The Veteran received prior authorization for a series of three lumbar nerve root blocks, but the second one was performed after the prior authorization expired. The Board found that payment or reimbursement should be made as the prior authorization specifically approved the procedure and the Veteran reasonably relied on it.
The deciding factor: Prior authorization specifically approved the series of three lumbar nerve root blocks and the Veteran reasonably relied on this information in obtaining the authorized medical services.
- Claimed conditions
- low back disability
- How they argued it
- Direct service connection
- Exposure basis
- None
- Rating assigned
- None in this decision
- Decision date
- April 28, 2014
- Citation
- 1418747
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 1418747.
What this means for you
A grant means the Board agreed the veteran was entitled to the benefit. Decisions like this show the kind of evidence and arguments that tend to succeed for claims like it.
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 remand is needed for the Veteran's claims due to duty to assist errors, including clarification of periods of service and obtaining relevant records. The Veteran will be afforded new medical examinations for each claimed disability.
- Remanded (sent back)
The Board has denied service connection for bilateral hearing loss and remanded the claims of right shoulder disability and low back disability due to insufficient evidence.
- Granted
The Veteran's claim for service connection of a low back disability was granted with an effective date of January 9, 2018. The Board accepted her November 21, 2019 VA Form 20-0996 as a valid opt-in of the April 2019 SOC into the modernized review system.
- Dismissed
The Veteran's appeal concerning diabetes and a low back disability has been dismissed due to their death during the pendency of the appeal.
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