The veteran's claim for payment or reimbursement of unauthorized medical expenses incurred from July 7, 2005 to July 18, 2005 is granted due to prior authorization being obtained and the emergency nature of his admission.
The deciding factor: Prior authorization was obtained through VA Fee Services Division within 72 hours of the veteran's admission to Central Maine Medical Center (CMMC), and arrangements were made for transfer to the VA hospital after he left the ICU. The veteran signed himself out against medical advice, but this did not affect the reimbursement as subsequent treatment by non-VA providers was not claimed.
- Claimed conditions
- Post-Traumatic Stress Disorder
- How they argued it
- Direct service connection
- Exposure basis
- None
- Rating assigned
- 100%
- Decision date
- December 21, 2005
- Citation
- 0534427
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 0534427.
What this means for you
A grant means the Board agreed the veteran was entitled to the benefit. Decisions like this show the kind of evidence and arguments that tend to succeed for claims like it.
What you can do next
Related decisions
Other Board decisions on a similar condition or argued the same way.
- Granted
The Board has granted service connection for Post-Traumatic Stress Disorder (PTSD) due to a verified in-service stressor, and the positive and negative medical evidence is at least in equipoise.
- Granted
Your claim for a higher rating and service connection for PTSD has been granted. The new evidence supports reopening your case.
- Partly granted
The Veteran's asthma was rated at 30% from May 4, 2011, to August 27, 2019. The rating was increased to 60% on September 25, 2019, and then to 100% effective that same day.,The Veteran is granted SMC at the housebound rate from December 7, 2018, to September 24, 2019.
- Remanded (sent back)
The Board has remanded the claims for service connection due to incomplete service personnel records, which are necessary to determine if the appellant's National Guard service was 'federalized' (i.e., Title 10 or Title 32 service).
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