Citation Nr: 21077093 Decision Date: 12/28/21 Archive Date: 12/28/21 DOCKET NO. 17-39 498 DATE: December 28, 2021 ORDER Entitlement to payment or reimbursement of unauthorized medical expenses incurred at Centennial Medical Plaza (CMP) on June 18, 2015 is denied. FINDING OF FACT The Veteran was enrolled in the VA health care system but had not received medical services within the previous 24 months. CONCLUSION OF LAW The criteria for payment or reimbursement for unauthorized medical expenses incurred at CMP on June 18, 2015 have not been met. 38 U.S.C. §§ 1703, 1725; 38 C.F.R. §§ 17.52, 17.53, 17.120, 17.121, 17.1002. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1994 to February 2001, from June 2006 to March 2007, from January 2008 to August 2008, January 2010 to August 2010, and from May 2012 to February 2013. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2015 decision of the Department of Veterans Affairs (VA) Veterans Health Administration (VHA). In June 2021, the Veteran appeared and testified at a virtual Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing has been associated with the record. Entitlement to payment or reimbursement of unauthorized medical expenses incurred at CMP on June 18, 2015 The Veteran seeks reimbursement of expenses incurred at CMP on June 18, 2015. Eligibility for reimbursement for emergency medical treatment furnished at a non-VA provider requires that the Veteran be "enrolled in the health care system established under section 1705(a) of this title; and the veteran received care under this chapter within the 24-month period preceding the furnishing of such emergency treatment." 38 U.S.C. § 1725(b)(2). Both conditions must be met for a Veteran to be eligible for reimbursement under this statute. See Zimick v. West, 11 Vet. App. 45, 49 (1998); Malone v. Gober, 10 Vet. App. 539, 547 (1997); see also Melson v. Derwinski, 1 Vet. App. 334, 337 (the use of the conjunctive "and" in a statutory provision meant that all of the conditions listed in the provision must be met). Here, there is no question that the Veteran was enrolled in the VA health care system. However, as the Veteran testified, she had not received care in the 24-month period preceding the furnishing of the emergency treatment. As such, she is not eligible for reimbursement of such care. The Board is sympathetic to the Veteran's claim that she had recently enrolled in the VA health care system and had not scheduled a physical prior to needing the emergency treatment. Further, the Board recognizes the steps the Veteran took to verify her eligibility for emergency treatment subsequent to her enrollment in the VA health care system. However, the legal authority pertaining to the reimbursement of the costs incurred in obtaining emergency medical treatment is prescribed by Congress and implemented via regulations enacted by VA, and neither the agency of original jurisdiction nor the Board is free to disregard laws and regulations enacted for the administration of VA programs. See 38 U.S.C. § 7104(c); 38 C.F.R. § 20.101(a). In other words, the Board is bound by the governing legal authority, and is without authority to grant benefits on an equitable basis. As, on these facts, there is no legal basis to award reimbursement of the costs incurred in obtaining emergency medical treatment, the appellant's claim must be denied as a matter of law. See Sabonis v. Brown, 6 Vet. App. 426, 430 (1994). Cynthia M. Bruce Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Uller, 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.