Other conditions Board decisions

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 has dismissed the appeal for payment of non-VA medical services provided by the appellant from September 29, 2019 to October 7, 2019 as the billing process and rates are governed by statutory and contractual authority that does not allow for review by the Board.

The Board has dismissed the appeal because it does not have authority to review disputes over contractual payment rates for services provided under Veterans Care Agreements (VCAs).

Your appeal has been dismissed because the VA approved payment for your medical services provided by a non-VA provider. The issue is resolved and no further action is needed.

Your appeal of service connection for breast condition and breast cancer has been dismissed due to a claims processing error.

The Veteran's claim for reimbursement of licensing/certification tests taken between June 10, 2006, and September 26, 2015, is denied as the regulations pertaining to Post 9/11 GI Bill reimbursement are not obvious or intuitive.

The Board dismissed the appeal as it is not within its jurisdiction to review the contractual rate for non-VA medical services provided by Barnes Jewish Hospital.

The Board has granted the restoration of a total disability rating for individual unemployability (TDIU) and Dependents' Educational Assistance (DEA), effective May 1, 2020. The decision is based on the improper discontinuation of these benefits due to insufficient information provided by the agency of original jurisdiction.

The Veteran's appeal for educational assistance benefits under Chapter 30 was denied because her service began after the effective date of a law that prevents duplication of eligibility based on a single period of service.

The appeal is dismissed because the appellant, a non-VA healthcare provider within the Veterans Community Care Program network, provided medical services to the Veteran and the billing process for these services is governed by statutory and contractual authority that does not allow for review by the Board.

The Board has dismissed the appeal because the dispute over the contractual payment rate for home health services provided under a Veterans Care Agreement is subject to specific administrative procedures that do not allow for further review by the Board.

The Board denied the Veteran's claim for payment or reimbursement of unauthorized medical expenses incurred at Greenwich Hospital on November 30, 2018 due to lack of prior authorization from VA.

The Veteran's pension benefits were adjusted to reflect his new spouse, A.L., effective June 1, 2019. The Board denied the claim for an earlier effective date as he has been in receipt of the maximum rate of pension for a veteran with one dependent since May 19, 2019.

The Board found that the overpayment of education benefits under Chapter 33 (Post-9/11 GI Bill) was validly created due to the Veteran's withdrawal from her coursework and receipt of a non-punitive grade. The Board also determined there was no fault on the part of VA in creating the overpayment, and that recovery would not be against principles of equity and good conscience.

The Board dismissed the appeal because it does not have jurisdiction to review the claims for payment of non-VA medical services provided on January 10, 2020.

The Board dismissed the appeal regarding the propriety of the contractual payment rate for medical services provided by the appellant between February 3, 2020 and February 28, 2020. The decision is based on the specific statutory authority governing VCA disputes which does not include review by the Board.

The Veteran's appeal for additional educational assistance benefits under the Post-9/11 GI Bill was denied as his eligibility period ended on October 10, 2020. The Board found that he did not meet the criteria for an extension of his delimiting date.

The Board has decided that the decision regarding eligibility for PCAFC benefits is legally inadequate and there are procedural issues with notification. The case is being remanded to ensure a complete record, proper legal notice, and an adequate medical opinion.

The Board has decided to remand the case due to inadequate examination and opinion regarding service connection for bladder and bowel conditions secondary to a service-connected low back disability. The Veteran needs an appropriate VA examination to address these issues.

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).