SMC-N: Both arms preventing natural elbow action, leg or arm-and-leg loss preventing a prosthesis, or no light perception

What this level is

SMC-N is the basic rate in 38 U.S.C. § 1114(n) and 38 CFR § 3.350(d). It is not loss of both feet, and it is not loss of both feet with aid and attendance. Both feet is an SMC-L basis under § 1114(l).

How it is paid

SMC-N is a basic rate. It is paid instead of the schedular 10 to 100 percent table. It is not added on top of a 100% schedular rate.

Criteria

• Under § 1114(n), as amended by Public Law 111-275: anatomical loss or loss of use of both arms with factors preventing natural elbow action with prostheses in place; anatomical loss of both legs with factors that prevent the use of prosthetic appliances; anatomical loss of one arm and one leg with factors that prevent the use of prosthetic appliances; anatomical loss of both eyes; or blindness without light perception in both eyes.
• Section 3.350(d) still phrases the arm loss as anatomical loss or loss of use of both arms at a level, or with complications, preventing natural elbow action with a prosthesis in place. It still phrases the leg losses as anatomical loss of both legs so near the hip as to prevent use of a prosthetic appliance, and anatomical loss of one arm so near the shoulder with anatomical loss of one leg so near the hip as to prevent use of a prosthetic appliance.
• Section 3.350(d) says amputation is a prerequisite except for loss of use of both arms and blindness without light perception in both eyes. If a prosthesis cannot be worn at the present level of amputation but could be applied if there were a reamputation at a higher level, the paragraph (d) requirements are not met. Consideration is then given to loss of natural elbow or knee action.

Anatomical loss of both arms so severe that a prosthetic appliance cannot be used is an SMC-O condition under § 1114(o) and § 3.350(e), not SMC-N. Section 1114(o), as amended by Public Law 111-275, describes that arm loss as anatomical loss of both arms with factors that prevent the use of prosthetic appliances. Section 3.350(e) still says “so near the shoulder as to prevent use of a prosthetic appliance.”