Other conditions decisions — 2024

The Board has dismissed the appeals for payment of non-VA care provided by Shore Acupuncture, LLC (SAL) from October 7, 2019, to October 30, 2019, as the VA Office of Community Care denied the claims due to a lack of authorization number from the TPA TriWest.

The Veteran's appeal for additional VR&E benefits was dismissed as moot because he received the benefits in question after his case was pending. The Board found there is no longer a case or controversy with respect to the Veteran's entitlement to these benefits.

The Board denied service connection for polycythemia vera, finding that the condition did not manifest during or as a result of active service and there is no evidence linking it to in-service exposure to chemicals and fuel.

The Board has decided to remand the case due to errors in notification and a need for an adequate medical determination regarding eligibility for PCAFC benefits. The AOJ must provide complete notice of the decision as required by law, including identification of whether or not the claim meets the criteria under the program.

The Veteran's claim for additional VA educational assistance benefits in excess of six months and two days is granted, but only for an additional 12 months, in compliance with the statutory cap of 48 months of aggregate benefits.

Your claim for adding your spouse F.S. as a dependent has been granted, and the appeal is dismissed because the benefit was already awarded.

The Board has decided to remand the claims for payment or reimbursement of non-VA medical services provided on May 16, 2020, by four different providers. The reasons are that the AOJ did not provide proper notice and due process as required by law, and there is insufficient evidence available for review.

The Board has determined that the Veteran's right elbow lateral epicondylitis is related to his military service and granted service connection for this condition.

The Board has determined that the Veteran does not have a current diagnosed ulcer condition and therefore service connection for an ulcer condition is denied.

The Veteran withdrew her appeal regarding the claim of service connection for endometriosis.

The Board has decided to remand the case due to pre-decisional duty to assist errors, including failing to obtain a medical opinion regarding the appellant's mental condition at the time of his misconduct and not obtaining complete service records. The Board also noted that there was a recent change in law related to consideration of an appellant's mental or cognitive impairment at the time of the in-service misconduct.

The Board has dismissed the appeal for payment rate of non-VA medical services provided by Barnes Jewish Hospital (BJH) from May 22, 2019, to May 27, 2019, as the process for billing and rates is governed by contractual agreements that do not allow for review by the Board.

The Board has determined that the Veteran's entire period of service from November 1978 to August 17, 1982 was dishonorable for VA purposes. The AOJ issued an administrative decision in October 2010 regarding the character of the Veteran's service and a higher-level review rating decision made the favorable finding that the Appellant had two separate and distinct periods of service. However, the Board finds that remand is appropriate to satisfy a statutory or regulatory duty.

The Veteran's claims for increased ratings of thoracic scoliosis and paresthesia of the left mandibular area involving the fifth cranial nerve were denied as there was no evidence to support a higher rating based on functional impairment or other criteria.

The Veteran's claim for payment of medical expenses incurred at a non-VA hospital was denied because he did not meet the eligibility requirements under 38 U.S.C. § 1725, specifically having received VA health care within the last 24 months before the emergency treatment.

The Veteran's claim for a higher rating for his other specified trauma and stressor related disorder with panic attacks is remanded due to the need for a new VA medical opinion to assess the severity of his condition, considering the ameliorative effects of his medication.

The Veteran withdrew his appeal for the issue of entitlement to Total Disability Rating Based on Individual Unemployability (TDIU) during a hearing before the Board. The appeal is dismissed.

The appeal of the issues regarding payment for non-VA dental services provided in June and July 2020 has been dismissed because these episodes were covered by the Veterans Community Care Program, which is not subject to Board review.

The Board has vacated the previous decision and is remanding the case due to a failure to apply the combat presumption for service connection of the left hip condition. The Veteran's claim will be returned to the AOJ to obtain an adequate VA medical opinion regarding the etiology of his left hip condition.

The Board denied the Veteran's claim for service connection for left proximal anterior lower extremity atrophy as it found no current disability and insufficient evidence to establish a link between his claimed condition and service.