Who Brought the Wolfe Lawsuit and Why the Lawsuit Was Filed
In 2018, two veterans who filed VA claims for reimbursement of their emergency medical expenses – Amanda Wolfe and Peter Boerschinger – filed a class action lawsuit against the Department of Veterans Affairs (the VA). The lawsuit was filed in the U.S. Court of Appeals for Veterans Claims (the Court) and is known as Wolfe v. Wilkie. The two veterans were represented in the Wolfe lawsuit by the National Veterans Legal Services Program (NVLSP) and Sidley Austin LLP at no cost to the veterans. NVLSP is a nonprofit veterans service organization founded in 1981 that has forced the VA over the last decade to pay billions of dollars in VA disability and health care benefits to more than 100,000 veterans and their survivors. Sidley Austin LLP is a private law firm with many lawyers who spend part of their time representing veterans for free].
The two veterans who filed the Wolfe lawsuit had been receiving their health care at the VA, but then experienced a medical emergency that required them to go to a non-VA hospital for treatment. They incurred thousands of dollars in emergency medical expenses at the non-VA facility. They both had private health care insurance (like Medicare or employee-based health care) that paid part but not all of their emergency medical expenses. They applied to the VA for reimbursement of the part of the emergency medical expenses that was not covered by their private health care insurance. The VA denied these reimbursement claims for the same reason – the VA said that they could not reimburse veterans for the copayments, deductibles, and coinsurance payments they owed under their private health care insurance policy.
NVLSP believed that although VA could legally deny reimbursement for copayments, it was against the law for VA to refuse to reimburse veterans for deductibles, and coinsurance payments they owed under their private health care insurance policy. NVLSP also knew that the VA had denied reimbursement to many other veterans for their deductibles and coinsurance. So, in an effort to force the VA to reimburse all of these veterans for their deductible and coinsurance payments, NVLSP filed a class action lawsuit with Amanda Wolfe as the lead representative of the class.