The Veteran's treatment at Tulane Medical Center for an infected sebaceous cyst was denied reimbursement because VA facilities were feasibly available and the Veteran did not demonstrate that seeking care from a VA facility beforehand would have been reasonable.
The deciding factor: VA facilities were closer to the Veteran's home than the private facility where he received treatment, making them feasibly available.
- Claimed conditions
- paranoid schizophrenia, infected sebaceous cyst
- How they argued it
- Direct service connection
- Exposure basis
- None
- Rating assigned
- None in this decision
- Decision date
- October 2, 2018
- Citation
- 18140348
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 18140348.
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 non-VA emergency medical services for an infected sebaceous cyst on December 5, 2020 are granted as they met the criteria for reimbursement under 38 U.S.C. § 1725.
- Dismissed
The Veteran's appeal has been dismissed as the appellant, through his representative, withdrew the appeal prior to a decision being made.
- Remanded (sent back)
The Veteran's claim for an earlier effective date for service connection of paranoid schizophrenia is denied. The Board has also remanded the case to obtain a VA examination regarding his current disability rating for paranoid schizophrenia.
- Denied
The Veteran's sole service-connected condition, paranoid schizophrenia, is rated at 100% disabling. The Board denied Special Monthly Compensation (SMC) based on housebound due to the lack of additional service-connected disabilities independently ratable at 60%, and because the Veteran's substantial confinement was not solely attributable to his service-connected disability.
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