Citation Nr: A21020480 Decision Date: 12/21/21 Archive Date: 12/23/21 DOCKET NO. 200331-198992 DATE: December 21, 2021 REMANDED Entitlement to payment of cost of non-VA medical services provided to the Veteran on February 25, 2020 is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1976 to February 1981. The appellant in this matter provided medical services to the Veteran on February 25, 2020. The decision on appeal was issued in March 2020 by the Department of Veterans Affairs (VA), Veterans Health Administration (VHA) and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies. In the March 2020 VA Form 10182, Decision Review Request: Board Appeal, the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the agency of original jurisdiction (AOJ) decision on appeal. Entitlement to payment of cost of non-VA medical services provided to the Veteran on February 25, 2020 is remanded. Unfortunately, the Board finds that remand is necessary to obtain a copy of the complete record before the agency of original jurisdiction (AOJ) at the time the decision on appeal was rendered. Decisions of the Board must be based on a de novo review of the evidence of record at the time of the AOJ decision on the issue or issues on appeal, and any additional evidence considered as part of the evidentiary record pursuant to applicable statute and regulation. 38 U.S.C. §§ 7104(d), 7113; 38 C.F.R. § 20.801(a). In the instant matter, the decision being appealed cannot be located in the claims file as presently constituted, 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 appeals to the electronic claims file. If such records are unable to be located, the AOJ should make a formal finding of unavailability and reissue any pertinent decisional documents so the appellant may continue the appeal. Per 38 C.F.R. § 20.802, the Board may remand for correction of any error by the AOJ in satisfying a regulatory or statutory duty if correction of the error would have a reasonable possibility of aiding in substantiating the appellant's claim. The Board finds that the AOJ erred by not ensuring that all the necessary evidence was of record for review by the Board. On remand, if the original decision is unable to be located, the AOJ must provide the appellant with complete notice of the decision as required by 38 U.S.C. § 5104. If the claim is for reimbursement for medical services provided pursuant to a referral to the community care network under 38 U.S.C. § 1703, the notice should explain this to the appellant and inform the appellant how a claim for reimbursement should be submitted. Additionally, the AOJ should ensure that all evidence upon which the decision is based is identified in the notice and made part of the electronic record for review by the Board should the appellant submit an additional notice of disagreement to the Board. The matters are REMANDED for the following action: 1. Reconstruct the record and upload to the electronic claims file all documentation related to the claim of payment of the cost of non-VA medical services provided to the Veteran on February 25, 2020. 2. If such records are unable to be associated with the record, make a formal finding of unavailability and issue to the appellant a decision and notice of decision on this matter which adheres to the content requirements of 38 U.S.C. § 5104, including but not limited to a summary of the applicable laws and regulations, as well as identification of findings favorable to the claimant. MICHAEL E. KILCOYNE 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.