The veteran's unauthorized medical expenses for a rotator cuff repair were denied as there was no emergency requiring immediate treatment, and VA facilities were feasibly available.
The deciding factor: VA reimbursement is not warranted because the private medical care did not meet the criteria of being in an emergency situation or due to a service-connected disability.
- Claimed conditions
- Left rotator cuff tear
- How they argued it
- Direct service connection
- Exposure basis
- None
- Rating assigned
- None in this decision
- Decision date
- July 10, 2002
- Citation
- 0207550
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 0207550.
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.
- Granted
The Veteran's left shoulder disability is granted with a 30 percent rating from September 5, 2011 to July 31, 2019. A higher 40 percent rating is granted for the period August 6, 2018 to July 31, 2019. The Veteran's TDIU claim is also granted.
- Denied
The Veteran's appeal for higher ratings for his left shoulder disability was denied. From September 5, 2011 to July 19, 2018, the Veteran was rated at 20 percent and from July 19, 2018, he was rated at 40 percent.
- Remanded (sent back)
The Veteran's claim for increased ratings for scars of the left upper extremity and a left rotator cuff tear is remanded due to insufficient evidence. The VA will obtain additional medical records, schedule the Veteran for an examination, and consider any new information provided.
- Granted
The Board found that the evidence was at least in equipoise as to whether the injury underlying the Veteran's left rotator cuff tear was incurred during a period of INACDUTRA or aggravated during a period of ACDUTRA, and thus granted service connection for residuals of left rotator cuff repair.
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