The Veteran seeks reimbursement for medical care provided on June 3, 2014 at Florida Hospital Fish Memorial Regional. The AOJ denied the claim due to the Veteran having third-party insurance coverage that is primary to VA coverage. The case is being remanded to obtain an Explanation of Benefits from his insurance company.
The deciding factor: The denial was based on the Veteran's third-party insurance coverage, which makes him ineligible for reimbursement under VA policy.
- Claimed conditions
- Not specified in this decision
- How they argued it
- Not specified
- Exposure basis
- None
- Rating assigned
- None in this decision
- Decision date
- November 19, 2018
- Citation
- 18151312
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 18151312.
What this means for you
A remand is not a loss. The Board sent the case back for more development — often a new exam or missing records — before making a final decision. Many remands later end in a grant, and the decision spells out exactly what the Board wanted to see.
What you can do next
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