The Veteran's appeal for reimbursement of unauthorized private medical expenses is denied as the VA did not provide prior authorization and he had private health insurance covering his treatment.
The deciding factor: VA did not provide prior authorization for the non-VA medical care, and the Veteran had private health insurance that covered his treatment.
- Claimed conditions
- periodic limb movements, myoclonus (etiology unknown), major depressive disorder, undiagnosed illness manifested by fatigue, muscle and joint pain, and weight gain/chronic fatigue syndrome, undiagnosed illness manifested by lesions in the mouth and throat
- How they argued it
- Direct service connection
- Exposure basis
- None
- Rating assigned
- None in this decision
- Decision date
- September 23, 2014
- Citation
- 1442576
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 1442576.
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.
- Denied
The Veteran's claim for specially-adapted housing assistance and a special home adaptation grant was denied because he does not meet the criteria for either benefit based on his service-connected disabilities.
- Remanded (sent back)
The Veteran's claim for service connection for an acquired psychiatric disorder, including PTSD and major depressive disorder, is being remanded due to the need for additional development regarding his alleged stressors.
- Dismissed
The Veteran's appeal for service connection for posttraumatic stress disorder and major depressive disorder has been dismissed as the appellant requested withdrawal of the appeal.
- Remanded (sent back)
The Board has decided that the Veteran's service connection claim for an acquired psychiatric disorder, including PTSD, should be remanded due to a failure to verify a stressor related to the death of his two best friends in Iraq. The AOJ needs to develop this stressor.
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