The Veteran's claim for payment or reimbursement of unauthorized medical expenses incurred at the Mease Countryside Hospital Emergency Department on January 19, 2008 is denied as his treatment was not for a medical emergency and VA facilities were feasibly available.
The deciding factor: The Board found that the Veteran did not seek treatment until three days after the motor vehicle accident, which was deemed non-emergent. Additionally, VA facilities (Bay Pines VAMC) were feasibly available and an attempt to use them beforehand would have been reasonable.
- Claimed conditions
- Left flank pain, Posttraumatic stress disorder (PTSD)
- How they argued it
- Direct service connection
- Exposure basis
- None
- Rating assigned
- None in this decision
- Decision date
- November 17, 2009
- Citation
- 0943736
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 0943736.
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 is granted special monthly compensation (SMC) at the (o) rate and SMC at the (r)(2) rate, effective January 19, 2025. The decision finds that the Veteran's service-connected conditions warrant these awards due to his need for aid and attendance.
- Remanded (sent back)
The Board has identified a contradiction in the AOJ's determinations regarding the Veteran's need for aid and assistance, which requires clarification. The remanded issues are entitlement to SMC based on the need for regular aid and attendance of another and on the basis of statutory housebound status.
- Dismissed
The Veteran's appeals for increased rating and earlier effective date for PTSD have been dismissed due to her withdrawal of the appeal.
- Remanded (sent back)
The Board has granted service connection for a right knee scar secondary to the Veteran's service-connected right knee disability status post knee replacement. However, the rating for PTSD remains at 30 percent and needs to be re-adjudicated due to a failure to obtain private mental health treatment records.
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