What Did the Court Decide in the Wolfe Case and How Does it Affect Me?

On September 9, 2019, the Court ruled that the Emergency Care Fairness Act of 2010 prohibits the VA from denying reimbursement for deductibles and coinsurance that veterans owed under their health insurance policy for emergency medical expenses incurred at a non-VA facility.   This means that if the VA denied some or all of your claim because they were deductibles or co-insurance under your insurance policy, the VA must re-decide your reimbursement claim.

The Court also ordered the VA to identify all veterans who meet the definition of the class in the Wolfe case and notify each of them about the Court’s decision and that VA will re-decide their reimbursement claim.  As a result, the VA has now identified nearly 72,000 veterans who meet the definition of the class in the Wolfe case and gave NVLSP a list of these veterans.  The VA will begin mailing notices to each of these veterans starting on May 11 and ending on August 3, 2020.  The notice tells the veteran that he or she is a member of the class in the Wolfe case, that the VA will re-decide the veteran’s claim and issue a new decision, and that there is no action the veteran needs to take.  This means that if you have already received this notice, you are a member of the class.  This also means that some of the veterans who are members of the class will not receive this VA notice until August 2020.

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