12-23 937, 12-23 937

Veteran served Feb 1952–Feb 1954; died July 2016; surviving spouse substituted as appellant. Claim on appeal from RO decision (Mar 2011).
Veteran had service-connected lumbar strain/osteoarthritis (40%), left lower extremity peripheral neuropathy (40%), right lower extremity peripheral neuropathy (20%); combined 70% and TDIU from April 2, 2003; SMC for loss of use of one foot assigned Jan 3, 2007.
Appellant and private records asserted need for regular aid and attendance and housebound status due to Alzheimer’s, incontinence, falls, mobility limits; death certificate and private notes reflect end‑stage dementia and nursing‑home care before death.
VA obtained and reviewed service, VA, and private treatment records and medical opinions; VA found insufficient evidence linking need for aid/attendance or housebound status to service‑connected disabilities.
Board concluded VA satisfied duty to notify and assist, that additional records/exams would be futile, and that the preponderance of evidence was against SMC based on aid & attendance or housebound criteria.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Entitlement to SMC for need of aid and attendance	Veteran/appellant: needed regular aid and attendance and was housebound due to service‑connected conditions (loss of leg use, neuropathy, back) and dementia/incontinence	VA/Board: record shows need for care but primarily due to non‑service‑connected conditions (Alzheimer’s, COPD, CHF); no sufficient nexus to service‑connected disabilities	Denied — preponderance of evidence shows need for aid/attendance and housebound status were not caused by service‑connected disabilities

Scott v. McDonald, 789 F.3d 1375 (Fed. Cir.) (Board need only address procedural arguments raised by veteran)
King v. Shinseki, 700 F.3d 1339 (Fed. Cir.) (lay claimant not competent to offer medical etiology opinions)
Bradley v. Peake, 22 Vet. App. 280 (Vet. App.) (interpretation of "permanently housebound" under §1114(s))
Buie v. Shinseki, 24 Vet. App. 242 (Vet. App.) (TDIU based on multiple disabilities cannot satisfy section 1114(s) requirement of a single service‑connected disability)
Turco v. Brown, 9 Vet. App. 222 (Vet. App.) (not all enumerated aid‑and‑attendance factors needed; at least one suffices)
Kahana v. Shinseki, 24 Vet. App. 428 (Vet. App.) (laypersons competent to provide some medical evidence but limited)
Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir.) (limitations on probative value of lay evidence for medical issues)
Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir.) (lay evidence insufficient for certain medical diagnoses/etiology)
Woehlaert v. Nicholson, 21 Vet. App. 456 (Vet. App.) (limits on lay competency for medical etiology)
Gilbert v. Derwinski, 1 Vet. App. 49 (Vet. App.) (preponderance standard for VA claims adjudication)
Ortiz v. Principi, 274 F.3d 1361 (Fed. Cir.) (applying evidentiary burden and proof standards in veterans benefits adjudication)