The Veteran's claim for reimbursement of medical expenses incurred at a private hospital due to a kidney stone is denied because he did not receive VA treatment within the 24 months prior to his emergency treatment.
The deciding factor: The Veteran did not receive VA care within the 24-month period preceding the emergency treatment, which was required by law for reimbursement.
- Claimed conditions
- Kidney Stone
- How they argued it
- Direct service connection
- Exposure basis
- None
- Rating assigned
- None in this decision
- Decision date
- May 16, 2018
- Citation
- 18102673
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 18102673.
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.
- Remanded (sent back)
The Board has remanded the case due to incomplete development and transfer considerations. The Veteran's claim will be reconsidered after obtaining additional information.
- Denied
The Veteran's unauthorized medical treatment for a kidney stone at Providence Holy Family Health Services on December 9, 2015 was denied as there was no prior authorization from VA and the Board found that the emergency treatment criteria were not met.
- Remanded (sent back)
The Veteran's unauthorized medical expenses for a kidney stone treatment on December 9, 2015 are remanded due to the need to associate relevant treatment records with the claims file.
- Remanded (sent back)
The Board has ordered the VA to locate and reconstruct the Veteran's VHA folder, obtain his private medical records related to a kidney stone treatment at Mercy Health Partners on July 12, 2010, and provide an accounting of all steps taken. The claim will be readjudicated after these actions.
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