Medical Necessity for Use of Foreign Air Carrier

A claimant protested a deduction for air travel fare as a penalty for not using U.S. air carrier service. The travel was performed by his wife, who flew for medical treatment from Rangoon, Burma to the Washington, D.C. area via London, England. The issue was whether, under current regulations, a U.S. air carrier was available in lieu of the foreign air carrier actually taken on the London to Washington portion of the trip. Medical specialist in Burma and Bangkok, Thailand were unable to account for the patient's medical symptoms and recommended more thorough diagnostic procedures in Washington, D.C. Medical travel to Washington was authorized at government expense. In accordance with regulations, U.S. air carriers must be used to the extent that they are available, which means the carrier should be used if it performs the commercial foreign air transportation needed by the agency and if the service will accomplish the agency's mission. In view of the patient's medical problem requiring evaluation and hospitalization immediately upon return to Washington, it appeared that the additional time and burden of making connections would have been a serious hardship and created an unreasonable risk to her health and safety. The use of direct foreign air carrier service between London and Washington may be viewed as necessary to accomplish the agency's mission to ensure the patient's safe and expeditious medical evaluation. The entire amount of the airfare may be paid and the previous decision for disallowance was overruled.