Citation Nr: 18159751 Decision Date: 12/20/18 Archive Date: 12/19/18 DOCKET NO. 15-21 607 DATE: December 20, 2018 ORDER Entitlement to payment or reimbursement for the cost of unauthorized medical expenses incurred at Capital Regional Medical Center from April 20 to April 25, 2014, is denied. FINDING OF FACT The Veteran did not file a timely claim for payment or reimbursement for medical expenses incurred at Capital Regional Medical Center from April 20 to April 25, 2014. CONCLUSION OF LAW The criteria for payment or reimbursement for unauthorized medical expenses incurred Capital Regional Medical Center from April 20 to April 25, 2014, are not met. 38 U.S.C. §§ 1725, 5107; 38 C.F.R. § 17.1004(d). REASONS AND BASES FOR FINDING AND CONCLUSION It appears that the Veteran served on active duty from January 1980 to July 1984; however, the Board is unable to verify the dates of the Veteran’s military service based on the evidence provided in the claims file. 1. Reimbursement for unauthorized medical treatment. To obtain payment or reimbursement under 38 U.S.C. § 1725, a claimant must submit to the VA medical facility of jurisdiction a completed standard billing form (such as a UB92 or a HCFA 1500). See 38 C.F.R. § 17.1004(b). Also, to receive payment or reimbursement, a claimant must file a claim within 90 days after the latest of the following: (1) the date that the veteran was discharged from the facility that furnished the emergency treatment; (2) the date of death, but only if the death occurred during transportation to a facility for emergency treatment or if the death occurred during the stay in the facility that included the provision of the emergency treatment; or, (3) the date the veteran finally exhausted without success, action to obtain payment or reimbursement for the treatment from a third party. See 38 C.F.R. § 17.1004(d). Regardless, VA will provide retroactive payment or reimbursement for emergency treatment received by the Veteran on or after July 19, 2001, but more than 90 days before May 21, 2012, if the claimant files a claim for reimbursement no later than 1 year after May 21, 2012. See 38 C.F.R. § 17.1004(f). The Veteran’s claim for reimbursement was denied because the HCFA form was received on January 20, 2015, after the 90-day filing limit, and as such, was not timely filed. See the April 2015 Statement of the Case. On appeal, the Veteran, in his February 2015 notice of disagreement and February 2015 substantive appeal (VA Form 9), asserts that he should be reimbursed for his treatment at Capital Regional Medical Center because he notified VA of his hospitalization, which he believed was the proper notification. The Board notes as a preliminary matter that the Veteran indicated in September 2018 that he received a letter approximately one month prior stating that “VA had paid all expenses,” and that “he does not have anything against the VA.” The Board subsequently sought clarification from the Veteran, including asking the Veteran whether he wished to withdraw the appeal. In a November 2018 brief, however, the Veteran’s representative indicated that the Veteran was unclear as to what was on appeal, and as such, did not wish to withdraw the appeal. The Board will therefore proceed with the appeal. Review of the record shows that the Veteran informed VA of the emergency room visit, and private treatment records were obtained and scanned into the Veteran’s VA treatment records in May 2014. However, Capital Regional Medical Center submitted a bill, HCFA 1500, to VA on January 20, 2015, well after the 90-day time limit for submission under 38 C.F.R. § 17.1004(d)(1) in this case. For a claim to have been timely filed, it needed to be filed no later than July 25, 2014. The Board finds that based on the evidence of record, the evidence does not demonstrate that the Veteran filed a claim for payment or reimbursement for the medical expenses associated with the services rendered from April 20 to April 25, 2014, at any time before January 20, 2015. In short, as the Veteran has not submitted evidence of a timely claim in this case, his claim for payment or reimbursement of unauthorized medical expenses incurred at Capital Regional Medical Center from April 20 to April 25, 2014, must be denied at this time. See 38 C.F.R. § 1725; 38 C.F.R. § 17.10004(d). H. SEESEL Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD N. Nelson, Counsel