The Veteran's claim for reimbursement of non-VA medical expenses incurred at Evergreen Health Medical Center and Radia, Inc. (Evergreen) from May 12, 2014 through May 16, 2014 was denied as the services were not authorized in advance by VA and the Veteran had health coverage under Medicare Part A and B which covered a significant portion of the Evergreen hospital bill.
The deciding factor: The claim was denied because prior authorization for non-VA care provided by Evergreen was not received, and the Veteran had health coverage under Medicare Part A and B that covered a substantial portion of the medical expenses incurred.
- Claimed conditions
- coronary atherosclerosis
- How they argued it
- Direct service connection
- Exposure basis
- None
- Rating
- Not verified here — check the original decision
- Decision date
- February 25, 2016
- Citation
- 1607381
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. Search VA.gov for the original decision (opens in a new tab) using citation 1607381.
What this means for you
A final Board denial may be appealed to the U.S. Court of Appeals for Veterans Claims, generally within 120 days of the Board mailing date. A Supplemental Claim with new and relevant evidence is a separate option. Another Higher-Level Review of the Board decision is not available. Check your own notice: this historical decision does not set your deadline.
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: Remanded (sent back)
The Board has granted the Veteran's requests to readjudicate his claims for service connection for coronary atherosclerosis and diabetes mellitus type II, but has remanded the cases due to new evidence received. The claims are being remanded for toxic exposure risk activity (TERA) medical opinions regarding any possible nexus between the Veteran's claimed exposures in Camp Lejeune and his conditions.
- Whole decision: Granted
The Veteran's claim for a rating in excess of 10 percent for chondromalacia patella and left knee instability is denied, but he is granted service connection for coronary atherosclerosis due to presumed exposure to herbicide agents.
- Whole decision: Remanded (sent back)
The Veteran's coronary atherosclerosis is remanded due to duty to assist error in obtaining an adequate TERA opinion, and the Board finds it at least as likely as not related to his service, including exposure to burn pits.
- Whole decision: Granted
The Board has granted an effective date of September 1, 1991 for the award of entitlement to service connection for the cause of the Veteran's death due to apparent entitlement to DIC benefits.
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