The Veteran's private hospitalization at Cape Coral Hospital on June 29, 2016 was related to his service-connected GERD with hiatal hernia. The appeal is about prior authorization for this treatment and reimbursement of unauthorized medical expenses.
The deciding factor: The appeal involves the issue of whether VA provided prior authorization for the Veteran's private hospitalization at Cape Coral Hospital on June 29, 2016, and if so, whether it was authorized under 38 U.S.C. § 1703(a).
- Claimed conditions
- Gastroesophageal reflux disease (GERD) with hiatal hernia
- How they argued it
- Direct service connection
- Exposure basis
- None
- Rating assigned
- None in this decision
- Decision date
- May 15, 2019
- Citation
- 19137845
Veterans Law Judge
Decisions by this judge: 2,156 · Granted: 29% (granted or partly granted, in the vetted decisions on this site)
Judge attribution: 2025 complete; earlier years partial.
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 19137845.
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
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 a duty to assist error, and will consider evidence submitted after the October 2024 Supplemental Statement of the Case (SSOC). The Veteran's GERD is presumed to have existed prior to service, but there is no clear and unmistakable evidence that it was not aggravated by service. The Board has requested an examination to determine if the Veteran's GERD had its onset during or is otherwise etiologically related to active-duty service.
- Granted
The Veteran's GERD with hiatal hernia is granted a 60 percent rating effective November 14, 2018. The Board found that the Veteran's symptoms are severe and productive of considerable impairment of health.
- Granted
The Veteran's GERD with hiatal hernia was restored to a 30 percent evaluation, and an increased rating for the condition is granted.
- Denied
The Board denied the veteran's appeal for a rating in excess of 10 percent for service-connected GERD with hiatal hernia, as there was no evidence of recurrent esophageal stricture(s) causing dysphagia requiring dilation.
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