The Board finds that the evidence is roughly in equipoise on whether prior authorization was given for the Veteran's care at St. Vincent's Ambulatory Care Center on April 1, 2011, and grants payment or reimbursement of unauthorized medical expenses incurred during this episode.
The deciding factor: The May 2011 review by Dr. DBC recommended approval of payment or reimbursement for the Veteran's inpatient treatment from March 14 to 24, 2011, and for the April 1, 2011 follow-up visit, despite lack of prior authorization.
- Claimed conditions
- Heart attack, Cholecystitis
- How they argued it
- Direct service connection
- Exposure basis
- None
- Rating assigned
- None in this decision
- Decision date
- June 4, 2014
- Citation
- 1425129
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 1425129.
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
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Other Board decisions on a similar condition or argued the same way.
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- Remanded (sent back)
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