medical situation could affect your eligibility. Veterans who receive this benefit should be aware that it’s not locked in forever unless the VA says so in writing. 

Eligibility Requirements for SMC-S 

To qualify for SMC-S, the VA requires that two main conditions be met: 

1. You must have one service-connected disability rated at 100%. This can be a condition that is either rated 100% on the schedule or granted Total Disability based on Individual Unemployability (TDIU), as long as it’s based on a single disability. 
2. You must have an additional, separate service-connected disability rated at 60% or higher, OR be considered permanently housebound due to your service-connected disabilities.  

These two qualifications are not interchangeable. You must have the 100% rating first, then either the additional 60% rating or housebound status to meet the criteria for SMC-S. 

It’s also important that the two disabilities, the 100% and the 60%, are completely separate from one another. They cannot be part of the same medical issue or grouped under the same diagnostic category. This is a common point of confusion and a reason why some SMC-S claims are denied.

VA Housebound Requirements and Criteria 

What Is the VA Definition of Housebound? 

The VA defines a veteran as housebound when their service-connected condition causes them to spend most of their time at home. This doesn’t mean a person is completely unable to leave the house. Instead, it means their ability to do so is severely limited; they only leave the house on rare occasions, usually for medical reasons like appointments or treatments. 

To qualify under this definition, the disability must be expected to be permanent, not just temporary or short-term. Veterans who meet this standard often experience difficulty managing regular activities outside their home due to pain, mobility issues, or mental health challenges caused by service-connected conditions. 

Does “Housebound” Status Require the Veteran to Be Bedridden? 

No, being housebound does not mean you must be stuck in bed all day. While bedridden veterans may qualify, the VA’s definition is broader. You can still move around your home and take care of some personal needs, but if your medical conditions limit your ability to leave the house regularly, that may be enough to qualify. 

The VA understands that veterans might need to go outside for certain reasons, such as going to the pharmacy or attending VA health appointments. These rare trips don’t disqualify you, as long as your condition still causes you to stay home most of the time.

Statutory vs Factual Housebound Criteria 

The VA offers two different ways to qualify for SMC-S: factual housebound and statutory housebound. 

Factual housebound means you are physically limited to your home because of your service-connected conditions. This is based on real-life evidence such as medical records and personal statements that show you rarely leave your house. The VA must see that your disability keeps you substantially confined to your home. 

Statutory housebound, on the other hand, is based purely on your VA disability ratings, not your physical activity or daily behavior. This method follows the “100 plus 60” rule, which is a shortcut to proving housebound status without needing to show that you rarely leave home. If your disability ratings meet the numbers required, the VA assumes you qualify for SMC-S even if you aren’t literally stuck at home. 

Both routes can lead to SMC-S approval. The main difference is that one looks at how your condition affects your day-to-day life (factual), while the other uses your disability ratings (statutory) as proof. 

The SMC 100 Plus 60 Rule 

The “100 plus 60” rule is the key requirement for qualifying for SMC-S under the statutory housebound criteria. To meet this rule, a veteran must have: 

1. One service-connected disability rated as totally disabling (100%), AND 
2. One or more additional, separate service-connected disabilities rated at 60% or more.   

This means the VA will not consider a group of conditions that add up to 100%, you must have one single disability that is either: 

• Rated 100% on its own by the VA’s schedule, or 
• Considered totally disabling due to TDIU, as long as the TDIU is based on just one disability.   

The second part of the rule is that you must have another condition, not related to the first one, that is rated at 60% or higher. These two disabilities must be completely independent from each other. You can’t count two conditions affecting the same body system or arising from the same injury to meet both parts of the rule. 

This method of qualifying does not require you to prove you are physically stuck at home, just that your ratings meet the required threshold. 

Can A Veteran Meet VA SMC(s) Eligibility with Multiple Disabilities That Combine to 100 Percent, but No Single Disability Rated at 100 Percent? 

No, a combined rating of 100% is not enough to qualify for SMC-S under the statutory housebound rule. 

The VA’s regulations are very clear: to qualify for SMC-S under the “100 plus 60” rule, you need one single disability rated at 100%, and a separate disability rated at 60% or more. This rule ensures the benefit is only given to veterans whose individual conditions are severe enough on their own to meet these strict thresholds. 

So, even if your overall disability rating is high, the VA won’t approve SMC-S unless it clearly sees a single 100% rating and an independent 60% rating that aren’t connected to each other. 

Is SMC-S Given to Veterans Whose 100% Rating Is Based on TDIU? 

Yes, veterans who receive a Total Disability Individual Unemployability (TDIU) rating can qualify for SMC-S, but only under certain conditions. 

To meet the “100 plus 60” rule using TDIU, the TDIU must be based on a single service-connected disability. This is important because if the VA granted your TDIU based on multiple disabilities combined together, it does not satisfy the “single 100% disability” requirement. 

However, there’s a potential workaround. If your TDIU was awarded based on several conditions, but the evidence shows that one of those disabilities alone could have justified TDIU, you might still qualify for SMC-S, with back pay. In that case, you must also have a separate, unrelated disability rated at 60% or more. 

TDIU as a Pathway to SMC-S 

Total Disability based on Individual Unemployability (TDIU) can sometimes be a valid route to qualify for SMC-S, but it depends on how the TDIU was awarded. There are two main ways TDIU can be granted: 

• Based on a single service-connected disability 
• Based on multiple service-connected disabilities that combine to meet the criteria under 38 C.F.R. § 4.16(a)  

For SMC-S purposes, only the first route qualifies under the “100 plus 60” statutory rule. That means the VA must have granted your TDIU solely due to one condition, not a combination of several. To qualify for SMC-S using TDIU, you must also have a completely separate disability rated at 60% or higher. The VA needs to see that:

• One condition alone is so disabling it makes you unemployable, and 
• Another, unrelated service-connected condition is independently rated at 60% or more   

Even if the VA originally based your TDIU on multiple disabilities, you might still qualify for SMC-S if the evidence supports that one condition could have supported TDIU on its own. The VA has a legal duty to consider this possibility. 

The VA is supposed to look into whether your TDIU could have been based on one condition alone. If they fail to review this properly, or you were unaware of this rule when TDIU was awarded, you may be eligible for retroactive SMC-S payments going back to the effective date of your TDIU. This could significantly increase the total amount of compensation you receive. 

Veterans with complex TDIU situations are encouraged to seek legal support to ensure their claim is fully reviewed. Get a free case evaluation with Hill and Ponton to see how we can assist you in getting the benefits you deserve.

Can You Work with SMC-S? 

Whether you can work while receiving SMC-S depends on how you qualified for the benefit. If you receive SMC-S based on the “100 plus 60” rule, and your 100% rating is schedular (not based on TDIU), then you can work.

A 100% schedular rating does not automatically mean you are unemployable. Veterans in this category are allowed to have a job, even full-time work, as long as their medical condition still meets the VA’s criteria for the rating. However, if your 100% rating comes from TDIU, the situation is different.  

TDIU means the VA has declared you unable to work due to your service-connected condition. That rating is based entirely on unemployability. So, if you begin engaging in substantially gainful employment, meaning consistent work that earns above the poverty level, your TDIU will be terminated. This would also disqualify you from receiving SMC-S based on TDIU. 

In cases where SMC-S is granted due to factual housebound status, meaning your medical condition keeps you mostly confined to your home, regular employment is also a problem. Working outside the home might show that you are not truly housebound, which could lead to a loss of eligibility. 

That said, marginal employment (jobs that pay below the poverty line or involve sheltered work environments) may still be allowed under certain circumstances. Veterans who want to explore working while receiving SMC-S should consult with a VA representative or attorney to avoid risking their benefits. 

What Conditions Qualify for SMC-S? 

SMC-S is not limited to just one type of illness or injury. Both physical and mental service-connected conditions can be used to qualify as long as they meet the 100% and 60% rating requirement or cause the veteran to be permanently housebound. The key is that the conditions must be: 

• Service-connected (approved by the VA as related to military service), 
• Severe enough to meet the rating thresholds, and 
• Completely separate if using the “100 plus 60” rule. 

Veterans often qualify with a combination of physical and mental health issues. For example, someone with a 100% rating for post-traumatic stress disorder (PTSD) and a 60% rating for a severe back injury could meet the criteria. 

It’s important to note that you can’t use the same condition twice; for instance, you can’t count different symptoms of PTSD as both the 100% and 60% disabilities. Each condition must stand on its own and have a separate diagnostic code with distinct impacts. 

Physical Disabilities 

Veterans with serious physical service-connected conditions often qualify for SMC-S, especially when those conditions cause severe functional loss or long-term health problems. These physical disabilities must meet either the 100% rating level or be rated 60% or higher as a separate condition. 

Common 100% Physical Disabilities 

• Loss of use of both lower extremities: Inability to walk or move the legs without assistance such as a wheelchair. 
• Amputation of a leg or arm: Complete surgical removal of a limb due to combat injury or other service-related trauma. 
• Complete paralysis of a limb: Often related to spinal cord damage, preventing movement or control of the affected area. 
• Respiratory failure requiring oxygen: Lung conditions such as severe COPD or interstitial lung disease that need constant oxygen support. 
• End-stage renal disease on dialysis: Kidney failure so severe that the veteran requires ongoing dialysis treatment. 
• Total blindness or bilateral hearing loss: Complete loss of vision or hearing in both eyes or ears, severely limiting daily function.  

These disabilities typically lead to extreme physical limitations and can make a veteran eligible for the 100% portion of the “100 plus 60” rule. 

Common 60%+ Physical Disabilities  

• Back or spine injuries: Conditions like herniated discs, spinal stenosis, or degenerative disc disease that significantly impair mobility or cause chronic pain. 
• Neurological disorders: Such as epilepsy, Parkinson’s disease, or multiple sclerosis when symptoms are severe. 
• Heart disease: Like congestive heart failure or ischemic heart disease that restricts physical activity and poses life-threatening risks. 
• Post-stroke residuals: Lasting effects of a stroke such as hemiplegia (paralysis on one side) or serious motor control issues. 
• Hip or knee replacements: When complications or severe pain persist after joint replacement surgery, especially if mobility remains limited.

These conditions can significantly impact a veteran’s ability to live independently and, when paired with a separate 100% condition, will qualify for SMC-S under the statutory rule. 

Mental Disorders 

Service-connected mental health conditions can also qualify a veteran for SMC-S. These disorders must be diagnosed and rated under the VA’s mental health rating schedule. Just like physical conditions, mental disorders can count toward the 100% rating, the 60% rating, or toward proving the veteran is housebound.

Common 100% Mental Disabilities 

• Post-Traumatic Stress Disorder (PTSD) with total occupational and social impairment (e.g., isolation, violent outbursts, or inability to function in public or private settings) 
• Schizophrenia, particularly when it causes delusions, hallucinations, and loss of reality contact 
• Bipolar Disorder in manic or depressive phases that cause complete dysfunction 
• Cognitive Disorders like TBI-related dementia that lead to full memory loss or lack of basic mental processing 

Common 60% Mental Disabilities

• Severe Depression: When symptoms don’t rise to 100% but still create major problems with functioning 
• Generalized Anxiety Disorder with obsessional rituals or behaviors that interfere with daily routines 
• Traumatic Brain Injury (TBI) with moderate cognitive deficits like memory loss, poor decision-making, or impaired judgment that limits independent living   

Again, the two mental health conditions must be independently rated and diagnosed. You can’t use different symptoms of the same mental disorder to satisfy both parts of the eligibility rule. The VA looks at whether each diagnosis has its own separate impact and whether it qualifies under different diagnostic codes.

How and When to Apply for SMC-S 

In many cases, the VA is supposed to automatically consider SMC-S when a veteran qualifies for it. If your disability ratings meet the “100 plus 60” rule or if you are clearly housebound due to service-connected conditions, the VA should award SMC-S without you having to apply separately. 

However, mistakes happen. The VA may overlook eligibility or misinterpret your medical records, which can result in the benefit not being granted. If that happens, you have the right to take action. Veterans who believe they meet the criteria but were not granted SMC-S can: 

• File a Supplemental Claim with new or relevant medical evidence 
• Request a Higher-Level Review, asking a more experienced reviewer to reexamine the case  

We recommend working with a VA-accredited representative or attorney to help with the process. They can make sure the correct conditions are identified and rated properly, especially when the VA fails to apply the rules fairly or miscalculates eligibility.  

If you’ve been denied SMC-S or suspect you should have been getting it all along, it’s important to act quickly to preserve your right to appeal and to potentially receive retroactive compensation. Hill & Ponton can help you file a claim or appeal for SMC-S – contact us here. 

When Should You Not Apply for SMC-S? 

While SMC-S can offer higher monthly compensation, applying for it isn’t always without risk. If your case isn’t solid, requesting SMC-S could trigger a reexamination of your current service-connected disabilities. 

When the VA reviews your file during an SMC-S claim, they may take a closer look at all your rated conditions. If they decide that any of your existing ratings were too high or no longer supported by medical evidence, they could reduce those ratings.  

That means you could end up with less compensation than you started with. This is especially important to consider if: 

• Your 100% disability rating was granted a long time ago but may no longer reflect your current condition 
• Your housebound status is questionable or temporary 
• Your medical records show improvement or inconsistencies  

That said, if your claim is well-documented and clearly meets the SMC-S requirements, applying may be worth the risk. The SMC-S benefit pays more than the standard 100% VA compensation rate, so the potential increase in monthly income can be significant. 

Before filing, veterans should carefully review their medical records and, if possible, consult with a VA-accredited attorney or representative. They can assess whether your file is strong enough and help avoid unnecessary rating reductions. 

SMC-S Payment Rates and Compensation 

Veterans who qualify for SMC-S receive a higher monthly payment than those rated at the standard 100% disability level. This extra compensation is meant to reflect the added burden of being housebound or having multiple serious service-connected conditions. 

In addition to the base rate for SMC-S, veterans may also receive additional allowances if they have dependents. This includes spouses, children and dependent parents. The added amounts are based on family size and may raise your total monthly compensation even further. 

SMC-S Pay Chart

Dependent Status	SMC-S Pay Rate
Veteran Alone (No Dependents)	$4,288.45
Veteran with Spouse Only	$4,502.06
Veteran with Spouse and One Parent	$4,673.50
Veteran with Spouse and Two Parents	$4,844.94
Single Veteran with One Parent	$4,459.89
Single Veteran with Two Parents	$4,631.33
Additional amount for spouse receiving Aid and Attendance	$195.92

Each year, the VA adjusts these compensation amounts based on the Cost-of-Living Adjustment (COLA), which is tied to inflation. Small yearly increases in SMC-S help ensure that veterans keep up with rising expenses.  

SMC-S provides important support to help manage medical costs, home needs, and loss of mobility or independence. If you qualify for SMC-S or other types of compensation, Hill & Ponton can make sure you won’t leave money on the table. Contact us to evaluate your case.