Some service-connected losses are not fully captured by a percentage on the rating schedule. Special monthly compensation exists for those, and it is paid in addition to the schedular evaluation rather than instead of it.
This guide is part of our series on VA claims for women veterans.
Where the rules live
38 CFR 3.350 contains the special monthly compensation ratings, lettered by category. The VA publishes the current dollar amounts on its special monthly compensation rates page.
Anatomical loss categories that come up
Two categories appear most often in claims covered by this series:
- Loss of a creative organ, which the regulation defines to include anatomical loss of reproductive organs
- Anatomical loss of one or both breasts, including surgical removal, which is addressed in the same regulation
How it interacts with the schedular rating
The schedular evaluation for the underlying condition continues under 38 CFR 4.116. Special monthly compensation is an additional payment layered on top when the regulation's criteria are met, and it is not subject to the pyramiding limit in the same way, because it compensates a different thing than the schedular percentage does.
Where veterans start
Every case is different, and there is no obligation at any step. When veterans want to understand what their records actually support, these are the two most common starting points:
- Medical records review
A licensed physician reviews your records for a $250 flat fee and identifies which conditions the available evidence may support. The fee is refunded in full if nothing supportable is identified.
- Nexus letter
When the records support one, a licensed provider writes the medical opinion that addresses the link between your condition and your service.
What the evidence has to show
Entitlement follows the evidence of record: the specific anatomical loss, documented in the medical records, and service connection for the condition that caused it. Where that evidence is evenly balanced, 38 CFR 3.102 directs resolving reasonable doubt in the veteran's favor.
How claims for SMC are typically raised
Special monthly compensation is not always the subject of a separate claim form. It can be raised within a claim for the underlying condition once the record documents the anatomical loss, or it can be identified later if the VA's review of the file shows that the criteria in 38 CFR 3.350 are met. Either way, the medical evidence describing the loss has to be part of the record.
Because entitlement depends on documented findings rather than on the label used in a claim, records from the surgeon or treating physician, physician assistant, or nurse practitioner describing exactly what was removed or lost are the evidence that matters most.
Combining categories
38 CFR 3.350 lists multiple lettered categories of special monthly compensation, and more than one can potentially apply where a veteran has more than one qualifying loss or level of impairment. How the categories combine is set out in the regulation itself and depends on the specific findings in a case.
Because this area of the regulation is technical, and because entitlement depends closely on the specific medical findings, this is one of the areas where working with an accredited representative familiar with SMC determinations can be particularly useful.
This guide is educational. It summarizes the VA's own published rules and links to the exact sources it relies on. It is not legal or claims advice, and it is not a substitute for an accredited representative, who can advise you about your specific claim. Accredited help is free - search the VA's accreditation database to find a Veterans Service Organization, accredited agent, or attorney.
Frequently asked questions
What is special monthly compensation?
Special monthly compensation is an additional payment for specific circumstances that the ordinary rating schedule does not capture, such as anatomical loss or loss of use. 38 CFR 3.350 sets out the ratings and the VA publishes the rates.
Does it replace the regular rating?
No. Special monthly compensation is paid in addition to the schedular evaluation for the condition when the criteria in the regulation are met.
Is it awarded automatically?
38 CFR 3.350 sets the criteria, and entitlement is decided on the evidence of record. The findings that support it - the specific anatomical loss and its service connection - need to appear in the medical evidence.