If entitlement to A&A is established under the provisions of then i. Drafting and PL 96-128, Coding the Rating Decision cite relevant evidence and information in the to fully justify Narrative Awarding awarding or denying A&A, and Entitlement to use SMC code 43 or 44 in higher level care claims. A&A Under PL 96-128 Pay the rate allowed for SMC at the +k” level, plus the additional Note: “n½ amount allowed under or , whichever is appropriate. For more information on entitlement to a higher A&A allowance Reference: , see M21-1, Part IV, Subpart ii, 2.H.9. 9. Entitlement to a Higher A&A Allowance Under 38 U.S.C. 1114(r)(2) This topic contains information on the statutory provisions for a higher A&A Introduction allowance, including information on entitlement to a higher A&A allowance under 38 U.S.C. 1114(r)(2) when to award a higher A&A allowance under 38 U.S.C. 1114(r)(2) evidentiary considerations for higher level of care processing claims for entitlement to a higher A&A allowance under 38 U.S.C. 1114(r)(2), and possible hospitalization adjustment under 38 CFR 3.552(b)(2). Change Date January 5, 2016 a. Entitlement A Veteran entitled to the A&A allowance is entitled to receive, in lieu of to a Higher that allowance, a higher A&A allowance under if the Veteran is found to be A&A in need of, and receiving, a higher level of care. Allowance 38 U.S.C. 1114(r)(2) b. When to Award the higher A&A allowance under when the only Award a Higher A&A need is clearly established, and Allowance the amount of skilled service required by the Veteran is substantial. Under 38 U.S.C. Base eligibility to the higher allowance on medical certification that the 1114(r)(2) Veteran meets the criteria set forth in .
i. Drafting and Coding the Rating Decision Awarding Entitlement to A&A Under PL 96-128 If entitlement to A&A is established under the provisions of PL 96-128, then cite relevant evidence and information in the Narrative to fully justify awarding or denying A&A, and use SMC code 43 or 44 in higher level care claims. Note: Pay the rate allowed for SMC at the “n½ +k” level, plus the additional amount allowed under or , whichever is appropriate. Reference: For more information on entitlement to a higher A&A allowance , see M21-1, Part IV, Subpart ii, 2.H.9. 9. Entitlement to a Higher A&A Allowance Under 38 U.S.C. 1114(r)(2) Introduction This topic contains information on the statutory provisions for a higher A&A allowance, including information on entitlement to a higher A&A allowance under 38 U.S.C. 1114(r)(2) when to award a higher A&A allowance under 38 U.S.C. 1114(r)(2) evidentiary considerations for higher level of care processing claims for entitlement to a higher A&A allowance under 38 U.S.C. 1114(r)(2), and possible hospitalization adjustment under 38 CFR 3.552(b)(2). Change Date January 5, 2016 a. Entitlement to a Higher A&A Allowance 38 U.S.C. 1114(r)(2) A Veteran entitled to the A&A allowance is entitled to receive, in lieu of that allowance, a higher A&A allowance under if the Veteran is found to be in need of, and receiving, a higher level of care. b. When to Award a Higher A&A Allowance Under 38 U.S.C. 1114(r)(2) Award the higher A&A allowance under only when the need is clearly established, and the amount of skilled service required by the Veteran is substantial. Base eligibility to the higher allowance on medical certification that the Veteran meets the criteria set forth in .