The Veteran's unauthorized medical expenses incurred on June 15, 2015 at Cape Coral Hospital were denied as VA facilities were deemed feasibly available and prior authorization was not provided.
The deciding factor: VA did not provide prior authorization for the private care received by the Veteran on June 15, 2015.
- Claimed conditions
- Low back pain
- How they argued it
- Direct service connection
- Exposure basis
- None
- Rating assigned
- None in this decision
- Decision date
- January 17, 2019
- Citation
- 19104393
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.
- Partly granted
The Board granted service connection for low back pain and migraines, effective October 1, 2019. The claim for sciatic nerve pain was remanded.
- Remanded (sent back)
The Board remands the claims for service connection for low back pain, left shoulder osteoarthritis, right shoulder rotator cuff, right bicep tendonitis, left bicep tendonitis, obstructive sleep apnea, and Meniere's Syndrome (vertigo) to address duty-to-assist errors.
- Denied
The Board denied service connection for bilateral hearing loss, an increased rating for generalized anxiety disorder with depression (GAD), and a compensable rating for pseudofolliculitis barbae. The claims for service connection for chronic left knee pain, chronic right knee pain, low back pain, neurogenic erectile dysfunction, onychomycosis, and pain and dysfunction of the right shoulder were remanded.
- Partly granted
The Board granted service connection for low back pain, right knee pain, and neck pain (cervical strain) but denied service connection for bilateral hearing loss. The claim for headaches was remanded.
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