Denied
The Veteran's private care at Oak Hill Hospital on April 5, 2014 was not authorized in advance by VA and did not meet the definition of an 'emergency' requiring reimbursement. The claim for payment or reimbursement is denied.
The deciding factor: VA facilities were deemed feasibly available at the time of the unauthorized treatment, and prior authorization was not provided as required by regulations.
- Claimed conditions
- Not specified in this decision
- How they argued it
- Not specified
- Exposure basis
- None
- Rating assigned
- None in this decision
- Decision date
- January 24, 2019
- Citation
- 19105520
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
We are not the VA. Veterans’ Rights is an independent resource built for veterans. We are not the U.S. Department of Veterans Affairs, not part of the government, and not endorsed by any government agency.
This is general information, not legal advice. For advice about your own situation, talk to a VA-accredited representative — many help for free.