The Board denied payment for non-VA medical services provided to the Veteran on June 15, 2015 due to lack of prior authorization and failure to meet emergency treatment criteria.,The Board also denied payment for non-VA medical services provided to the Veteran on September 17, 2015 because it was not found to be an emergency condition.
The deciding factor: The non-VA care did not qualify as emergency treatment and a VA facility was feasibly available.,The non-VA care did not qualify as emergency treatment due to the Veteran's delay in seeking medical attention, which was deemed reasonable given his circumstances.
- Claimed conditions
- Back spasm, Right ankle swelling
- How they argued it
- Not specified
- Exposure basis
- None
- Rating assigned
- None in this decision
- Decision date
- March 8, 2022
- Citation
- 22013199
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 22013199.
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Related decisions
Other Board decisions on a similar condition or argued the same way.
- Denied
The Veteran's claims for payment of non-VA medical expenses on June 15, 2015 and September 17, 2015 were denied as there was no indication that the treatment was for a condition requiring immediate medical attention.,For the June 15, 2015 incident, the Board found that the Veteran's back pain did not meet the criteria of an emergency condition. For September 17, 2015, the Board determined there was no indication VA sent the Veteran to Fawcett Memorial Hospital.
- Remanded (sent back)
The Board has denied the Veteran's claim for service connection for a right ankle disability and remanded her claim for a higher rating for her service-connected right knee patella fracture.
- Denied
The Board found no current, chronic disease process causing swelling in the veteran's right ankle and concluded that service connection for a right ankle disability manifested by swelling is not warranted.
- Remanded (sent back)
The Board has decided to remand the case for additional development, including obtaining informed consent documents and scheduling a VA examination.
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