The veteran's unauthorized private hospital care on May 7, 1999 was denied reimbursement or payment due to lack of prior VA authorization and the absence of permanent total service-connected disability, a service-connected disability associated with or aggravating PTSD, or medical emergency.
The deciding factor: Reimbursement is only available if all three criteria under 38 U.S.C.A. § 1728 are met: (1) care was rendered in a medical emergency of such nature that delay would have been hazardous to life or health; (2) the veteran had an adjudicated service-connected disability, a nonservice-connected disability associated with and aggravating a service-connected disability, total disability permanent in nature resulting from a service-connected disability, or participated in a rehabilitation program. In this case, only one criterion was met.
- Claimed conditions
- Post-Traumatic Stress Disorder (PTSD)
- How they argued it
- Direct service connection
- Exposure basis
- None
- Rating assigned
- 70%
- Decision date
- March 20, 2001
- Citation
- 0108104
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 0108104.
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 claim for an effective date prior to December 27, 2019 for the grant of service connection for PTSD was denied as there is no earlier claim document in the claims file and the Veteran did not timely perfect an appeal.
- Granted
The Veteran's PTSD is granted as a result of military sexual trauma (MST) that occurred during service. The Board found the Veteran's testimony and supporting evidence credible, including her VA and private treatment records.
- Granted
The Veteran's claim for TDIU is granted with an effective date of August 17, 2022. The decision also denies the Veteran's request for Special Monthly Compensation (SMC) due to lack of need for aid and attendance or being housebound.
- Granted
The Board has granted eligibility to attorney fees based on past-due benefits awarded in the October 2024 rating decision for an increased PTSD rating and denied TDIU.
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