Citation Nr: 21022666 Decision Date: 04/19/21 Archive Date: 04/19/21 DOCKET NO. 15-01 334 DATE: April 19, 2021 REMANDED Entitlement to reimbursement of medical expenses for an injury sustained on April 24, 2013. REASONS FOR REMAND The Veteran served on active duty from August 1974 to April 1975. This appeal is before the Board of Veterans’ Appeals (Board) from a June 2013 decision of a Department of Veterans Affairs (VA) Medical Center. The Veteran testified at a Board hearing before the undersigned Veterans Law Judge in June 2015. The Board remanded the matter on appeal to the agency of original jurisdiction (AOJ) in December 2017, in which it stated the following: The Veteran fractured her arm on April 24, 2013. She testified about a series of events which ultimately led to her having surgery to repair the fractures on May 3, 2013. The surgeon also performed “an urgent carpal tunnel decompression” the same day according to a Report of Operation. Unfortunately, the record does not specifically establish the medical providers for whom the Veteran seeks reimbursement nor the amounts for each provider. It contains billing statements–some of which are illegible–for treatment related to the fracture, surgery, and post-surgical treatment. Therefore, while it appears that VA only considered expenses incurred on May 3, 2013 in its June 2013 decision, the Veteran is possibly seeking reimbursement for expenses incurred prior to and after this date. Before the Board can determine whether reimbursement is warranted, it needs to know specifically what expenses the Veteran is claiming. The AOJ was therefore to ask the Veteran to identify the expenses for which she was seeking reimbursement, preferably in an itemized list with the date, provider, nature of expense, and whether any portion was paid by insurance. The AOJ was also to ask the Veteran to submit a letter from “the doctor who did the surgery,” which she mentioned during her Board hearing, which allegedly explained her May 3, 2013, surgery and why it was emergent. It was then to readjudicate the appeal and issue a Supplemental Statement of the Case (SSOC) before returning the appeal to the Board. The AOJ issued the Veteran an SSOC in February 2020. As reflected in a VA report of contact, the AOJ at that same time provided the Veteran a ledger to list the expenses for which she was seeking reimbursement, in accordance with the Board’s remand. According to the report of contact, in March 2020, the Veteran submitted the ledger listing expenses, including payments to a Dr. C. However, this list of expenses provided by the Veteran is not in the claims file. In this regard, subsequently, in June 2020, the AOJ issued decision letters to the Veteran denying reimbursement for medical expenses from two other providers than Dr. C. for treatment on May 5, 2013; it is unclear from the record whether such decisions were the result of the Veteran’s March 2020 submitted list or not. Also, in April 2020, the AOJ sent a letter to Dr. C. requesting a list of all payments made by the Veteran for her April 30 and May 3, 2013, episodes of care, and a letter “stating why this was an emergent situation.” Dr. C. did not respond. However, there is no indication in the record that the AOJ informed the Veteran of the nonresponse from Dr. C. or requested that she attempt to obtain the records from Dr. C. herself, or that it provided her with any further information before returning the appeal to the Board; the AOJ did not readjudicate the appeal and issue an SSOC to the Veteran after undertaking the development requested by the Board, as specified in the Board’s December 2017 remand. Therefore, the appeal must again be remanded for the AOJ to associate with the claims file the list of claimed expenses, providers, and treatment dates submitted by the Veteran in March 2020, and to inform the Veteran of its unsuccessful attempts to obtain information from Dr. C. and that she may attempt to obtain such information from Dr. C. herself and submit it to VA. The matter is thus REMANDED for the following action: 1. Associate with the claims file the March 2020 list of claimed expenses, providers, and treatment dates submitted by the Veteran. 2. Inform the Veteran of any unsuccessful attempts to obtain records from Dr. C. or any treatment provider for her April 24, 2013, injury, and advise her that she may attempt to obtain such information herself from any such providers and submit it to VA in support of her claim. 3. After completing the above and any other necessary development, readjudicate the appeal. If any benefit sought remains denied, provide an SSOC to the Veteran. KELLI A. KORDICH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Andrew Mack, 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.