Other conditions decisions — 2015

The Veteran is entitled to payment or reimbursement for unauthorized medical expenses incurred on July 12, 2011 at Memorial Hermann Northeast Hospital due to an acute muscle strain. The treatment was considered emergency care and all conditions for payment under the Veterans Millennium Health Care and Benefits Act were met.

The Board has determined that prior authorization for the Veteran's private hospitalizations was provided by VA, and thus all medical expenses incurred should be covered by VA.

The appellant is not eligible for VA death benefits as a surviving spouse because she and the Veteran were not married for at least one year prior to his death, they had no children, and their marriage did not last 15 years after the termination of the period of service in which the injury or disease causing the Veteran's death was incurred.

The Board has determined that the change in the Veteran's means test eligibility category from prescription copay exempt to required for prescriptions in 2010 was proper, as his income exceeded the threshold for cost-free prescriptions but remained below the threshold for cost-free VA health care.

The Board has determined that the Veteran's Reiter's syndrome is related to his active service and has granted his claim for service connection.

The Veteran's nonservice connected pension benefits were correctly adjusted, effective October 10, 2010, based on income received from the SSA and horse-related activities. The claim for treatment in VA healthcare system without a co-payment requirement was denied.

The Board has remanded the claims due to failure to adhere to the remand directives, and the Veteran failed to report for scheduled VA examinations. The case is now being returned to the RO for further development.

The Veteran's agoraphobia was found to be manifested by occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks due to symptoms such as depressed mood, anxiety, and panic attacks. The Veteran's agoraphobia did not meet the criteria for a higher rating.

The Board's decision on the basic entitlement to VA benefits, including a one-time payment from the FVEC Fund, is dismissed due to the death of the appellant during the appeal process.

The Veteran's pilonidal cyst and recurrent anal fistula have been rated at 20 percent since February 25, 2008. The current condition does not warrant a higher rating as there are no scars covering more than 72 square inches or five or more unstable or painful scars.

The Board has denied the appellant's claim for service connection for the cause of the Veteran's death, finding that it is not due to Agent Orange exposure.

The Veteran's claims for service connection and increased ratings were denied. The Board found no credible post-service diagnosis of chronic prostatitis, and the criteria for an initial compensable rating for right ankle disability prior to November 30, 2010, and a higher rating from that date have not been met.

The Board finds that the preponderance of the evidence is against a finding that the Veteran currently has a disability of the left lung or seventh left rib. Service connection for lesions in the left lung and lesions on the seventh left rib is not warranted.

The Board has determined that the Veteran does not have colon cancer and therefore, service connection for this condition is denied. The issue of appendix cancer due to herbicide exposure remains pending.

The Board denied service connection for soft tissue injuries to the right and left hips, bilateral hearing loss, tinnitus, and a history of urinary tract infections due to lack of medical evidence linking these conditions to service.

The Veteran's effective date for the addition of his dependent spouse to his award is granted as March 10, 1994.

The Veteran's appeal is remanded due to the need for updated VA examinations and additional treatment records.

The Veteran's diabetes is granted service connection as it is etiologically related to his active duty service. The Veteran does not have a skin disability for which service connection is warranted.

The Board has ordered a remand to obtain additional VA treatment records and ensure all pertinent evidence is included in the record before proceeding with the appeal.

The Veteran died from respiratory failure, right arm arteriovenous graft infection, and gastric cancer. The cause of death is not service-connected as there was no evidence linking the conditions to his military service.