Citation Nr: 21001402 Decision Date: 01/08/21 Archive Date: 01/08/21 DOCKET NO. 17-00 693 DATE: January 8, 2021 REMANDED Entitlement to reimbursement for services provided by Phoenix ED SRV of Leesburg, LLC for the period of care commencing July 13, 2015 is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from October 1975 to August 1977. The Veteran seeks entitlement to reimbursement for services provided by a private hospital for the period of care commencing July 13, 2015. Because the Veteran is not service connected for any disability, reimbursement of unpaid medical expenses is governed by 38 U.S.C. § 1725. The implementing regulation for that statutory section provides that, to be timely, a claim for reimbursement must be filed within 90 days of the latest of either the date that the claimant was discharged, or the date that 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). To this point, the Agency of Original Jurisdiction (AOJ) denied the Veteran’s claim on the basis that it was not received within 90 days of his discharge. The Statement of the Case also noted that the Veteran was listed as a cash payer with no third-party insurer provided. In response, the Veteran has made two claims. First, he has contended that he was not billed by the private provider in a timely fashion, and that he filed his claim within 90 days of receiving his bill. More recently, in his substantive appeal, the Veteran contended that he filed an earlier claim for reimbursement that was erroneously sent to Orlando, which is interpreted by the Board to mean the Orlando VAMC. The record does not contain any proof of an earlier claim filing by this provider, nor has the question of whether the Veteran sought third-party reimbursement been answered. Though the AOJ found that the Veteran was not covered by any insurance, other documents from the private provider reflect that he was covered by Medicare. Thus, at this point, the Board does not have sufficient information to determine whether the Veteran’s claim for reimbursement should be considered timely under the applicable regulation. The claim is remanded to allow for development in an effort to answer that question. The matters are REMANDED for the following action: 1. Request proof from the Veteran regarding any earlier claim filing or any efforts to obtain payment of the claim from any third-party provider, to include Medicare. If the Veteran contends that a third party has such proof, secure any necessary releases to obtain such. Associate documentation of such efforts with the record. 2. Obtain any relevant records from the Orlando VA offices regarding this claim, and associate such with the record. 3. Thereafter, readjudicate the claim on appeal. If the benefit sought remains denied, issue a Supplemental Statement of the Case. Evan M. Deichert Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. C. King, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.