Other conditions decisions — 2024

The Board has dismissed the appeal regarding contractual payment rates for home health services provided by a non-VA provider to the Veteran, as the applicable statute and regulation do not allow for Board review of such disputes.

The Board denied service connection for periodontal disease as it is not a compensable dental disorder for VA purposes.

The Board denied the Veteran's request to revise a January 2016 rating decision that assigned an 80 percent disability rating for bilateral macular degeneration with pseudophakia, finding no clear and unmistakable error (CUE). The effective date remains December 12, 2014.

The Veteran's disability rating for acute rheumatic fever with mitral valve disease and endocarditis was reduced from 30% to 10%, effective September 1, 2020. The reduction is granted as the evidence does not show actual improvement in her ability to function under ordinary conditions of life and work.

The Veteran's appeals for service connection for diaphragmatic hernia, diverticulitis, and gastritis have been resolved in full. The claims were granted by the AOJ in February and April 2023, making the appeal moot.

The Board has decided to remand the case due to a duty to assist error in the July 2018 VA examination, which was based on an inaccurate factual premise and relied on the absence of records. The Veteran's neck strain is being reviewed again for proper service connection.

The Board has dismissed the appeal regarding the contractual payment rate for home health services provided to a veteran from April 1, 2020, to April 30, 2020. The dispute is governed by specific administrative procedures under VCA and does not allow for further review.

The Board dismissed the appeal regarding contractual payment rates for home health services provided by MGHAL to the Veteran from January 2, 2020, to January 30, 2020, and in January 2020. The reasons were that VA's administrative dispute resolution process is exclusive and does not allow for further appeal.

The Board has determined that the appeal regarding the contractual payment rate for home health services provided in February 2020 is not within its jurisdiction due to a specific administrative dispute resolution process under Veterans Care Agreements (VCAs), which does not allow for appellate review by the Board.

The Board denied service connection for Lower Urinary Tract Symptoms (LUTS) as the evidence did not establish a direct relationship to service, including exposure to herbicide agents. The Veteran's LUTS was attributed to benign prostatic hyperplasia which is not service-connected.

The Board has dismissed the appeal as there is no administrative review process for disputes related to contractual payment rates under Veterans Care Agreements (VCAs).

The Board dismissed the appeal for payment of non-VA medical care provided by Aegis Sciences Corporation (ASC) on January 21, 2021 due to the lack of a prior authorization and the governing statutes and regulations do not allow for Board review in this case.

The Veteran's attorney has withdrawn the appeal for four issues involving limited hip flexion and extension, resulting in the dismissal of these cases.

The Board has decided to remand the case due to a duty-to-assist error in the April 2021 VA opinion, and a new medical opinion is needed.

The Veteran's service-connected obsessive-compulsive disorder with associated depressed mood resulted in significant occupational and social impairment, warranting a disability rating of 70 percent.

The Board dismissed the appeal regarding entitlement to special monthly compensation (SMC) based on aid and attendance as it was a deferral of decision by the AOJ, not an appealable decision.

The appeal was dismissed because the appellant requested to withdraw their appeal prior to a decision being made.

The appellant's claim for accrued benefits as a substitute claimant was denied because it was not filed within one year of the Veteran's death.

The Veteran's claims for service connection and increased ratings have been denied. The Veteran is granted a rating of 30% for left knee instability, but the other issues remain denied.

The Board has remanded the case due to a duty to assist error, requiring an additional VA examination to address the Veteran's right flank pain.