BVA win of medical reimbursement claim

[McRay]

Just got the letter today. My medical reimbursement claim was granted at the BVA level. Original claim was because St Petersburg, FL denied payment to the hospital in Sarasota, saying I could have traveled to Bay Pines for surgery and 2 pints of blood. I tried to explain in the NOD and Form 9 that I wasn't given any opportunity to go there, but they didn't listen. Shame I had to wait 6 years and all the expense to the VA that could have been eliminated if they knew what they were doing. Or maybe they did know.. Anyhow, I wonder how long it will take for the reimbursement to show up? In the past I've got the deposit in my account before the envelope.

[broncovet]

Congratulations!   Wow.  6 years to appeal..That is consistent with what it takes other Vets to appeal.  

 

[Vync]

@McRayCongratulations on your win!

A few years ago, the CAVC slammed the VA for failing to pay for emergency care: https://www.nbcnews.com/news/veterans/court-rules-va-must-pay-veterans-emergency-room-care-decision-n1052131

[Berta]

Great- my neighbor was worried about that- I called the right person at the local VAMC and that was squared away very fast. He had a NSC heart attack. VA paid it by now.

The local VA cannot handle emergencys like that.

 

[Rattler]

I had a similar thing happened to me this year. I had the VA community care do a total knee replacement on March 14, 2022. After a 4 day stay in the hospital, they decided to send me to a rehab facility for about two weeks.  I had transport lined up to take me from the hospital to the rehab facility via some retied veteran friends from church. (Go Navy) Well the powers at bay decided
I need to go via ambulance, so they made the arrangement for the ride.  So I get bounced around in an ambulance for 35 miles to this so called rehab facility.  (The rehab facility is another whole post.) I stayed about 1 ½ hours than checked my self out and had the wife take me home to do me rehab. (Another whole post about getting that done)

 

Anyway, so months later I start getting notices in the mail that the ambulance bill had not been paid. So, I call Community Care about why it wasn’t getting paid. I was first told that it was because the ambulance co. didn’t submit it right. So, I got instructions on how and where for them to submit it. So, it goes to United Health Care the ones who process the community care claims.  Well I get a notice in the mail from United Health Care saying that the claim was denied because it was a non-emergency. I aging call Community Care about the denial. They say well travel at the local VA hospital (Birmingham AL) should have paid for it, so I get transferred to them the person at travel says they are denning it because I did not stay at the rehab facility. I ask them what that had to do with them paying for an ambulance ride that they ordered? They said no not paying for it. After a week and a half of my life I will never get back I gave up and called the Whitehouse Hot line. They went to work on it, they told me to file for a higher-level review. Within the next week, I receive about 5 calls from different people in the local VA.  In the end they paid the bill.

I said the above to advise you not to take no for an answer no matter what you get told by the VA especially when you know that the VA is required to pay.

[Vync]

@Rattler767I also have had similar issues with the Birmingham VAMC travel office... The fact that we have to routinely go over their head says a lot.