The VA denied the veteran's claim for payment or reimbursement of unauthorized medical expenses for private care rendered on May 24, 1999 due to lack of authorization and because the treatment was not in a medical emergency that would have been hazardous to life or health.

The deciding factor: The VA found that prior authorization was not obtained and that the treatment did not meet the criteria for reimbursement as it was not rendered in a medical emergency, nor were VA facilities feasibly available at the time of the treatment.

Claimed conditions

post-traumatic stress disorder (PTSD), duodenal ulcer disease, post operative, bilateral hearing loss, shrapnel wound, right patella, fragment wound, left arm with retained foreign bodies, shell fragment wound scars, left thumb, scars, multiple shell fragment wounds, superficial, right upper and lower thighs, left thigh and leg, left knee, left ankle, and left foot

How they argued it

Direct service connection

Exposure basis

None

Rating assigned

None in this decision

Decision date

April 3, 2001

Citation

0109763

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 0109763.