Citation Nr: 19122811 Decision Date: 03/26/19 Archive Date: 03/26/19 DOCKET NO. 14-16 171 DATE: March 26, 2019 REMANDED Entitlement to payment or reimbursement of the cost of medical services received from June 6, 2012, to June 7, 2012 at Miller County Hospital (MCH) in Colquitt, Georgia is remanded. REASONS FOR REMAND The Veteran had active service from February 1967 to December 1969. This claim was previously before the Board in April 2018 and November 2018, at which time the Board remanded it for additional development. Additional development is needed before the claim can be decided on the merits. Entitlement to payment or reimbursement of the cost of medical services received from June 6, 2012, to June 7, 2012, at Miller County Hospital (MCH) in Colquitt, Georgia is remanded. The July 2018 and January 2019 supplemental statements of the case (SSOCs) state that the claim was received on October 17, 2012. In April 2018 and November 2018, the Board remanded the claim to obtain the Veteran’s original claims form, which is not in the claims file. Compliance by the Board or the RO with remand instructions is neither optional nor discretionary. See Stegall v. West, 11 Vet. App. 268, 271 (1998). The October 17, 2012, claims form must be associated with the claims file unless there is a formal finding that it cannot be obtained. In January 2019 the VA medical center (VAMC) requested claim and payment information from MCH regarding the Veteran’s claim. A response was not received. On remand, the information should again be requested from MCH. The Veteran’s VA treatment records for the 24-month period preceding June 6, 2012, will be relevant should the claim be found to have been timely filed. Therefore, these records should be obtained on remand. The matter is REMANDED for the following action: 1. Obtain the Veteran’s VA treatment records from June 6, 2010, through June 6, 2012. 2. Associate a copy of the initial claim from Miller County Hospital (MCH) with the claims file, which the VAMC noted in the July 2018 and January 2019 SSOCs was received on October 17, 2012. If it is unavailable, inform the Veteran and afford him an opportunity to submit any copies in his possession. 3. Obtain any necessary release of information from the Veteran for MCH. Then request that MCH provide any information it has concerning its efforts to claim payment or reimbursement from VA and Medicare for the cost of the treatment provided to the Veteran from June 6, 2012, to June 7, 2012. The request to MCH should include the following inquiries: (a.) When was a claim first filed with VA for payment of the cost of the treatment the Veteran received at the hospital from June 6, 2012 to June 7, 2012? (b.) If a claim was filed with VA for payment of this treatment prior to October 17, 2012, please provide a copy of this claim and/or other documentation indicating that the claim was filed with VA on that earlier date. Also, if a claim was not filed with VA for payment for the treatment the Veteran received within 90 days of June 7, 2012, please explain the delay. (c.) Describe any efforts to obtain payment from Medicare for the treatment the Veteran received at the hospital from June 6, 2012, to June 7, 2012, along with the dates that such efforts were undertaken. Provide documentation of these efforts to obtain payment from Medicare and any documentation of pertinent responses received from Medicare. Make at least two attempts to obtain records from MCH. If any such records are unavailable, inform the Veteran. 4. Ask the Veteran to provide information concerning Medicare payment for part of the cost of the services he received at MCH from June 6, 2012, to June 7, 2012. Advise the Veteran that if he has access to any additional information pertinent to this claim, including any additional information pertaining to the timing of the claim filed with VA by MCH, and/or any efforts taken by the hospital or by himself to obtain payment or reimbursement for the cost of the treatment from Medicare within 90 days of June 7, 2012, it is in his interest to submit this information for inclusion in the record on appeal. The request to the Veteran should include the following inquiries: (a.) Provide documentation concerning Medicare payment for the June 6, 2012, to June 7, 2012 hospitalization at MCH, including a copy of the Medicare explanation of benefits (EOB), if he has a copy of this document. (b.) Indicate whether you made any efforts to obtain payment or reimbursement from Medicare for the cost of the treatment at MCH from June 6, 2012, to June 7, 2012, or whether this task was handled solely by MCH. (c.) Indicate the approximate dates of any efforts to obtain payment from Medicare for the treatment received at MCH from June 6, 2012, to June 7, 2012, submit any documentation or other corroborating evidence of these efforts, and submit documentation of any pertinent responses received from Medicare. Michael J. Skaltsounis Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Scott Shoreman, Counsel