The Veteran's claim for payment or reimbursement of unauthorized non-VA medical expenses incurred at a private facility in March 2011 was denied because the treatment did not meet the criteria for reimbursement under VA regulations, specifically due to lack of authorization and failure to demonstrate a medical emergency.
The deciding factor: The treatment was unauthorized and there was sufficient time for the Veteran to seek pre-authorization. The absence of a medical emergency also disallowed reimbursement under Section 1728 of the Veterans' Claims Assistance Act (VCAA).
- Claimed conditions
- fibrocystic breast disease
- How they argued it
- Direct service connection
- Exposure basis
- None
- Rating
- Not verified here — check the original decision
- Decision date
- August 17, 2016
- Citation
- 1632723
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 1632723.
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: Granted
The Veteran's service-connected disabilities rendered her unable to secure and follow a substantially gainful employment for the periods on appeal prior to May 2, 2020, and after June 1, 2020. For the period from March 2, 2020, to June 1, 2020, she was in receipt of a 100 percent schedular rating for total left wrist fusion.
- Whole decision: Granted
The Veteran is granted earlier effective dates of August 21, 2015 for TDIU and DEA benefits due to service-connected disabilities.
- Whole decision: Granted
The Board granted service connection for fibrocystic breast disease, finding that the Veteran's condition had its onset in service and has continued since then.
- Whole decision: Remanded (sent back)
The Board remands the claims for an increased evaluation of fibrocystic breast disease and service connection for left and right sciatic nerve pain due to inadequate VA examinations.
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