Citation Nr: 18159824 Decision Date: 12/20/18 Archive Date: 12/20/18 DOCKET NO. 15-14 675A DATE: December 20, 2018 ORDER Payment or reimbursement of medical expenses incurred from September 26, 2014, to October 2, 2014, at Tampa General Hospital (TGH) is denied. FINDING OF FACT The earliest claim filed for payment or reimbursement of medical expenses incurred at TGH for the Veteran’s September 26, 2014, to October 2, 2014, treatment was not within 90 days of either the October 2 discharge date or a date on which he exhausted action to obtain payment or reimbursement from a third party. CONCLUSION OF LAW The criteria for payment or reimbursement of medical expenses incurred from September 26, 2014, to October 2, 2014, at TGH have not been met. 38 U.S.C. §§ 1725, 5107; 38 C.F.R. §§ 17.1000-1008, 17.127. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from September 2004 to September 2008. This appeal is before the Board of Veterans’ Appeals (Board) from a January 2016 decision of the VA Veterans Health Administration. The Veterans Millennium Health Care and Benefits Act provides general authority for reimbursement for the reasonable value of emergency treatment furnished in a non-VA facility to those Veterans who are active VA health-care participants (i.e., enrolled in the annual patient enrollment system and recipients of a VA hospital, nursing home, or domiciliary care under such system within the last 24-month period) and who are personally liable for such non-VA treatment and not eligible for reimbursement under the provisions of 38 U.S.C. § 1728. 38 U.S.C. § 1725; 38 C.F.R. §§ 17.1000-1008. Pursuant to 38 U.S.C. § 1725, under certain circumstances, VA shall reimburse a veteran for the reasonable value of emergency treatment furnished the veteran in a non-Department facility. VA regulations at 38 C.F.R. §§ 17.1000 through 17.1008 constitute the requirements under 38 U.S.C. § 1725 that govern VA payment or reimbursement for non-VA emergency services furnished to a veteran for nonservice-connected conditions. 38 C.F.R. § 17.1000. For purposes relevant to the facts of this case, to receive payment or reimbursement for emergency services under 38 U.S.C. § 1725, a claimant must file a claim within 90 days after the latest of the following: the date that the veteran was discharged from the facility that furnished the emergency treatment; or the date the veteran finally exhausted, without success, action to obtain payment or reimbursement for the treatment from a third party. 38 C.F.R. § 17.1004(d). The date of filing any claim for payment or reimbursement of the expenses of medical care and services not previously authorized shall be the postmark date of a formal claim, or the date of any preceding telephone call, telegram, or other communication constituting an informal claim. 38 C.F.R. § 17.127. The pertinent facts of this case are not disputed. The Veteran does not have any service-connected disabilities. He received emergency treatment at TGH for injuries sustained after being hit and run over by automobile as a pedestrian on September 26, 2014, and was hospitalized there from that date until October 2, 2014. He initially filed a claim for payment or reimbursement of the expenses of this treatment on January 15, 2015. There is no indication that, between the time of treatment and the time his January 2015 claim, the Veteran attempted action to obtain payment or reimbursement for the treatment from a third party. As reflected in his March 2015 notice of disagreement and April 2015 substantive appeal, the Veteran acknowledges that he did not file a claim within 90 days of his October 2, 2014, date of his discharge from TGH. He asserts the following: he was unaware of the nature of his VA benefits; he requested assistance and information regarding his situation from his local VA office, and was told by a VA representative that VA would not be able to assist him because he was not treated at a VA facility; he was given no notice of the 90-day window for filing a claim for payment or reimbursement, even though he went to the local VA office for assistance; and, had he known about the 90-day deadline, he would have filed a timely claim. While the Veteran asserts having received erroneous information from a VA employee, this would not provide an exception to VA regulations. See Morris v. Derwinski, 1 Vet. App. 260 (1991), citing Fed. Crop Ins. Corp. v. Merrill, 332 U.S. 380, 384-85 (1947) (noting that the United States Supreme Court has recognized that persons dealing with the United States Government are charged with knowledge of federal statutes and lawfully promulgated agency regulations, regardless of actual knowledge or hardship resulting from innocent ignorance). Furthermore, “[e]rroneous advice given by a government employee cannot be used to estop the government from denying benefits.” McTighe v. Brown, 7 Vet. App. 29, 30 (1994) (citing OPM v. Richmond, 496 U.S. 414 (1990)). The Board acknowledges the Veteran’s contentions, but is bound by VA regulations regarding limitations on reimbursement, including time limitations for filing claims. See 38 U.S.C. § 1725(c)(1)(B); 38 C.F.R. § 17.1004(d). The record reflects, and the Veteran does not dispute, that he did not meet the basic filing requirements for his medical reimbursement claim under 38 C.F.R. § 17.1004 regarding the time limitations for filing claims. As the law is dispositive of the claim, rather than the facts, the claim must be denied because of lack of legal entitlement. See Sabonis v. Brown, 6 Vet. App. 426, 430 (1994). Accordingly, payment or reimbursement of medical expenses incurred at TGH from September 26, 2014 to October 2, 2014, must be denied. JONATHAN B. KRAMER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Andrew Mack, Counsel