If you’ve been diagnosed with a traumatic brain injury (TBI) and are receiving benefits for that disability, you should consider if you’re earning what you should be! Are you earning 4k in benefits a month when you could be earning 10k? The secret to this dramatic increase in compensation is a specialized VA disability benefit called SMC-T.
What Is SMC-T?
SMC-T is a Special Monthly Compensation level created for veterans suffering the effects of severe TBI, with pay rates that go beyond the standard VA disability payments. SMC-T is designed to give extra financial support to veterans who need constant personal care, such as help with bathing, eating, using the bathroom, or staying safe at home. These veterans would have to live in a nursing home, hospital, or other care facility if they didn’t have someone helping them with their activities of daily living.
What makes SMC-T different from other VA compensation levels is that it focuses entirely on the long-term impact of TBI, not just the injury itself. Veterans who qualify for SMC-T are typically unable to live alone or make basic decisions without help. Some may need round-the-clock supervision because of seizures, confusion, memory loss, poor judgment, or severe mood swings. SMC-T provides the financial support to make sure they get the care they need to stay out of a full-time medical facility.
Eligibility Requirements for SMC-T
To qualify for SMC-T, a veteran must meet three very specific requirements. All three must be true at the same time, or the VA will not approve the benefit.
1. You must have a service-connected traumatic brain injury (TBI). This means your TBI must have been caused or worsened by your military service and officially recognized by the VA as a service-connected condition.
2. You must need regular Aid and Attendance (A&A). This means you need another person to help you with daily tasks, such as:
- Bathing or dressing
- Preparing meals and feeding yourself
- Managing medications
- Going to the bathroom
- Staying safe from danger (for example, due to memory loss or seizures)
This help doesn’t have to come from a nurse, it could be a spouse, adult child, friend, or professional caregiver; but the help must be frequent and necessary.
3. You must show that you would require residential institutional care if you didn’t have help at home.
This is the part that makes SMC-T unique. The VA will look at your situation and ask: Would this veteran need to live in a hospital or skilled nursing facility without someone to provide regular aid and attendance to the veteran? If the answer is yes, then you meet this part of the requirement even if you’re currently staying at home with help.
This last point is very important. The VA understands that some veterans only stay out of a facility because a caregiver provides the kind of care they would otherwise get in a hospital. SMC-T exists to support those exact situations.
If you qualify for SMC-T and you are not in a hospital or care facility, you’ll receive pay at the same level as SMC-R2—the highest monthly rate available for any Special Monthly Compensation. Keep in mind that you cannot receive SMC-T and SMC-R1 or R2 at the same time. The VA does not allow both payments together because they cover similar care needs. SMC-T was created to assist those veterans with TBIs who cannot otherwise qualify for the higher levels of Aid and Attendance such as SMC R-1 and R-2.
Medical Criteria
To be approved for SMC-T, you have to prove your need for Aid and Attendance with strong medical evidence. The VA needs documentation showing your traumatic brain injury is so severe that you can’t live independently and would need to be in a hospital or nursing home if you didn’t have help.
The VA will review how much the TBI affects your brain function. This includes:
- Cognitive impairment (trouble with memory, attention, or thinking clearly)
- Communication issues (difficulty understanding or expressing words)
- Behavioral problems (anger, poor judgment, mood swings)
- Physical problems (such as trouble walking or frequent seizures)
To measure these things, the VA might use cognitive assessment tools (tests that check your memory, thinking, and problem-solving) and Functional Independence Measures – these show how much help you need for things like dressing, bathing, eating, and moving around.
The results from these evaluations help the VA understand how serious your injury is and whether it meets the threshold for institutional-level care. Visit our Diagnosing and Rating TBI Residuals page to learn more.
How to Get SMC-T VA Disability
Winning a claim for SMC-T is all about showing the VA that your traumatic brain injury creates such a severe impairment that you would need to live in a hospital or care facility unless someone is helping you every day at home. This doesn’t just mean you forget things or need help occasionally, it means you:
- Need help regularly to do basic tasks
- Could get hurt or worsen your condition without supervision
- Would need to be placed in a hospital, nursing home, or mental health facility without a caregiver’s support
Supporting Medical Documentation
- VA Form 21-2680: This form is an “Examination for Housebound Status or Permanent Need for Regular Aid and Attendance.” A doctor completes this to show the VA how much help you need each day.
- Private medical opinions: You can also include reports from neurologists or brain injury specialists who have evaluated your condition.
- Neuropsychological evaluations: These detailed tests can show how your brain injury affects your daily life.
- Home health care records: If you use a professional caregiver or home health agency, their documentation can show the level of care you receive.
- Caregiver statements: A letter from a spouse, family member, or other caregiver explaining your daily care needs can also strengthen your case.
Can Other Disabilities Help You Win SMC-T?
Yes, they absolutely can as long as they are secondary to the TBI. For instance, if your TBI causes migraines or depression or incontinence issues which are service-connected secondary to your TBI, VA should provide separate ratings for those disabilities and should consider them as a part of your TBI when determining if your TBI is the reason that you need Aid and Attendance.
The VA has to look at the whole picture when deciding if you qualify. If you have other conditions that make it even harder to live safely or manage your health, those combined effects may help you meet the criteria for SMC-T. Imagine this situation:
A veteran has a severe TBI that affects memory and causes confusion. They also have seizures, which are linked to the TBI. On top of that, they’ve been diagnosed with PTSD, another service-connected condition. This veteran might:
- Forget to take medication on time
- Wander outside and get lost
- Have unpredictable emotional outbursts
- Experience seizures that require someone to step in and help immediately
Now ask yourself: Could this veteran safely live alone? Probably not. Without someone there constantly, the veteran could easily end up hurt, lost, or worse. That’s the kind of situation the VA looks at and says: “Yes, this person needs round-the-clock care, even if they’re getting it at home instead of in a facility.”
In that case, the VA could award SMC-T, paid at the SMC-R2 level, which is the highest possible SMC monthly payment.
Even if your TBI by itself doesn’t meet the strict standards for institutional care, your other service-connected disabilities might still help you “stack” your conditions to increase your overall VA rating or qualify for higher levels of SMC, like SMC–O or SMC–R1.
So, while SMC-T may be the goal, other SMC levels might still offer significant financial help if your disabilities are severe and well documented. We recommend exploring all possibilities – and can help you determine what you qualify for.
SMC-T Pay Rates and Benefits
SMC-T offers the highest payment available to veterans. SMC-T pay is the same rate as SMC-R2, which is the top tier of Special Monthly Compensation.
As of now the monthly payment for SMC-R2, which is the payment rate for veterans approved under SMC-T, can exceed $10,000 per month depending on your dependent status (such as having a spouse, children, or dependent parents). This figure varies each year based on cost-of-living adjustments.
However, it’s important to understand that SMC-T does not add to your regular VA disability compensation, it replaces it. That means if you qualify for SMC-T, you won’t receive your standard VA disability payment in addition to SMC-T. Instead, you’ll receive a single, higher monthly amount (tax-free) that includes the special monthly compensation and reflects the level of your need for care.
Other Benefits
Eligibility for Paid In-Home Medical Attendants
Veterans who qualify for SMC-T don’t just receive the highest possible monthly payment from the VA, they may also qualify for additional programs and resources that can make life more manageable. These benefits are especially important for veterans who are being cared for at home instead of in a facility, because they help with daily medical needs, home modifications, and family support.
If your medical condition requires skilled care, such as medication management or assistance with serious health needs, the VA may cover the cost of having a registered nurse (RN) or licensed practical nurse (LPN) come to your home. Examples of services a paid caregiver may provide:
- Administering or organizing daily medications
- Wound care or catheter management
- Helping with hygiene, transfers, or feeding
- Supervision to prevent injury, especially in cases of severe cognitive decline or seizures
Housing and Equipment Benefits
Because veterans approved for SMC-T often have significant physical and cognitive impairments, they may also be eligible for specialized grants and adaptive equipment to make their home and vehicle safer and more accessible, such as:
- Specially Adapted Housing (SAH) Grants that help veterans build or remodel a home to meet their needs—adding wheelchair ramps, widened doorways, roll-in showers, and more.
- Home Improvement and Structural Alterations (HISA) Grants to assist with smaller home modifications that improve mobility or safety, such as grab bars, walk-in tubs, or stair lifts.
- Automobile and Adaptive Equipment Benefits covering the cost of vehicles modified for wheelchair access or with hand controls, so veterans can maintain some independence or get to medical appointments safely.
These benefits aren’t automatically included with SMC-T, but they may be approved for veterans who meet the SMC-T criteria because of the severity of their injuries. Learn about disabled veterans’ housing allowance.
Benefits for Veterans’ Families
SMC-T doesn’t just help the veteran—it can also unlock support for family members, especially if the veteran is rated permanent and total or if SMC-T is the highest award on record. Family benefits may include:
- CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs) – Provides healthcare coverage for spouses and dependents if the veteran isn’t eligible for TRICARE.
- Dependents’ Educational Assistance (DEA) – Helps pay for school or training programs for children and spouses of disabled veterans.
- VA Caregiver Support Program – Offers services like training, respite care, mental health support, as well as monthly stipends for the veteran’s primary family caregiver.
These additional benefits can make a major difference in the life of a veteran with TBI and his or her family. They provide much needed financial relief, improve safety and accessibility, and support those who take on the demanding task of caregiving. If you qualify for SMC-T, don’t stop there; make sure you also explore these other programs and apply for the help you’ve earned.
Are You Owed More Pay from the VA?
If you were previously rated at a lower level of Special Monthly Compensation such as SMC–M or SMC–L, but your records at the time showed that your TBI-related needs met the criteria for SMC–T you may be eligible for retroactive compensation.
The VA can make rating errors, especially when claims involve complex conditions like traumatic brain injury. Veterans who met the standards for Aid and Attendance and either required residential care or would have without in-home support may have been misrated.
If that applies to you, you have the right to request a review of your past rating decision. You may be able to appeal or pursue a CUE claim (Clear and Unmistakable Error) if the evidence at the time supported a higher SMC rating.
Correcting a past rating could result in substantial back pay, covering the difference between what you were paid and what you should have received under SMC–T. Hill & Ponton specializes in VA disability and can help you win SMC-T. Get a free evaluation of your case here.
SMC-T Appeal Paths
Many veterans miss out on SMC-T because they apply incorrectly or don’t send in enough proof. If your paperwork is missing details or your evidence doesn’t clearly show your need for care, the VA may deny your claim—even if you should qualify.
If the VA denies your claim for SMC–T, or you believe the decision was incorrect, you have the right to appeal just like with any other VA benefits decision. You can pursue one of the standard VA appeal paths:
- Supplemental Claim – Submit new and relevant evidence for the VA to review
- Higher-Level Review – Ask for a senior reviewer to reconsider your case without adding new evidence
- Board Appeal – Take your case directly to the Board of Veterans’ Appeals and choose between a direct review, submission of additional evidence, or a hearing
Each option comes with different timelines and requirements, so it’s important to choose the right path for your situation. Our VA-accredited disability lawyers can guide you through the appeals process and build a stronger case to win the VA’s approval. Call us at 1-888-477-2363 for a free evaluation of your claim.
