Statutory housebound benefits under 38 U.S.C. § 1114(s) and 38 CFR 3.350(i) are, in theory, determined from existing disability ratings: you need one disability rated 100% schedular (or a TDIU rating that meets the single-disability test) plus additional service-connected disabilities that independently combine to 60% or more. When those numbers already exist in the rating decision, no new medical exam should technically be required to establish entitlement.
In practice, VA and its contracted examiners (QTC/Leidos, VES, LHI) often route any claim coded as SMC through the same general Housebound/Aid and Attendance DBQ template, regardless of whether the veteran is claiming statutory entitlement or factual (need-for-care) entitlement. That DBQ asks about activities of daily living, how often the veteran leaves home, and whether help is needed, because the same form is used for both types of determinations. This does not necessarily mean VA is reevaluating your individual disability ratings or requiring you to prove factual housebound status; it may simply reflect an administrative default in how the exam request was coded.
Official 2026 VA monthly compensation, including the 2.8% COLA increase.
Dependent add-ons start at a 30% rating. Child-only and dependent-parent rates: see the full 2026 pay chart.
| Rating | Monthly (2026, incl. 2.8% COLA) |
|---|---|
| 10% | $180.42 |
| 20% | $356.66 |
| 30% | $552.47 |
| 40% | $795.84 |
| 50% | $1,132.90 |
| 60% | $1,435.02 |
| 70% | $1,808.45 |
| 80% | $2,102.15 |
| 90% | $2,362.30 |
| 100% | $3,938.58 |
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Analyze my claim free →There is also a substantive reason VA may want more information in some cases. Under Bradley v. Peake and related case law, if TDIU was granted based on multiple disabilities rather than one disability alone reaching 100%, the rating specialist may need to confirm which single disability could stand alone at 100% (schedular or via extraschedular/TDIU analysis) before combining it with the remaining 60%. Since your PTSD/MDD is now rated 100% schedular on its own, that prong is generally satisfied without needing new medical evidence, but the file reviewer may still want the exam findings on record to support the decision or to address any ambiguity from the 2018 TDIU grant that cited multiple conditions.
Outcomes on this vary by regional office and rating specialist, and there is no fixed rule about whether the exam changes the outcome. Some veterans report the exam has no effect on a straightforward statutory SMC-S grant once the 100%+60% math is confirmed; others find the exam findings get folded into a broader SMC review that also considers factual A&A/Housebound entitlement, which can work in the veteran's favor if it reveals a higher level of need.
Attend the scheduled exam, answer the examiner's questions honestly and completely even if some seem irrelevant to statutory entitlement, and keep a copy of your appointment letter and the 2018 TDIU decision. If the resulting rating decision denies statutory SMC-S despite your ratings meeting the 100%+60% criteria, that decision can be appealed using VA Form 20-0995 (Supplemental Claim) or 20-0996 (Higher-Level Review), citing 38 CFR 3.350(i) and the existing combined ratings as the basis for entitlement.
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