SMC-R: Additional aid and attendance allowance

What this level is

SMC-R is an additional aid-and-attendance allowance for a veteran who is already at the § 1114(o) rate, the maximum rate under § 1114(p), or the intermediate rate between § 1114(n) and (o) plus a rate under § 1114(k), and who needs regular aid and attendance. It is not the aid-and-attendance basis for SMC-L. It is not anatomical loss of both arms or both legs. Those losses are SMC-N or SMC-O, depending on the level.

How it is paid

Section 1114(r) pays the allowance in addition to that underlying compensation, subject to 38 U.S.C. § 5503(c). Subsection (r)(1) is the regular aid-and-attendance allowance. Subsection (r)(2) is a higher-level allowance paid in lieu of (r)(1). VA.gov’s rate table effective December 1, 2025 labels the veteran-alone totals SMC-R.1 and SMC-R.2/T. Those table amounts are the totals in those columns. This page does not print them. Section 3.350(h) says the allowance is payable during periods the veteran is not hospitalized at United States Government expense. See § 3.552(b)(2) on continuance after admission. The same paragraph says the allowance is payable whether or not the need for regular aid and attendance, or a higher level of care, was a partial basis for the maximum rate under § 1114(o) or (p), or was an independent factual determination.

Criteria

• The veteran is otherwise entitled to the rate under § 1114(o), the maximum rate under § 1114(p), or the intermediate rate between § 1114(n) and (o) together with a rate under § 1114(k).
• The veteran is in need of regular aid and attendance. Section 3.350(h) uses the criteria in § 3.352.
• Section 1114(r)(2): a higher level of care, in addition to the need for regular aid and attendance. The statute defines that need as personal health-care services provided on a daily basis in the veteran’s home by a person who is licensed to provide such services, or who provides them under the regular supervision of a licensed health-care professional. In the absence of that care, the veteran would require hospitalization, nursing home care, or other residential institutional care.
• Section 1114(r) says the higher-level need is determined by a physician employed by the Department or, where no such physician is available, by a physician under contract or fee arrangement, based on an examination by that physician.
• The (r)(2) allowance is in lieu of the (r)(1) allowance. It is not paid on top of (r)(1).