The Veteran's appeal for payment or reimbursement of unauthorized medical expenses incurred at a private hospital is denied as the inpatient rehabilitation treatment was not rendered pursuant to an emergency, and he has coverage under Medicare Part B.
The deciding factor: VA did not meet the criteria for reimbursement under 38 U.S.C.A. § 1725 due to the Veteran's coverage under Medicare Part B.
- Claimed conditions
- PTSD with organic mental disorder
- How they argued it
- Direct service connection
- Exposure basis
- None
- Rating assigned
- 100%
- Decision date
- January 6, 2016
- Citation
- 1600467
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 1600467.
What this means for you
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What you can do next
Related decisions
Other Board decisions on a similar condition or argued the same way.
- Denied
The Board denied the veteran's claims for increased ratings for his service-connected lumbar myositis, psychoneurosis and conversion hysteria, residuals of shrapnel wounds of the left thigh and pelvis with retained foreign bodies and scars, and residuals of shell fragment wounds of the right thigh and left leg. The veteran was also denied entitlement to a total disability rating based on individual unemployability due to service-connected disabilities.
- Denied
The Board denied the Veteran's claim for an initial evaluation in excess of 10 percent for his service-connected coronary artery disease, finding that the evidence did not support a higher rating based on the severity of his condition.
- Denied
The Veteran's service-connected musculoligamentous strain, right knee, is currently rated at 10 percent and the Board finds that a higher rating is not warranted.
- Granted
The Veteran's claim for service connection for PTSD is granted as the evidence shows a current diagnosis of PTSD, an in-service stressor, and a medical link between the two.
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