The Veteran's claim for payment or reimbursement of unauthorized medical expenses incurred at various Florida private medical facilities from November 5, 1999, through March 31, 2011 is denied as the treatment was not rendered in a medical emergency and VA facilities were reasonably available.
The deciding factor: The Veteran did not receive prior authorization for his non-VA medical care and there is no evidence that the private medical care was necessary due to an emergent situation or that VA facilities were unavailable.
- Claimed conditions
- schizophrenic reaction
- How they argued it
- Direct service connection
- Exposure basis
- None
- Rating assigned
- None in this decision
- Decision date
- January 26, 2017
- Citation
- 1702028
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 1702028.
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 Board has granted service connection for the Veteran's cause of death, which was related to his schizophrenia that began during service. The Board found that this disability substantially contributed to the Veteran's untimely death by suicide.
- Granted
The Board found that the May 1988 rating decision incorrectly applied presumptive service connection for a psychotic disorder, leading to a grant of service connection for schizophrenic reaction.
- Remanded (sent back)
The Board has remanded the case due to a lack of VA examination in connection with the Veteran's service-connected disabilities and their impact on his eligibility for specially adapted housing or special home adaptation grant.
- Remanded (sent back)
The Board has remanded the claims for a rating higher than 50 percent for service-connected schizophrenic reaction, entitlement to SMC based on a need for aid and attendance, and TDIU due to service-connected disabilities. The remand is necessary to obtain retrospective VA medical opinions regarding the severity of the Veteran's service-connected schizophrenia from March 2000 until his death in November 2009.
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