OCTOBER 25, 1923, 3 COMP. GEN. 248

OCTOBER 25, 1923, 3 COMP. GEN. 248

VETERANS' BUREAU - REIMBURSEMENT FOR DENTAL WORK A CIVILIAN DENTIST PERFORMING DENTAL WORK UNDER AUTHORIZATION ISSUED TO HIM BY PROPER OFFICER OF THE VETERANS' BUREAU WITHOUT ANY PERSONAL KNOWLEDGE OF THE RIGHT OF THE BENEFICIARY TO SUCH TREATMENT IS ENTITLED TO PAYMENT FOR THE REASONABLE VALUE OF THE SERVICES RENDERED, NOTWITHSTANDING THAT THE PERSON FOR WHOM SUCH WORK IS PERFORMED WAS NOT ENTITLED TO DENTAL WORK, AT THE EXPENSE OF THE VETERANS' BUREAU. THE HOSPITAL, DENTAL, MEDICAL, SURGICAL, AND CONVALESCENT CARE AND TREATMENT AUTHORIZED BY SECTION 13, OF THE ACT OF AUGUST 9, 1923, 42 STAT. 152, CAN NOT LEGALLY BE FURNISHED (EXCEPT POSSIBLE EMERGENCY TREATMENT FOR RELIEF OF PAIN) IN ADVANCE OF A DETERMINATION BY THE PROPER OFFICERS OF THE VETERANS' BUREAU THAT THE DISABILITY WAS OF SERVICE ORIGIN.

DECISION BY COMPTROLLER GENERAL MCCARL, OCTOBER 25, 1923:

DR. MERRITT E. BROWN HAS REQUESTED REVIEW OF SETTLEMENT M-346, THIS OFFICE, DATED MAY 18, 1923, DISALLOWING HIS CLAIM FOR DENTAL EXAMINATION AND TREATMENT RENDERED LOUIS JACOBI AS A BENEFICIARY OF THE UNITED STATES VETERANS' BUREAU DURING NOVEMBER AND DECEMBER, 1921.

REPORT FROM THE VETERANS' BUREAU SHOWS THE FOLLOWING FACTS:

THIS IS A VERY IRREGULAR CASE AS PER ATTACHED RECORDS. YOU WILL NOTE UNDER DATE OF NOVEMBER 28TH, 1921, COPY OF TELEGRAM RECEIVED FROM THE SUBDISTRICT MEDICAL OFFICER AT ALBANY REQUESTING DENTAL EXAMINATION AND TREATMENT, PATIENT HAVING BEEN HOSPITALIZED.

UNDER DATE OF DECEMBER 15TH, 1921, AS PER COPY ATTACHED, DR. BROWN WAS AUTHORIZED TO GO AHEAD WITH DENTAL TREATMENT IN THE AMOUNT AS SHOWN ON EXAMINATION BLANK OF $270.00. THE CLAIMANT THEN DISAPPEARED AND THE DENTIST ONLY DID $110.00 WORTH OF WORK, AS SHOWN ON THE BLANK.

THE AUTHORIZATION WAS GIVEN BEFORE A RATING WAS MADE. UNDER DATE OF SEPTEMBER 7TH, 1922, THE DENTAL REFEREE MADE A RATING ENTITLING THE CLAIMANT TO TREATMENT WITHOUT COMPENSATION FOR "MISSING TEETH AND FRACTURE.'

UNDER DATE OF MARCH 15TH, 1922, AS PER COPY ATTACHED, A LETTER WAS ADDRESSED TO THE CENTRAL OFFICE ASKING WHETHER THE CLAIMANT WOULD BE ENTITLED TO THE DENTAL TREATMENT.

UNDER DATE OF MAY 4TH, 1922, AS PER COPY ATTACHED, A LETTER WAS RECEIVED FROM THE CENTRAL OFFICE REQUESTING THAT A RULING BE MADE BY THE RATING SECTION IN THIS DISTRICT. THE RULING WAS MADE SEPTEMBER 7TH, IN THIS DISTRICT, AS QUOTED ABOVE.

UNDER DATE OF FEBRUARY 26TH, 1923, THE RATING SECTION DECLARED THE CONDITION NOT DUE TO SERVICE, AS PER ATTACHED COPY OF RATING.

THE RATING OF FEBRUARY 26, 1923, MENTIONED IN THE ADMINISTRATIVE REPORT, HELD AS FOLLOWS:

NOT ENTITLED TO TREATMENT OR COMPENSATION.

DENTAL CONDITION.

SERVICE CONNECTION NOT SHOWN.

CLAIMANT HAS LOST TEETH IN MOLAR REGION OF MANDIBLE, DUE TO POST OPERATION FOR FRACTURE, WHICH IS PRESUMED TO HAVE OCCURRED IN NOV., 1921, ONE YEAR SUBSEQUENT TO DISCHARGE.

DENTAL TREATMENT AS A FORM OF MEDICAL OR HOSPITAL TREATMENT IS AUTHORIZED PRIMARILY THROUGH GOVERNMENTAL FACILITIES UNDER THE WAR RISK INSURANCE ACTS FOR PERSONS SHOWN TO BE "BENEFICIARIES" OF THE UNITED STATES VETERANS' BUREAU. BENEFICIARIES ARE THOSE IN RECEIPT OF DISABILITY COMPENSATION, 26 COMP. DEC., 485; ID., 699; 27 COMP. DEC., 774; 1 COMP. GEN., 230, OR VOCATIONAL TRAINING, DECISION OF OCTOBER 4, 1923, 3 COMP. GEN., 184. SEE SECTION 302 (6) OF THE WAR RISK ACT OF OCTOBER 6, 1917, AS AMENDED BY ACTS OF DECEMBER 24, 1919, AND MARCH 4, 1923, 42 STAT., 1542, AND ANNUAL APPROPRIATION ACTS PROVIDING FOR "MEDICAL AND HOSPITAL SERVICES," THE LATEST BEING ACT OF FEBRUARY 13, 1923, 42 STAT., 1243. ADDITION TO SUCH CLASSES OF BENEFICIARIES THERE WAS TEMPORARILY ANOTHER CLASS PROVIDED FOR BY SECTION 13 OF THE ACT OF AUGUST 9, 1921, 42 STAT., 152, AS FOLLOWS:

SEC. 13. IN ADDITION TO THE CARE, TREATMENT, AND APPLIANCES NOW AUTHORIZED BY LAW, SAID BUREAU ALSO SHALL PROVIDE WITHOUT CHARGE THEREFORE HOSPITAL, DENTAL, MEDICAL, SURGICAL, AND CONVALESCENT CARE AND TREATMENT AND PROSTHETIC APPLIANCES FOR ANY MEMBER OF THE MILITARY OR NAVAL FORCES OF THE UNITED STATES SEPARATED THEREFROM UNDER HONORABLE CONDITIONS DISABLED BY REASON OF ANY WOUND OR INJURY RECEIVED OR DISEASE CONTRACTED, OR BY REASON OF ANY AGGRAVATION OF A PREEXISTING INJURY OR DISEASE, SPECIFICALLY NOTED AT EXAMINATION FOR ENTRANCE INTO OR EMPLOYMENT IN THE ACTIVE MILITARY OR NAVAL SERVICE WHILE IN THE ACTIVE MILITARY OR NAVAL SERVICE OF THE UNITED STATES ON OR AFTER APRIL 6, 1917: PROVIDED, THAT THE WOUND OR INJURY RECEIVED OR DISEASE CONTRACTED, OR AGGRAVATION OF A PREEXISTING INJURY OR DISEASE, FOR WHICH SUCH HOSPITAL, DENTAL, MEDICAL, SURGICAL, AND CONVALESCENT CARE AND TREATMENT AND PROSTHETIC APPLIANCES SHALL BE FURNISHED, WAS INCURRED IN LINE OF DUTY AND NOT CAUSED BY HIS OWN WILLFUL MISCONDUCT: PROVIDED FURTHER, THAT APPLICATION FOR SUCH CARE AND TREATMENT AND APPLIANCES PROVIDED FOR IN THIS SECTION SHALL BE MADE WITHIN ONE YEAR FROM DATE OF SEPARATION FROM SERVICE OR FROM THE DATE THIS ACT GOES INTO EFFECT, WHICHEVER IS THE LATER.

IN CONSIDERING WHETHER AN APPLICANT FOR TREATMENT UNDER THIS STATUTE WAS ENTITLED THERETO IT WAS FOR PRIMARY CONSIDERATION WHETHER THE DISABILITY WAS OF SERVICE ORIGIN. THE ONLY POSSIBLE EXCEPTION INVOLVES CASES OF EMERGENCY TREATMENT WHICH WHEN APPLIED TO DENTAL WORK WOULD BE FOR THE PURPOSE OF RELIEVING PAIN.

UNDER THESE STATUTES THE TREATMENT IN THE PRESENT CASE WAS AUTHORIZED BEFORE THE STATUS OF THE APPLICANT FOR TREATMENT WAS DETERMINED ADMINISTRATIVELY WITH RESPECT TO HIS RIGHT TO RECEIVE THE TREATMENT AT GOVERNMENT EXPENSE. THE CIVILIAN DENTIST, HOWEVER, HAD NO KNOWLEDGE OF THE ADMINISTRATIVE IRREGULARITY AND WAS NOT IN A POSITION TO QUESTION THE AUTHORIZATION ISSUED TO HIM FOR THE TREATMENT OF THE PATIENT SENT BY THE PROPER OFFICERS OF THE BUREAU TO HIM. THE DENTIST, RELYING ON THE REGULARITY AND LEGALITY OF THE ORDER ISSUED TO HIM, IS ENTITLED TO PAYMENT FOR SERVICES RENDERED IN GOOD FAITH.

THE SERVICES RENDERED ARE APPARENTLY OF THE REASONABLE VALUE OF $110, THERE BEING NO EVIDENCE OTHERWISE, AND UPON REVIEW OF THE SETTLEMENT THERE IS CERTIFIED DUE CLAIMANT $110.