SMC-K: Loss or Loss of Use of an Anatomical Part

SMC-K is an add-on payment, on top of your regular monthly compensation, for the anatomical loss or loss of use of specific body parts. Authority: 38 USC § 1114(k), implemented at 38 CFR § 3.350(a).

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Summary of qualifying SMC-K loss or loss of use involving organs, hands, feet, senses, and breast tissue.
Visual guide: SMC-K Loss and Loss of Use View full size · All 30 visual guides

What Is SMC-K?

SMC-K is an additional monthly payment, currently $139.87/month, paid on top of your regular schedular compensation when you have suffered the anatomical loss or loss of use of a specific body part listed in 38 CFR § 3.350(a).

Unlike SMC-L through SMC-T (which replace your schedular rate with a higher monthly amount), SMC-K stacks on top of your existing pay. Veterans at any rating from 0% to 100% can receive SMC-K if they qualify.

Key distinction: SMC-K is the only SMC tier that's purely additive. Higher tiers (L, M, N, O, R-1, R-2, T) replace your monthly rate. So if you qualify for both SMC-K and SMC-L, you receive SMC-L's rate plus SMC-K's add-on, both.

The Qualifying Losses

The regulation lists the qualifying anatomical losses or losses of use (see 38 CFR § 3.350(a)):

#CategoryNotes
1Creative organ (testicle / ovary)Loss or loss of use of either, or sterility from service-connected condition.
2One footLoss or loss of use. Both feet = qualifies for SMC-L instead.
3One handLoss or loss of use. One hand + one foot = qualifies for SMC-L.
4Both buttocksLoss of use due to severe gluteal injury.
5Blindness in one eye having only light perceptionThe regulatory test: cannot recognize test letters at 1 foot, and cannot make out objects, hand movements, or count fingers at 3 feet (§ 3.350(a)(4)). Not the 5/200 standard, which is the bilateral test for SMC-L.
6Deafness in both ears (with absence of air and bone conduction)Total deafness, not partial.
7Complete organic aphoniaLoss of voice, no functional speech possible.
8One or both breastsFrom mastectomy or wide local excision (radical or modified radical). Treated as loss of one breast.
9Loss of erectile functionCounted as loss of use of a creative organ. SMC-K does not require penile deformity; that is the separate requirement for a compensable rating under DC 7522, which is a different question from SMC-K.

The list above shows the most common categories. The full regulation also covers loss of use of mastectomy on the female anatomy, and a handful of less-common scenarios. Read 38 CFR § 3.350(a) directly for the full list.

"Loss of Use" Standard

"Loss of use" of a hand or foot is defined in 38 CFR § 3.350(a)(2):

"Loss of use of a hand or a foot will be held to exist when no effective function remains other than that which would be equally well served by an amputation stump at the site of election below elbow or knee with use of a suitable prosthetic appliance."

The legal test is functional, not anatomical. A foot that is technically intact but completely unable to bear weight or perform any locomotor function may satisfy "loss of use." Severe peripheral neuropathy, end-stage drop foot, or complete tarsal-tunnel syndrome commonly meet this standard.

For a creative organ, "loss of use" means the organ cannot perform its reproductive function. Sterility from service-connected radiation exposure, chemotherapy, or surgical removal qualifies even when the organ is anatomically present.

One-page guide: SMC-K Addition Rules Rules for adding one to three SMC-K awards and the exclusions for SMC-O, Q, and R. Opens the full-size chart, free to save or print.

Stacking Multiple SMC-K Awards

SMC-K awards stack: each separate qualifying loss adds another $139.87/month. Two losses = $279.74. Three = $419.61.

Example: a veteran with service-connected diabetes who has lost erectile function (SMC-K #1) and has loss of use of one foot from peripheral neuropathy (SMC-K #2) and is sterile from chemotherapy for service-connected cancer (SMC-K #3) receives 3 × SMC-K, an additional $419.61/month on top of their schedular rate.

Stacking K awards does not, by itself, move you up the ladder. The intermediate and next-higher rates in § 3.350(f) have their own predicates, and a count of K awards is not one of them. They are: specific paired anatomical losses (for example loss of use of one foot together with loss of use of one leg preventing natural knee action); certain blindness and blindness-with-deafness combinations; a separate and distinct permanent disability independently ratable at 50 percent, or at 100 percent, involving a different anatomical segment or body system from the loss that established the base rate; and loss or loss of use of three extremities. Those bumps build on an existing SMC-L through N rate, not on a pile of K awards. Model the full ladder, because a qualifying loss can support both a K award and a higher-tier predicate, but the K count itself is not the trigger.

Illustrative Example

Fictional example, not a real claimant. Names and facts are invented to show how the criteria above could apply in a single case.

Marcus T. served in the Army from 2003 to 2007. During his second tour in Iraq, an IED blast cost him his left foot below the ankle. The VA rated his amputation at 40% under diagnostic code 5165, but because losing a foot is a "loss of use" event under the SMC rules at 38 CFR § 3.350(a), Marcus also receives the SMC-K special monthly payment of $139.87 on top of his regular compensation. He walks with a prosthesis and lives independently.

2026 Rate

SMC-K's 2026 monthly add-on is $139.87, set by VA each December 1 alongside COLA-adjusted compensation rates. The rate has no dependent supplements, it's a flat add-on regardless of family composition.

Per loss, the rate stacks linearly: two qualifying losses = $279.74, three = $419.61. It is not unlimited. 38 CFR § 3.350(a) caps the total by rate rather than by a headcount: added to the ordinary rates or to SMC-S, the combined amount cannot exceed the SMC-L rate; added to SMC-L through N or to an intermediate SMC-P rate, it cannot exceed the SMC-O rate. VA's published rate tables reflect that ceiling by showing K added one, two, or three times, and K is not added on top of SMC-O, Q, or R.

Use the VA Math Calculator to model SMC-K stacking against your underlying schedular rate.

Evidence framework for loss of use of a hand, foot, eye, or reproductive organ.
Visual guide: Loss of Use Evidence View full size · All 30 visual guides

Evidence That Wins

SMC-K evidence depends on the category claimed:

  • Anatomical loss (amputation, surgical removal): operative reports, post-op imaging, surgical pathology. Usually undisputed.
  • Loss of use of foot/hand: EMG/nerve conduction studies, orthopedic exam findings of "no effective function," videotape evidence of weight-bearing or grip limitations.
  • Creative organ / loss of erectile function: urology workup, hormone panels, treatment records (PDE-5 inhibitors documented as ineffective). The bar is lower than commonly assumed, treatment failure on standard medications often suffices.
  • Sterility: semen analysis (azoospermia / severely abnormal counts), gynecologic exam findings of premature ovarian failure, oncology records linking sterility to service-connected treatment.
  • Blindness in one eye: an ophthalmology report addressing the regulatory test, whether you can recognize test letters at 1 foot and whether you can perceive objects, hand movements, or count fingers at 3 feet. Ask the examiner to answer those two questions directly; a bare Snellen figure often does not.
  • Deafness: audiologic testing showing absence of both air and bone conduction.
  • Aphonia: ENT/laryngology records, speech-pathology evaluation, video evidence of attempted phonation.
One-page guide: Evidence Cited in SMC Decisions Counts of evidence labels cited across 38,839 confirmed claims in the extracted SMC Board corpus. Opens the full-size chart, free to save or print.

SMC-K vs SMC-L and Higher

SMC-K (Add-On)

How it pays: $139.87 ON TOP of your schedular rate.

Stacks: yes, each qualifying loss adds another $139.87.

Triggers: single anatomical loss/loss of use from the § 3.350(a) list.

SMC-L+ (Replacement)

How it pays: replaces schedular rate with higher SMC monthly amount.

Stacks: with SMC-K only (different mechanism).

Triggers: A&A need, bedridden, both feet/hand+foot/blindness, or higher combined losses.

The two coexist. A veteran with regular A&A need (SMC-L) plus loss of erectile function (SMC-K) receives the SMC-L rate plus the SMC-K add-on.

How to File

  1. File VA Form 21-526EZ. SMC-K can be claimed on the same disability claim that establishes the underlying condition (e.g., file diabetes + claim SMC-K for loss of erectile function as secondary).
  2. Document the qualifying loss. Operative reports, EMG/NCS, audiology, ophthalmology, urology workup, depending on category.
  3. Establish service connection of the underlying cause. SMC-K only pays for losses caused by service-connected conditions. The cancer, the diabetes, the trauma, must itself be service-connected.
  4. Identify all SMC-K losses on the claim. If multiple categories apply, list each one. VA does not infer additional SMC-K losses, claim them explicitly.

Common Mistakes

  • Not claiming SMC-K with the underlying condition. File the disability claim and the SMC-K claim together. Claiming SMC-K years later loses back pay.
  • Missing erectile-dysfunction SMC-K secondary to diabetes / PTSD / SSRI medication. Treatment failure on standard meds satisfies "loss of use" and the claim is widely under-filed.
  • Stopping at one SMC-K when multiple categories apply. Each separate loss adds another $139.87. Audit the full § 3.350(a) list against your conditions.
  • Confusing SMC-K with SMC-L. SMC-K is the add-on. SMC-L is the replacement rate. Different rules, different amounts.
  • Reading the ladder only through SMC-K. A loss that earns a K award can also be a predicate for a higher tier, so check both. What does not work is treating the number of K awards as the trigger: the intermediate-rate rules turn on specific paired losses, blindness combinations, an independently ratable 50 or 100 percent disability in a different body system, or loss of three extremities.
One-page guide: SMC-K Board Outcomes Board outcomes across 8,725 appealed SMC-K issues, 2,465 granted and 2,414 denied, with recurring named denial reasons and cited evidence types. Opens the full-size chart, free to save or print.

This page is educational and is not legal advice. For help with an SMC-K claim, work with a VA-accredited representative.