Citation Nr: 0004527 Decision Date: 02/22/00 Archive Date: 02/28/00 DOCKET NO. 97-17 670 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Cleveland, Ohio THE ISSUE Entitlement to special monthly pension on account of being housebound. WITNESS AT HEARING ON APPEAL The veteran ATTORNEY FOR THE BOARD Raymond F. Ferner, Counsel INTRODUCTION This matter comes before the Board of Veterans' Appeals (BVA or Board) on appeal from the Department of Veterans Affairs (VA) Regional Office (RO) in Cleveland, Ohio, which denied the benefit sought on appeal. The veteran, who had active service from January 1953 to July 1955, appealed that decision to the BVA, and the case was referred to the Board for appellant review. FINDINGS OF FACT 1. All relevant evidence necessary for an equitable disposition of the veteran's appeal has been obtained by the RO. 2. The veteran is in receipt of nonservice-connected pension benefits, but does not have a single disability rated as 100 percent disabling with a separate disability independently ratable at 60 percent or more. 3. The veteran is not shown by reason of his disabilities to be substantially confined to his dwelling and immediate premises and is not institutionalized due to his disabilities. CONCLUSION OF LAW The requirements for special monthly pension on account of being housebound have not been met. 38 U.S.C.A. §§ 1502, 1521, 5107 (West 1991); 38 C.F.R. §§ 3.102, 3.351 (1999). REASONS AND BASES FOR FINDINGS AND CONCLUSION As a preliminary matter, the Board finds that the veteran's claim is "well grounded" within the meaning of 38 U.S.C.A. § 5107(a) (West 1991). See Murphy v. Derwinski, 1 Vet. App. 78, 81 (1990); Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). That is, the Board finds that the veteran has presented a claim which is not implausible when his contentions and the evidence of record are viewed in the light most favorable to that claim. The Board is also satisfied that all relevant facts have been properly and sufficiently developed. The veteran essentially contends that, due to a second heart attack he had in September 1996, he is housebound, and thus should be entitled to special monthly pension benefits. He asserts that he is unable to walk for any significant distance. He relates that he takes a significant amount of medication for his disabilities. The veteran has been found entitled to nonservice-connected pension benefits. 38 U.S.C.A. § 1521 (West 1991). Increased pension benefits are payable to a veteran who is housebound. 38 U.S.C.A. §§ 1502(c), 1521(e) (West 1991); 38 C.F.R. § 3.351 (d) (1999). The pertinent regulations provide that the rate of pension payable to a veteran who is entitled to pension under 38 U.S.C.A. § 1521 and who is not in need of regular aid and attendance shall be as prescribed in 38 U.S.C.A § 1521(e) if, in addition to having a single permanent disability rated 100 percent disabling under the VA's Schedule for Rating Disabilities (not including ratings based upon unemployability under § 4.17 of this chapter) the veteran: (1) has additional disability or disabilities independently ratable at 60 percent or more, separate and distinct from the permanent disability rated as 100 percent disabling and involving different anatomical segments or bodily systems, or, (2) is "permanently housebound" by reason of disability or disabilities. This requirement is met when the veteran is substantially confined to his or her dwelling and the immediate premises or, if institutionalized, to the ward or clinical area, and it is reasonably certain that the disability or disabilities and resultant confinement will continue throughout his or her lifetime. 38 C.F.R. § 3.351 (d) (1999). A review of the evidence of record discloses that the veteran does not have a single disability that is rated as 100 disabling along with an additional disability independently rated at 60 percent disabling. The veteran's disabilities consist of a 60 percent evaluation for coronary artery disease, status post myocardial infarction, hypertension and atrial fibrillation/atrial flutter; a 20 percent evaluation for a herniated nucleus pulposus at L4-5; 10 percent evaluation for residuals of a brain stem stroke; 10 percent for arthritis/synovitis of the right knee; 10 percent for arthritis/synovitis of the right thumb; 10 percent for anxiety/depression; 10 percent for diabetes mellitus; and 10 percent for mononeuritis complex involving the right saphenous, sural and tibial motor nerves, for a combined evaluation of 80 percent. At this point, the Board notes that the veteran does not appear to contend that any specific disability should be rated higher, but appears to contend that he is housebound primarily due to his heart disease. However, even assuming that the veteran's heart disease was evaluated as 100 percent disabling, none of the other disabilities would appear to warrant a 60 percent evaluation. The medical evidence for consideration includes VA hospital and outpatient treatment records, as well as the reports of VA examinations performed in February and July 1997. The February 1997 VA examination for aid and attendance and housebound benefits indicated that the veteran complained of dyspnea on exertion and right lower extremity weakness. Examination disclosed no functional restrictions of the upper extremities and no limitation of motion or deformities affecting breathing of the spine, trunk, and neck. The right lower extremity had weakness with decreased mobility secondary to weakness and mononeuritis complex. This was noted to affect the veteran's ability to make it to the bathroom at night. The veteran was also noted to have a deficit in weight bearing in the right lower extremity and decreased propulsion. There was some evidence of dizziness, especially with medication because of orthostasis. At one point the examiner indicated that the veteran did not leave his home if he could help it and that he stayed home all day. However, it was also noted that he was able to walk 100 feet without assistance, utilized a cane to ambulate and left his home 6 to 10 times a month, with 2 or 3 of those times for attendance at church with the remaining times for medical appointments with the VA. A VA aid and attendance examination performed in July 1997 shows the examiner recorded that the veteran related that he managed his own personal care and managed the home finances. It was also noted that the veteran performed household chores and that he took his medication without difficulty. It was also indicated that the veteran continued to drive without difficulty. Musculoskeletal examination disclosed the veteran had normal bulk and tone in muscles in both the upper and lower extremities and that he had a full range of motion of all joints with no evidence of fixed deformity, erythema or effusion. There was no instability of any joints and there was no evidence of muscle atrophy or tenderness. Neurological examination revealed 5/5 muscle strength in both the upper and lower extremities. The veteran's gait was noted to be normal. Following the examination, the examiner indicated that the veteran was not obviously bed bound or housebound at the present time. The veteran appeared for a personal hearing at the RO in October 1997 at which time he indicated that he rode a bus to the hearing and that he did not have any trouble doing so given the proximity of the bus stop right across the street where he lived. He reported experiencing pain with ambulation primarily in the right knee. The veteran testified that, because of his diabetes, a dietitian had told him to take a 15-minute walk every day and that he was able to do so. Based on this evidence, the Board finds that the veteran does not meet the requirements for special monthly pension on account of being housebound. The veteran does not have a single disability that is evaluated as 100 percent disabling along with an additional disability which is independently evaluated as 60 percent disabling. The Board also finds that even were the veteran's heart disability evaluated as 100 percent disabling, the medical evidence does not demonstrate that any of the other disabilities would be evaluated as 60 percent disabling. See 38 C.F.R. Part 4, Diagnostic Codes 5003, 5293, 7913, 8008 and 8699-8625. In addition, the veteran is not shown to be factually confined to his dwelling or immediate premises due to his disabilities. In this regard, the Board notes that the record reflects that the veteran does travel beyond his premises as necessary, and the veteran testified that part of his treatment included a 15-minute walk on a daily basis. Accordingly, the Board concludes that the requirements for housebound benefits have not been met. ORDER Special monthly pension on account of being housebound is denied. S. L. KENNEDY Member, Board of Veterans' Appeals