The Veteran's claim for reimbursement of unauthorized medical treatment at a private facility was denied as the services were not authorized in advance by VA and there was no emergency that would have made it hazardous to delay seeking care.
The deciding factor: VA determined that prior authorization was not granted, and the services provided did not meet the criteria for payment under 38 U.S.C.A. § 1728 due to lack of an emergency requiring immediate treatment.
- Claimed conditions
- Right lower extremity
- How they argued it
- Direct service connection
- Exposure basis
- None
- Rating assigned
- None in this decision
- Decision date
- March 4, 2016
- Citation
- 1608767
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 1608767.
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.
- Dismissed
The Veteran's appeals for increased disability ratings for service-connected right and left lower extremity conditions have been dismissed due to the Veteran's death. The Board has no jurisdiction to adjudicate these claims as they are moot.
- Granted
The Board has granted service connection for peripheral neuropathy of the extremities as secondary to service-connected diabetes mellitus, and assigned a disability rating of 70 percent.
- Denied
The Board denied the Veteran's increased rating claims for peripheral neuropathy of the sciatic and femoral nerve of the right lower extremity, finding that the evidence did not support a higher than 10 percent evaluation.
- Denied
The Board denied service connection for peripheral neuropathy of the left and right lower extremities due to Agent Orange exposure, finding that there was no medical evidence linking the condition to service.
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