The veteran's unauthorized private medical expenses incurred in September 1995 for a total knee replacement were denied because the treatment was not an emergency, and VA facilities were feasibly available.
The deciding factor: The treatment provided was not an emergent situation as required by law.
- Claimed conditions
- thrombophlebitis of the right leg, discogenic disease of the lumbar spine, residuals of a gunshot wound of the left thigh affecting muscle groups XIII and XIV, residuals of a gunshot wound of the left buttock affecting muscle group XVII, traumatic arthritis of the right knee, traumatic arthritis of the right ankle, right leg shortening, atriial fibrillation due to service-connected thrombophlebitis of the right leg, osteomyelitis of the right thigh
- How they argued it
- Direct service connection
- Exposure basis
- None
- Rating assigned
- 60%
- Decision date
- July 26, 2000
- Citation
- 0019501
This is a plain-language summary generated by AI from a public Board of Veterans’ Appeals decision. It can contain errors — always verify against the original. Look up the original decision on VA.gov (opens in a new tab) using citation 0019501.
What this means for you
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What you can do next
Related decisions
Other Board decisions on a similar condition or argued the same way.
- Denied
The Veteran's service-connected disabilities do not meet the criteria for a special home adaptation grant as they do not result in anatomical loss or use of both hands, blindness in both eyes, deep partial thickness burns, full thickness or subdermal burns, or residuals of an inhalation injury.
- Denied
The appeal is denied as there was clear and unmistakable error (CUE) in the award of a separate rating for right leg shortening, leading to combined ratings. The Veteran's residuals of right tibia and fibular fracture are rated at 10 percent, with no higher rating due to functional loss.
- Denied
The Veteran's appeal for special monthly compensation (SMC) based on need for aid and attendance or housebound status was denied because the evidence did not demonstrate a factual need for such benefits due to his service-connected disabilities. The Board found that the majority of the Veteran's need for assistance stemmed from non-service connected conditions.
- Granted
The Veteran's annual VA clothing allowance for the HG80 hinged knee brace is granted. However, his claim for an annual VA clothing allowance due to use of hydrophilic and menthol topical creams is denied.
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