Citation Nr: 1318688 Decision Date: 06/07/13 Archive Date: 06/11/13 DOCKET NO. 11-23 277 ) DATE ) ) On appeal from the Department of Veterans Affairs Medical Center in Columbus, Ohio THE ISSUE Entitlement to payment or reimbursement for the cost of medical treatment provided from August 3, 2010 to August 7, 2010 at Riverside Methodist Hospital, Columbus, Ohio. WITNESS AT HEARING ON APPEAL The Veteran ATTORNEY FOR THE BOARD Robert E. P. Jones, Counsel INTRODUCTION The Veteran served on active duty from September 1953 to August 1955. This matter is before the Board of Veterans' Appeals (Board) on appeal from an August 2010 determination of a Department of Veterans Affairs (VA) Medical Center (VAMC) that denied payment or reimbursement of certain medical expenses incurred from August 3, 2010 to August 7, 2010. The VAMC is the Agency of Original Jurisdiction (AOJ) in the present matter. Please note this appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c) (2012). 38 U.S.C.A. § 7107(a)(2) (West 2002). The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the appellant if further action is required. REMAND In this case, the Veteran was provided emergency medical treatment at a private hospital from August 3, 2010 to August 7, 2010, after developing wound healing problems from a prior left ankle procedure performed in June 2010. The Veteran asserts that the medical services in question were rendered in a medical emergency of such nature that delay would have been hazardous to life and that no VA or other Federal facilities were feasibly available and an attempt to use them beforehand or obtain prior VA authorization for the services required would not have been practical. In April 2012, the Board remanded the Veteran's claim to the AOJ for consideration of the claim under the provisions of the Emergency Care Fairness Act, including the amended provisions of 38 U.S.C. § 1725. The Board noted that the AOJ had not adjudicated the Veteran's claim under the provisions of 38 U.S.C. § 1725 in effect subsequent to February 1, 2010. The April 2012 Board remand also noted that the Veteran had submitted a March 2011 letter from his private physician that, according to the Veteran, establishes that the medical services in question were rendered in a medical emergency of such nature that delay would have been hazardous to life, and that no VA or other Federal facilities were feasibly available, and an attempt to use them beforehand was not practical. The April 2012 Board remand stated that the AOJ must specifically discuss the March 2011 letter from the Veteran's private physician. The Board notes that the AOJ issued supplemental statements of the case (SSOC) in May 2012 and August 2012, but that neither SSOC made any reference to the March 2011 private physician letter. The Board recognizes that a June 2012 letter from VA to a U.S. Congressman states that the March 2011 private physician's statement was considered. However, the fact remains that the Veteran has not been issued an SSOC which shows consideration of the March 2011 private physician statement. Accordingly, the Veteran's claim must be remanded for such an SSOC. See Stegall v. West, 11 Vet. App. 268, 271 (1998). The Board additionally notes that the record does not contain sufficient evidence to adjudicate the Veteran's claim and that a medical opinion should be obtained. Accordingly, the case is REMANDED for the following action: (Please note, this appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c) (2012). Expedited handling is requested.) 1. Obtain a medical opinion that shows review of the Veteran's private medical treatment at Riverside Methodist Hospital, Columbus, Ohio from August 3, 2010 to August 7, 2010. The examiner must provide an opinion as to whether the private medical services were rendered in a medical emergency of such nature that a prudent layperson reasonably expects that delay would have been hazardous to life or health. The examiner should provide reasons and bases for the opinion and discuss the March 2011 private physician's opinion. The examiner should also opine as to whether a VA or other Federal facility was feasibly available and whether an attempt to use them beforehand or obtain prior VA authorization for the services required would have been reasonable. The examiner should provide reasons and bases for the opinion. If the examiner opines that such a facility was reasonably available, the examiner should state which facility was feasibly available and indicate that such facility was capable of performing the required services. 2. If the benefit sought is not granted to the Veteran's satisfaction, an SSOC should be issued. The SSOC must specifically discuss the March 2011 letter from the Veteran's private physician. The appellant has the right to submit additional evidence and argument on the matter the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2012). _________________________________________________ A. C. MACKENZIE Acting Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (2012).