The Board found that the medical treatment provided by SCH on June 25, 2009 did not meet the prudent layperson standard for an emergency condition and thus denied payment or reimbursement of unauthorized medical expenses.
The deciding factor: The Veteran's symptoms were not emergent in nature as determined by a prudent layperson at the time of the treatment. The Board found that the absence of immediate medical attention would not have placed the health of the individual in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part.
- Claimed conditions
- Residuals of a fractured coccyx with low back pain, Left knee chondromalacia, Dysthymia with chronic anxiety, Somatoform disorder, Lax sphincter tone associated with residuals of a fractured coccyx with low back pain
- How they argued it
- Direct service connection
- Exposure basis
- None
- Rating assigned
- None in this decision
- Decision date
- August 23, 2016
- Citation
- 1633317
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 1633317.
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.
- Granted
The Veteran's TDIU claim is granted from September 1, 2008 to May 20, 2015 due to his service-connected disabilities making him unable to secure and maintain substantially gainful employment.
- Partly granted
The Board granted a rating of 20 percent for left knee chondromalacia but denied service connection for body arthritis and left lower extremity neuropathy. The claims for service connection for left hip/knee disability and right hip disability were remanded.
- Granted
The Veteran's service-connected disabilities have precluded him from securing or following a substantially gainful occupation, and he is granted a total disability rating based on individual unemployability.
- Denied
The Veteran's initial disability ratings for right knee arthritis and left knee chondromalacia have been denied as his knee conditions do not meet the criteria for a higher rating.
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