Other conditions Board decisions

The Board has determined that the claims for service connection of superior vena cava syndrome, deep venous thrombosis, fibrosing mediastinitis, and hepatic steatosis must be remanded due to deficiencies in the previous VA opinions regarding their etiology. The AOJ is instructed to obtain addendum VA opinions addressing these issues.

The Board has dismissed the appeal as it is not within its jurisdiction to review disputes over contractual payment rates for services provided under Veterans Care Agreements (VCAs).

The Board has dismissed the appeal regarding the contractual payment rate for medical services provided to a veteran under a Veterans Care Agreement (VCA) due to the dispute resolution process established by law not allowing for further review.

The Veteran's Sjögren's syndrome rating was reduced from 100% to 10%, but the Board found clear and unmistakable error (CUE) in this decision, restoring the original 100% rating effective October 1, 2010.

The Veteran's acquired psychiatric condition of unspecified trauma and stressor related disorder is rated at 30 percent, but the Board found no evidence to warrant a higher rating based on his symptoms.

The appeal for the proposed reduction of the disability rating for panic disorder from 70 percent to 30 percent is dismissed. The Veteran's service-connected panic disorder precludes him from securing and maintaining substantially gainful employment, leading to a grant of TDIU.

The appeal is dismissed because the payment for medical services provided by a non-VA healthcare provider through the Veterans Community Care Program cannot be reviewed by the Board.

The Board dismissed the appeal because it does not have authority to review disputes arising under Veterans Care Agreements (VCAs), including disagreements over contractual payment amounts. The appellant's claim for additional payment under a VCA is therefore dismissed.

The Veteran's claim for an increased rating for residuals of esophageal adenocarcinoma was denied as his symptoms did not meet the criteria for a higher rating.

The Veteran died in December 2020 and was not service-connected for any disabilities. The Board found that the criteria for nonservice-connected burial death benefits have not been met.

The Board denied the Veteran's claim for payment or reimbursement of non-VA medical expenses incurred on April 19, 2023 due to a lack of VA authorization for such services.

The Board dismissed the appeal as it pertains to the issue of entitlement to additional payment for non-VA dental treatment services provided by the appellant on July 27, 2020. The decision states that the process for billing and payment is governed by contractual agreements within the Veterans Community Care Program.

The Veteran's claim for payment or reimbursement of non-VA medical expenses incurred on October 30, 2023 was denied because he did not meet the legal requirement to be an active VA health-care participant within the 24-month period preceding the treatment.

The appeal was dismissed as the VA administratively approved payment for non-VA emergency medical services provided to the Veteran on December 10, 2019.

The appeal was dismissed because the VA Medical Center approved payment for the non-VA medical services provided to the Veteran on December 20, 2020.

The Board denied the Veteran's claim for service connection for a genitourinary or urinary frequency condition, finding that it is not related to any service-connected disability and specifically not secondary to his diagnosed hypertension.

The Veteran's residual of the tibia and fibula is rated at 60 percent, which is the maximum schedular rating for ankylosis of the knee.,There is no evidence to support a finding that the bilateral eye disorder began during active service or is related to any in-service injury.

The Board denied a compensable rating for the Veteran's service-connected right inguinal hernia, finding that it did not meet the criteria for a higher rating based on recurrent or well-supported by a truss or belt.

The Veteran's service-connected Amyotrophic Lateral Sclerosis (ALS) caused him to need personal health-care services provided on a daily basis in his home by a person who is licensed to provide such services or who provides such services under the regular supervision of a licensed health-care professional. The Board has determined that this meets the criteria for higher level SMC based on aid and attendance.

The Veteran's pension benefits were reduced and then reinstated based on newly discovered unreported income. The effective date for the adjustment of his pension benefits to $1,075 monthly is February 1, 2017.