Citation Nr: 25005665 Decision Date: 04/25/25 Archive Date: 04/25/25 DOCKET NO. 11-23 966A DATE: April 25, 2025 ORDER Entitlement to payment or reimbursement of expenses associated with emergency medical treatment provided to the Veteran from March 16, 2010, to March 25, 2010, is granted. FINDING OF FACT Resolving all doubt in the Appellant's favor, the Appellant's claim was timely filed. CONCLUSION OF LAW The criteria for payment or reimbursement of emergency medical expenses are met.?38?U.S.C. §§?1725, 5107;?38?C.F.R. §§?17.1000-17.1008. REASONS AND BASES FOR FINDING AND CONCLUSION This matter comes to the Board of Veterans' Appeals (Board) from a December 2010 decision denying payment or reimbursement for the cost of the Veteran's emergency medical treatment on the basis that the claim was not timely filed. The Appellant is a non-VA provider. The Appellant appealed this matter to the Board in September 2011 and requested a hearing before a Veterans Law Judge. In 2021, the Board attempted to schedule a hearing, but a notice letter to the Appellant's representative was returned as undeliverable. After the Board determined that the Appellant's representative was not VA-accredited, the Board contacted the Appellant directly. The Board experienced apparent difficulty scheduling a hearing with the Appellant and the record appears to show that the Appellant failed to appear at a videoconference hearing that was scheduled at the St. Petersburg, Florida, regional office. However, as the Board is granting this claim, there is no prejudice to the Appellant to proceed with adjudication in lieu of a hearing. Entitlement to payment or reimbursement of expenses associated with emergency medical treatment of the Veteran from March 16, 2010, to March 25, 2010 The Appellant requests payment or reimbursement for medical expenses related to treatment of the Veteran from March 16, 2010, to March 25, 2010, on the basis that the care provided was under emergency circumstances. As a preliminary matter, the Board takes note that numerous claims for reimbursement were submitted to VA from various entities in relation to this episode of care, and most of them were processed and paid pursuant to 38 U.S.C. § 1725 that governs emergency medical treatment for nonservice-connected conditions. It is, therefore, not disputed that the requirements of section 1725 are met in this case. At issue here is whether the Appellant's claim was timely filed. To receive payment or reimbursement of emergency services, a claimant must file a claim within 90 days after the latest of the following: (1) The date the veteran was discharged from the facility that furnished the emergency treatment; (2) the date of death if the death occurred during transportation to a facility for emergency treatment or if the death occurred during the stay in the facility that included the provision of the emergency treatment; or (3) the date the veteran finally exhausted, without success, action to obtain payment or reimbursement from a third party. 38?C.F.R. §?17.1004(d). The record confirms that the Veteran was admitted to the Appellant hospital on March 16, 2010, in critical condition and that he died while he was still in the hospital on March 25, 2010. VA denied the Appellant's claim on the basis that its claim for reimbursement was received in December 2010, several months after the 90-day time limit had passed. While this appeal was pending, VA determined that the Appellant had filed an earlier claim in August 2010, but this date was also outside of the relevant time limit. The Appellant has consistently asserted that its claim was timely filed. In December 2010 and August 2011, the Appellant submitted multiple letters asserting that its claim was originally submitted within the 90-day deadline to the Miami VA Medical Center rather than the West Palm Beach VA Medical Center, and that it was not informed that the claim should have been submitted to the latter facility until July 2010. The Appellant provided tracking documentation indicating that first-class certified mail was delivered to the Miami VA Medical Center on April 30, 2010, well within the 90-day time limit. As the evidence appears to substantiate the Appellant's consistent assertion that its claim was timely filed, the Board resolves all doubt in the Appellant's favor. The claim is granted. Wendy Daknis Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Freda J. F. Smith, 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.