The Veteran's claim for reimbursement of unauthorized private medical expenses incurred on August 1 and 2, 2005 at Q.V. Hospital, N.V. Emergency Medical Group, and R. Medical Group was denied because the services were not authorized by VA prior to the treatment and the Veteran did not meet eligibility requirements under 38 U.S.C.A. § 1725.
The deciding factor: The Veteran's claim failed to meet all the requirements of 38 C.F.R. § 17.1002(e) due to a lack of enrollment in VA healthcare system within 24 months preceding the emergency treatment, which is a requirement for reimbursement under 38 U.S.C.A. § 1725.
- Claimed conditions
- abdominal pain, sigmoid diverticulitis with phlegmon
- How they argued it
- Not specified
- Exposure basis
- None
- Rating assigned
- None in this decision
- Decision date
- September 21, 2009
- Citation
- 0935344
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 0935344.
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.
- Remanded (sent back)
The Board has found that the Veteran does not have a current respiratory disability other than sleep apnea. The claims for abdominal pain, type I diabetes, peripheral neuropathy of the upper and lower extremities, and an immune disorder are remanded due to a duty to assist error.
- Denied
The Board denied service connection for irritable bowel syndrome (IBS) and abdominal pain as there is no current diagnosed disability of IBS or functional impairment due to abdominal or constipation symptoms.
- Granted
The Board has granted service connection for right knee disorder, left knee disorder, right ankle disorder, left ankle disorder, right foot disorder, and left foot disorder as secondary to the Veteran's service-connected lumbar spine disorder. Service connection for abdominal pain is denied.
- Remanded (sent back)
The Board has decided to remand the case due to insufficient medical opinion regarding whether the Veteran's gastrointestinal disability, including gastroenteritis and abdominal pain, was incurred in service.
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