The veteran is not eligible for payment or reimbursement of unauthorized medical expenses incurred at a non-VA facility because the criteria under 38 U.S.C.A. § 1725 and 38 C.F.R. § 17.1002(b) and (c) were not met.
The deciding factor: The treatment from October 10, 2000, to October 24, 2000 was not for a condition of such a grave nature that a prudent layperson would have reasonably expected that delay in seeking immediate medical attention would have been hazardous to life or health. Additionally, VA facilities were feasibly available and an attempt to use them beforehand would have been considered reasonable by a prudent layperson.
- Claimed conditions
- Not specified in this decision
- How they argued it
- Not specified
- Exposure basis
- None
- Rating assigned
- None in this decision
- Decision date
- May 23, 2008
- Citation
- 0816989
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
We are not the VA. Veterans’ Rights is an independent resource built for veterans. We are not the U.S. Department of Veterans Affairs, not part of the government, and not endorsed by any government agency.
This is general information, not legal advice. For advice about your own situation, talk to a VA-accredited representative — many help for free.