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
- Not verified here — check the original 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. Read the original VA decision (opens in a new tab) using citation 1425129.
What this means for you
A grant means the Board allowed the benefit or issue identified in this decision. Review the original order: other issues in the same appeal may have a different outcome, and this decision does not predict another claim.
What you can do next
Use your own notice and decision stage. A remanded issue is not a final court-appealable denial. VA review guidance and CAVC filing instructions (U.S. federal; reviewed October 7, 2026).
Related decisions
Other Board decisions on a similar condition or argued the same way.
- Whole decision: Granted
The Veteran's claim for a separate grant of service connection for GERD, as a residual of her cholecystectomy, is granted effective May 19, 2024. The claims for increased ratings for cholecystectomy residuals and esophageal spasms are remanded.
- Whole decision: Granted
The Veteran's claim for payment or reimbursement of ambulance transportation costs incurred on January 9, 2021, was granted. The ambulance transport was deemed necessary due to the Veteran experiencing symptoms consistent with a heart attack and required immediate medical attention.
- Whole decision: Granted
The Veteran's alcohol induced chronic pancreatitis with pancreatic insufficiency and gastroesophageal reflux disease, including gallbladder issues, has been granted a 100% rating effective November 19, 2024.
- Whole decision: Remanded (sent back)
The Veteran's claim for payment or reimbursement of medical expenses incurred from February 24 to February 26, 2020, at Santa Clara Valley Medical Center (SCVMC) is being remanded due to unclear decision notices and lack of documentation regarding any specific errors in the claim.
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