Citation Nr: 18140323
Decision Date: 10/03/18	Archive Date: 10/02/18

DOCKET NO. 15-00 221A
DATE:	October 3, 2018
REMANDED
Entitlement to payment or reimbursement for unauthorized medical expenses is remanded.
REASONS FOR REMAND
The Agency of Original Jurisdiction (AOJ) has indicated that the Veteran had active service from August 1968 to July 1976.  This matter appears to come before the Board of Veterans’ Appeals (Board) on appeal from a July 2014 letter of determination by a Department of Veterans Affairs (VA) Medical Center.  After review of the claims file, the Board reflects that many of the documents necessary for adjudication of this case are not of record, including the July 2014 letter of determination and any private medical records pertinent to this case.  The Board has attempted to obtain copies of the medical file from the VA Medical Center through an administrative process, as documented by the emails associated with the physical and electronic claims files.  However, that administrative process having failed to produce the documents needed to adjudicate this claim, the Board’s sole remedy in this case is to remand the case to the AOJ in order for them to either provide copies of the entirety of the claims file, or to re-develop the claim and readjudicate the claim based on the redeveloped evidence.
The matter is REMANDED for the following action:
1. The AOJ must make all necessary efforts to obtain copies of any and all documents noted in the January 2015 statement of the case relied upon in this case and associate those documents with the claims file; such documents include, but are not limited to: the Veteran’s initial claim for payment or reimbursement, any medical billing statements or appropriate hospital billing forms, any private medical records from the private medical facility, any service records, and a copy of the July 2014 letter of determination.  If the AOJ is unable to provide copies of any documents, the AOJ must complete all appropriate development of this claim in order to adjudicate this claim.
2. Following any additional indicated development, the AOJ should review the claims file and readjudicate the Veteran’s claim for payment or reimbursement of unauthorized medical expenses.  If the benefits sought on appeal remain denied, the Veteran and his representative, if any, should be furnished a supplemental statement of the case and given the opportunity to respond thereto before the case is returned to the Board.
 
JAMES G. REINHART
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	M. Peters, Counsel