Citation Nr: 21002323 Decision Date: 01/13/21 Archive Date: 01/13/21 DOCKET NO. 15-06 390A DATE: January 13, 2021 REMANDED Entitlement to payment or reimbursement of unauthorized medical expenses incurred at Boes Eye Care on September 10, 2012, March 20, 2013, and September 9, 2013 is remanded in order for the Agency of Original Jurisdiction (AOJ) to reconstruct the record and upload all documentation related to the appeal to the electronic claims file.   REASONS FOR REMAND The Veteran had active duty from November 1990 to May 1991. Prior service was not verified. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a May 2014 letter of determination by a Department of Veterans Affairs (VA) Medical Center (MC). The Veteran testified at a Board hearing before the undersigned Veterans Law Judge in July 2016. In a September 2019 decision, the Board denied the claim on appeal. The Veteran appealed the decision to the United States Court of Appeal for Veterans Claims (Court) and, in November 2019, the parties to this appeal entered into a Joint Motion for Remand (Joint Motion), in which the parties agreed that the decision should be vacated. The Court granted the parties’ Joint Motion in an Order issued in December 2019. Entitlement to payment or reimbursement of unauthorized medical expenses incurred at Boes Eye Care on September 10, 2012, March 20, 2013, and September 9, 2013. On appeal, the Veteran avers that VA should pay for or reimburse him for the medical expenses incurred at Boes Eye Care on September 10, 2012, March 20, 2013, and September 9, 2013, because he believed that he was given prior authorization by his VA doctor. In his November 2013 notice of disagreement, the Veteran indicated that he had a September 9, 2013 through March 2014 pre-authorization on file from his VA doctor; he additionally indicated that the VA medical facility had informed him that the bills from Boes Eye Care for the March 6, 2013 through October 3, 2013, were mistakes and should have been pre-authorized. The Veteran made similar statements in his April 2014 statement and in his March 2015 substantive appeal, VA Form 9. Similarly, the Veteran testified in his July 2016 hearing that beginning in 1997 he suffered from pigmentary glaucoma and that he had surgery at VA for that condition in 1998. He further testified that he has been referred by his VA doctor, Dr. B., to Boes Eye Care for treatment since at least 2005 and that all of those treatments prior to and subsequent to the dates on appeal have been authorized and paid for by VA. The Veteran further asserted in his hearing that he followed all of the same procedures for these visits to Boes Eye Care that he had followed previously for authorization purposes. Finally, during the July 2016 hearing, the Veteran and his representative indicated that they would be submitting a letter from the Veteran’s VA ophthalmologist, Dr. B., indicating that he had given the Veteran prior authorization for treatment at Boes Eye Care on September 10, 2012, March 20, 2013, and September 9, 2013. In a September 2018 decision, the Board denied the claim. The Board did not find that that there was any prior authorization from VA for treatment at Boes Eye Care on September 10, 2012, March 20, 2013, and September 9, 2013. The December 2019 Joint Motion found that the Veteran’s file is missing records, including the original claim for the issue on appeal and VA treatment records, and that the Veteran was not issued notice pursuant to the Veterans Claims Assistance Act of 2000 (VCAA). The Board finds that the complete file for the claim on appeal cannot be located, and documentation pertinent to the appeal is not in the electronic record. Therefore, it must be remanded in order for the AOJ to reconstruct the record and upload all documentation related to the appeal to the electronic claims file. If such records are unable to be located, the AOJ should make a formal finding of unavailability. In addition, after the record is reconstructed, the AOJ should ensure that the Veteran has been issued VCAA notice and his complete VA treatment records are associated with the file. The matter are REMANDED for the following action: 1. Reconstruct the record and upload all documentation related to the claim for payment or reimbursement of unauthorized medical expenses incurred at Boes Eye Care on September 10, 2012, March 20, 2013, and September 9, 2013 to the electronic claims file. If such records are unable to be associated with the record, make a formal finding of unavailability. 2. If the file does not include a VCAA letter for the claim on appeal after reconstruction, issue a VCAA letter addressing the Veteran’s claim for payment or reimbursement of unauthorized medical expenses incurred at Boes Eye Care on September 10, 2012, March 20, 2013, and September 9, 2013. 3. Associate complete VA treatment records with the file. H. N. SCHWARTZ Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Jimerfield 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.