The Board has determined that the Veteran's private outpatient vascular surgeries and follow-up visits at BASS on August 27, 2018, September 12, 2018, and September 28, 2018 were not covered by VA due to a lack of prior authorization under 38 U.S.C. § 1703(a).
The deciding factor: VA did not provide prior written authorization for the private medical services provided at BASS on the specified dates.
- Claimed conditions
- Peripheral Arterial Disease (PAD), Critical Limb Ischemia (CLI)
- How they argued it
- Direct service connection
- Exposure basis
- None
- Rating assigned
- None in this decision
- Decision date
- January 27, 2020
- Citation
- 20006532
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
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