Re-embursement for non VA Medical care.

[Hawks and Doves]

I was traveling in Australia and had to go the a local emergency room at a local hospital for treatment. This is illness is unrelated to any already compensated for service related disability. I am not trying to get my disability increased. All I want to do is to be re-embursed for the bills caused by this emergency room visit.  I sent the appropriate form and attached documentation, (VA Form 10-583 Claim For Payment of Costs Unauthorised Medical Services), to my local VA Medical Center. When I followed up in person they could not find any information related to my inquiry. I could not seem to be able to get it across is that I do not want increased compensation, just re-embursement for an emergency room visit. I was directed to re-sent (VA Form 10-583 Claim For Payment of Costs Unauthorised Medical Services), and all documentation to  this address, Department Of Veterans Affairs Evidence Intake Center, P.O. Box 4444, Janesville, WI 53547-4444, which I did.

I got a letter back saying the the information that I received was placed in VA records and that I submit a, (VA Form 21-526EZ, Application for Disability Compensation and related Compensation Benefits). Once again it seems I was misunderstood, I not want increased compensation, just re-embursement for an emergency room visit Any assistance in this matter is appreciated.

Thanks

 

 

 

 

[broncovet]

Well, VA "gets to interpret seperate and distinct", and their interpretation is subject to change minute by minute.   This could change, too, now that Chevron has been overturned by 

the US Supreme court.  

Here is the regulation: source:  38 CFR 3.350

Quote

(i) Total plus 60 percent, or housebound; 38 U.S.C. 1114(s). The special monthly compensation provided by 38 U.S.C. 1114(s) is payable where the veteran has a single service-connected disability rated as 100 percent and,

(1) Has additional service-connected disability or disabilities independently ratable at 60 percent, separate and distinct from the 100 percent service-connected disability and involving different anatomical segments or bodily systems, or

(2) Is permanently housebound by reason of service-connected disability or disabilities. This requirement is met when the veteran is substantially confined as a direct result of service-connected disabilities to his or her dwelling and the immediate premises or, if institutionalized, to the ward or clinical areas, and it is reasonably certain that the disability or disabilities and resultant confinement will continue throughout his or her lifetime.

 

Edited Sunday at 07:33 PM by broncovet

[Lemuel]

Thanks Bronco.  Looks good for me unless the 40% for TBI is considered responsible for the TDIU and then I qualify for SMC-T or S housebound now.

If my 1151 claim is processed and granted then granted, then I am in a different ballpark.  VARO ignored the 1151 claim so the BVA will have to do what it did with my extra-schedular TDIU claim and remand it for development.