Letter to Sloan Gibson, Acting Secretary of Veterans Affairs - Veterans Affairs Reimbursement

Letter

Dear Secretary Gibson,

I am writing to express my concern about the manner in which VA administrators are interpreting and applying the regulation governing VA reimbursement for emergency medical care obtained at civilian hospitals, 38 C.F.R. 17.1002 (hereafter §17.1002).

This regulation sets forth a standard whereby veterans are to be reimbursed for their medical expenses only when a "prudent layperson" might "have reasonably expected that delay in seeking immediate medical attention would have been hazardous to life or health." I have received casework from constituents who were denied reimbursement from the VA for emergency civilian care that they received due to lost vision, back spasms, and broken bones, among other emergency ailments. For that reason, I am concerned by the gap between veterans' expectations regarding emergency care and the VA's ex post analysis of the medical situation.

VA administrators should use their discretion to implement §17.1002 in the light most favorable to the veteran seeking timely, adequate care for their medical emergencies, rather than penalize them for doing so. Pursuant to §17.1002, such discretion can and should account for the severity of pain experienced by the veteran and the distance to the nearest VA medical center. Considering the ongoing difficulties that veterans experience in accessing VA medical care, I urge you to immediately promulgate guidance that encourages VA officials responsible for implementing §17.1002 to do so in a liberal manner that is expansive in granting reimbursement to veterans who seek civilian care in medical emergencies.

America's veterans have fought for our country during its times of greatest need. They should not have to fight their own government to obtain reimbursement for care received during their times of greatest need. Thank you for your attention to this matter and I look forward to your prompt response.

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