B-160798, APR. 3, 1967

B-160798, APR. 3, 1967

TO MR. MICHAEL E. MURPHY:

REFERENCE IS MADE TO YOUR LETTER DATED JANUARY 25, 1967, CLAIMING REIMBURSEMENT OF MEDICAL EXPENSES INCURRED ON ACCOUNT OF YOUR DEPENDENT CHILD SUBSEQUENT TO YOUR DISCHARGE FROM ACTIVE DUTY WITH THE UNITED STATES MARINE CORPS ON SEPTEMBER 30, 1966. YOUR LETTER WAS TRANSMITTED TO OUR OFFICE FOR CONSIDERATION AND ACTION BY THE HONORABLE KEN HECHLER, HOUSE OF REPRESENTATIVES.

IN YOUR LETTER YOU INDICATE THAT YOUR SON WAS BORN ON JULY 21, 1966, WHILE YOU WERE STATIONED AT ORDNANCE SCHOOL, MARINE CORPS STATION, QUANTICO, VIRGINIA. SHORTLY THEREAFTER, YOUR WIFE NOTICED A LUMP ON THE INFANT'S STOMACH, WHICH WAS EXAMINED BY A STATION DOCTOR AND CONSIDERED TO BE A MUSCLE SPASM. UPON A LATER EXAMINATION OF THE INFANT AT THE STATION HOSPITAL, ANOTHER DOCTOR ASSURED YOUR WIFE THAT YOUR CHILD WAS ALL RIGHT. YOU STATE FURTHER THAT SHORTLY AFTER YOUR RELEASE FROM ACTIVE DUTY ON SEPTEMBER 30, 1966, YOU TOOK YOUR SON FOR A CHECK-UP TO A LOCAL PRIVATE DOCTOR WHO DIAGNOSED THE LUMP AS A HERNIA AND THAT, UPON FURTHER EXAMINATION BY A SURGEON, SURGICAL REPAIR WAS RECOMMENDED. CERTIFICATION OF THE SURGEON INVOLVED, DATED OCTOBER 11, 1966, STATES THAT HE FOUND YOUR SON TO HAVE CONGENITAL INGUINAL HERNIA, THAT IN HIS OPINION IT HAD BEEN PRESENT SINCE BIRTH, AND THAT HE ADVISED SURGICAL REPAIR. YOU THEREFORE CLAIM REIMBURSEMENT FOR THE MEDICAL EXPENSES INCURRED AS EVIDENCED BY HOSPITAL AND DOCTOR'S BILLS TOTALING $290.58, ON THE BASIS THAT THIS MEDICAL SERVICE SHOULD HAVE BEEN RENDERED TO YOUR CHILD AT THE TIME YOU WERE STATIONED AT QUANTICO, VIRGINIA.

SECTION 1076 OF CHAPTER 55, TITLE 10, U.S.C. PROVIDES IN PERTINENT PART THAT A DEPENDENT OF A MEMBER OF A UNIFORMED SERVICE WHO IS ON ACTIVE DUTY FOR A PERIOD OF MORE THAN 30 DAYS, IS ENTITLED, UPON REQUEST, TO THE MEDICAL AND DENTAL CARE PRESCRIBED BY SECTION 1077 OF THAT TITLE, IN FACILITIES OF THE UNIFORMED SERVICES, SUBJECT TO AVAILABILITY OF SPACE AND FACILITIES AND THE CAPABILITIES OF THE MEDICAL AND DENTAL STAFF. TREATMENT FOR CHRONIC DISEASES OR ELECTIVE MEDICAL AND SURGICAL TREATMENT WERE NOT AUTHORIZED UNDER SECTION 1077, HOWEVER, AUTHORITY IN THAT RESPECT BEING LIMITED TO TREATMENT OF "ACUTE MEDICAL AND SURGICAL CONDITIONS.' SIMILAR LIMITATION IS STATED IN PARAGRAPH 15 OF JOINT REGULATIONS PROMULGATED BY THE VARIOUS SERVICES CONCERNED, PURSUANT TO CHAPTER 55 OF TITLE 10, U.S.C. ENTITLED "DEPENDENTS' MEDICAL CARE," DATED JULY 13, 1964 (DESIGNATED FOR THE DEPARTMENTS OF THE NAVY AND MARINE CORPS AS SECRETARY OF THE NAVY INSTRUCTIONS 6320.8B). PARAGRAPH 6 (A) (1) OF THE REGULATIONS FURTHER PROVIDES THAT THE ELIGIBILITY OF DEPENDENTS FOR CARE IN BOTH CIVILIAN FACILITIES AND UNIFORMED SERVICE FACILITIES ARE TERMINATED WHEN A MEMBER'S PERIOD OF ACTIVE DUTY ENDS (FOR ANY REASON OTHER THAN RETIREMENT).

IN A REPORT FROM THE BUREAU OF MEDICINE AND SURGERY, DEPARTMENT OF THE NAVY, DATED MARCH 21, 1967, WITH REGARD TO YOUR CLAIM, IT WAS STATED THAT BOTH THE INPATIENT AND OUTPATIENT RECORDS PERTAINING TO YOUR MINOR CHILD, OBTAINED FROM THE NAVAL HOSPITAL, QUANTICO, VIRGINIA, WERE THOROUGHLY REVIEWED BY THAT BUREAU AND WERE FOUND TO CONTAIN NO ENTRY PERTAINING TO THE CONDITION DESCRIBED IN YOUR CLAIM. THE ABSENCE OF ANY NOTATION IN THE RECORDS, IT WAS SUGGESTED, APPEARS TO CONFIRM THAT THE INFANT'S CONDITION WAS NOT WORTHY OF NOTE AT THE TIME HE WAS EXAMINED BY THE ATTENDING PHYSICIAN DURING THE PERIOD YOU WERE ON ACTIVE DUTY. IT WAS STATED FURTHER IN THE REPORT THAT SINCE THE CARE PROVIDED YOUR SON BY CIVILIAN PHYSICIANS WAS SUBSEQUENT TO YOUR SEPARATION FROM ACTIVE SERVICE, PAYMENT OF THE CIVILIAN MEDICAL EXPENSE CANNOT BE AUTHORIZED BY THE NAVY.

THE ADMINISTRATIVE REPORT INDICATES THAT THE NAVAL MEDICAL AUTHORITIES DID NOT REGARD YOUR SON'S CONDITION AS AN ACUTE MEDICAL AND SURGICAL CONDITION WITHIN THE CONTEMPLATION OF 10 U.S.C. 1077. THIS CONCLUSION IF IN ERROR, HOWEVER, AFFORDS NO LEGAL BASIS FOR PAYMENT OF YOUR CLAIM.

UNDER PRESENT LAW AND REGULATIONS, THEREFORE, NO AUTHORITY EXISTS FOR THE PAYMENT OF YOUR CLAIM AND IT MUST BE DISALLOWED.