Citation Nr: 18142989 Decision Date: 10/18/18 Archive Date: 10/17/18 DOCKET NO. 13-28 551A DATE: October 18, 2018 REMANDED Entitlement to payment or reimbursement for unauthorized dental expenses incurred on June 4, 2013, is remanded. REASONS FOR REMAND The Veteran had active duty service from January 1996 to July 1999. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2013 letter of determination by a Department of Veterans Affairs (VA) Medical Center. The Veteran initially requested a Board hearing before a Veterans Law Judge in his October 2013 substantive appeal, VA Form 9; the Veteran was scheduled for that hearing in September 2018 and he was informed of that hearing in an August 2018 letter. The Veteran, however, did not appear for that scheduled hearing, and he has not provided good cause for failure to appear. Consequently, the Board deems his hearing request to be withdrawn in this case, and the Board will proceed at this time. See 38 C.F.R. § 20.1304. The Board reflects that in a June 4, 2013—the same date as the Veteran’s dental services at issue in this appeal—rating decision, the Agency of Original Jurisdiction (AOJ) awarded service connection for a “dental condition with myofascial pain disorder of the muscles of mastication and nocturnal bruxism,” effective beginning in September 2011. In the August 2013 letter of determination, the sole basis for denial of this appeal is based on the fact that the Veteran did not obtain prior authorization for the dental services that he sought and received on June 4, 2013. Such a denial is under the statutory authority of 38 U.S.C. § 1703 only. The Veteran, however, in his September 2013 notice of disagreement indicated that he sought “emergency dental procedures” in 2011, and by June 4, 2013, had waited two years and attempted to obtain prior authorization for treatment several times; he asserts that he was told several times that he was “not in the system.” He further stated that it was “chronologically impossible to get preauthorization for someone who they claim is not in the system every time I called regarding emergency procedures. Also knowing there was no decision on my dental disability claim so it is also impossible to call and get preauthorization.” Given that the Veteran was seeking treatment—which he has characterized as an “emergency dental procedure”—for a service-connected disability, in addition to the statutory provisions of 38 U.S.C. § 1703, payment or reimbursement in this case has been raised under the statutory authority of 38 U.S.C. § 1728, which the AOJ in this case has not considered in any adjudicatory document. Consequently, the Board must remand this case in order for the AOJ to properly develop and adjudicate the case under 38 U.S.C. § 1728, in the first instance, at this time. Finally, in the Veteran’s October 2018 substantive appeal, VA Form 9, he wrote “see attached,” although it does not appear that the AOJ obtained copies of and associated any of the attached documents with the claims file. Accordingly, on remand, the AOJ should associate all “attached” documents that it received with the October 2013 substantive appeal, VA Form 9. The matter is REMANDED for the following action: 1. Obtain all copies of “attached” documents that the AOJ received with the October 2013 substantive appeal, VA Form 9, and associate those copies with the claims file. If copies of those attached documents are not available, the AOJ should contact the Veteran in order to obtain copies of the “attached” documents that he submitted with his substantive appeal, VA Form 9. If all efforts to obtain those documents have been exhausted and further efforts to obtain copies of those documents would be futile, the AOJ should document all efforts to obtain those documents and the finding of futility in a Memorandum of Unavailability which is associated with the claims file, and notification of such should be sent to the Veteran. 2. The AOJ should complete any and all necessary development and following completion of that development, the AOJ should review the claims file and readjudicate the Veteran’s claim for payment or reimbursement for unauthorized dental expenses incurred on June 4, 2013, under the statute 38 U.S.C. § 1728 and associated regulations. If the benefits sought on appeal remain denied, the Veteran and his representative 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