Citation Nr: 18148314
Decision Date: 11/07/18	Archive Date: 11/07/18

DOCKET NO. 16-35 936A
DATE:	November 7, 2018
REMANDED
Entitlement to reimbursement or payment of medical expenses incurred at a private hospital from October 5, 2012, to October 10, 2012, is remanded.
REASONS FOR REMAND
The Veteran had active military service from February 1970 to November 1971 and from October 1981 to August 1985.
This case comes before the Board of Veterans’ Appeals (Board) on appeal from a November 2012 administrative decision issued by the Department of Veterans Affairs (VA) Medical Center in Fayetteville, North Carolina.
Medical reimbursement
The issue on appeal has been continuously denied on procedural grounds by the agency of original jurisdiction (AOJ).  Specifically, the AOJ states the Veteran did not timely submit additional evidence requested by VA after he received notice that such evidence was needed in a November 2012 decision denying his claim.  The record does not reflect that the Veteran received that notification.  Indeed, the November 2012 decision is only addressed to the Cape Valley Fear Hospital.  Thus, it does not appear that the Veteran received proper notice pursuant to 38 C.F.R. § 17.131 and the original claim was not abandoned.  
Because the above issue has not been adjudicated on the merits by the AOJ, specifically, whether a VA or other federal facility was feasibly available, and whether there was a medical emergency as required by 38 U.S.C. §§ 1725 and 1728.  Thus, a remand is necessary to properly develop the record and readjudicate the issue.
The matter is REMANDED for the following action:
1. The AOJ should develop the record as if the Veteran timely filed any requested additional information after the November 2012 denial and did not abandon his original claim.  If any additional evidence is still needed, the AOJ should provide proper notice to the Veteran with a copy of such notice added to the record.
2. Then, readjudicate the issue on appeal.  If the decision is adverse to the Veteran, issue a supplemental statement of the case and allow appropriate time for response.  Then, return the case to the Board.
 
Kristin Haddock
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	I. Cannaday, Associate Counsel