The VA denied reimbursement for the cost of private medical services provided to the appellant at Mercy Hospital Emergency Room on August 23, 2005 due to lack of prior authorization and other eligibility criteria not being met.
The deciding factor: The appellant did not provide prior authorization for the non-VA medical care received in a private facility and failed to meet all the requirements under 38 U.S.C.A. § 1728 for reimbursement of emergency services.
- Claimed conditions
- Hernia, Urinary Tract Infection
- How they argued it
- Not specified
- Exposure basis
- None
- Rating assigned
- None in this decision
- Decision date
- May 15, 2009
- Citation
- 0918330
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 0918330.
What this means for you
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What you can do next
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