The Board denied the veteran's claim for reimbursement of medical expenses incurred at a non-VA hospital in January 1999, finding that the care was not authorized and did not meet the criteria for payment under VA regulations.
The deciding factor: The care provided to the veteran was not for an adjudicated service-connected disability or a nonservice-connected disability associated with and aggravating a service-connected disability. The private hospitalization was required due to unavailability of VA facilities, which does not qualify as reimbursement under VA regulations.
- Claimed conditions
- residuals of a right (dominant) humerus fracture with hemiarthroplasty, macular degeneration and scar, residuals of injury, right eye, a central scotoma, scars of the tip of the nose, right eyebrow and chin, high frequency hearing loss of the right ear
- How they argued it
- Direct service connection
- Exposure basis
- None
- Rating assigned
- None in this decision
- Decision date
- December 29, 2000
- Citation
- 0033938
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 0033938.
What this means for you
A denial is a starting point, not the end of the road. You can see why this claim fell short — and, if you are still inside the one-year window, the appeal lanes that may remain open to you.
What you can do next
Related decisions
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- Remanded (sent back)
The Board has determined that additional development is needed to properly adjudicate the Veteran's claims, including obtaining an examination and updating the claims file with recent VA treatment records.
- Granted
The Veteran's service-connected disabilities, including degenerative disc disease of the lumbar spine and peripheral neuropathy, are found to be so severe that they prevent him from obtaining or maintaining substantially gainful employment.
- Denied
The Board denied the veteran's claims for increased ratings for his service-connected lumbar myositis, psychoneurosis and conversion hysteria, residuals of shrapnel wounds of the left thigh and pelvis with retained foreign bodies and scars, and residuals of shell fragment wounds of the right thigh and left leg. The veteran was also denied entitlement to a total disability rating based on individual unemployability due to service-connected disabilities.
- Denied
The Board denied the Veteran's claim for an initial evaluation in excess of 10 percent for his service-connected coronary artery disease, finding that the evidence did not support a higher rating based on the severity of his condition.
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