The Veteran's unauthorized medical expenses at Colorado Springs Cardiology on May 15, 2014 were denied as there was no prior authorization and the treatment did not meet the criteria for emergency care under VA regulations.
The deciding factor: The treatment provided by Colorado Springs Cardiology was non-emergent and did not meet the criteria for payment or reimbursement under 38 U.S.C. § 1725 due to lack of prior authorization and failure to treat an emergent condition.
- Claimed conditions
- Heart attack
- How they argued it
- Direct service connection
- Exposure basis
- None
- Rating assigned
- None in this decision
- Decision date
- November 12, 2020
- Citation
- 20072846
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.
- Denied
The Board denied the claim for compensation under 38 U.S.C. § 1151 and payment or reimbursement of medical expenses incurred at University of Colorado Hospital in April 2015.
- Partly granted
The Veteran is granted special monthly compensation (SMC) based on housebound status but denied SMC based on regular aid and attendance.
- Remanded (sent back)
The Board remands the claim for compensation under 38 U.S.C. § 1151 for a heart attack due to insufficient evidence and failure to comply with prior remand directives.
- Granted
The Board granted service connection for obstructive sleep apnea, effective from the date of the February 2025 rating decision.
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