The Veteran's unauthorized medical expenses incurred from October 24 to 25, 2011 at the Munroe Regional Medical Center in Ocala, Florida are denied as he is personally liable for the treatment due to a non-service-connected syncopal episode and has health insurance coverage under Medicare Parts A and B.
The deciding factor: The Veteran's unauthorized medical expenses were not covered by VA because he had health insurance (Medicare) that would pay part of the costs associated with the emergency treatment at a private facility, which precluded VA from covering any portion of the expense.
- Claimed conditions
- syncopal episode
- How they argued it
- Direct service connection
- Exposure basis
- None
- Rating assigned
- None in this decision
- Decision date
- June 6, 2012
- Citation
- 1219904
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 1219904.
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
Related decisions
Other Board decisions on a similar condition or argued the same way.
- Dismissed
The Veteran withdrew his appeal for service connection and increased rating in excess of 30 percent for various conditions, including tinnitus, left knee condition, left hip condition, right shoulder condition, syncopal episode, and right knee condition.
- Denied
The Veteran's unauthorized private hospitalization for nonservice-connected conditions was not eligible for payment or reimbursement due to the lack of prior VA medical services within 24 months preceding the treatment.
- Denied
The Veteran's claim for payment of unauthorized medical expenses incurred on May 28, 2010 at Baptist Hospital in Pensacola, Florida is denied as he has other health insurance coverage (Tricare) that precludes VA from reimbursement.
- Granted
The Veteran's claim for payment or reimbursement of unauthorized medical expenses incurred at Lincoln General Hospital from February 18, 2007 to February 23, 2007 is granted due to the emergent nature of his treatment and the unavailability of VA facilities.
Free starter guide for your own claim
Reading this because you were denied or under-rated? Get the plain-English next steps — your appeal options, the deadline that protects you, and how appeals like yours turn out. One email, no spam.
We will only use this to send the guide. No spam, unsubscribe any time. We never sell your information.
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.