The Veteran's unauthorized medical expenses incurred during his private hospitalization at LRMC from April 18th - 19th of 2013 are denied as he did not meet the criteria for payment or reimbursement under VA regulations due to lack of prior authorization and partial coverage by Medicare Parts A and B.
The deciding factor: The Veteran failed to obtain prior authorization from VA before undergoing private hospitalization at LRMC, which is a requirement for unauthorized medical expenses reimbursement. Additionally, his health insurance - Medicare Parts A and B - covered most of the costs associated with the treatment.
- Claimed conditions
- coronary artery disease
- How they argued it
- Direct service connection
- Exposure basis
- None
- Rating assigned
- None in this decision
- Decision date
- May 31, 2019
- Citation
- 19141959
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 19141959.
What this means for you
A grant means the Board agreed the veteran was entitled to the benefit. Decisions like this show the kind of evidence and arguments that tend to succeed for claims like it.
What you can do next
Related decisions
Other Board decisions on a similar condition or argued the same way.
- Denied
The Board denied the Veteran's claim for an initial evaluation in excess of 10 percent for his service-connected coronary artery disease, finding that the evidence did not support a higher rating based on the severity of his condition.
- Remanded (sent back)
The Veteran's claim for an increased rating for coronary artery disease is being remanded due to the inadequacy of a previous VA examination.
- Denied
The Board denied service connection for coronary artery disease, hypertension, and stroke as there was no evidence of herbicide agent exposure during service and the medical opinions were against a nexus to service.
- Granted
The Veteran's service connection claim for coronary artery disease with myocardial infarction is granted on a presumptive basis due to exposure to herbicide agents during his active duty in Korea.
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