BVA9504413 DOCKET NO. 93-04 999 ) DATE ) ) On appeal from a decision by the Department of Veterans Affairs Medical Center in Milwaukee, Wisconsin THE ISSUE Entitlement to payment of costs associated with the installation of a stair glide system in the veteran's home. REPRESENTATION Appellant represented by: Wisconsin Department of Veterans Affairs ATTORNEY FOR THE BOARD Keith W. Allen, Associate Counsel INTRODUCTION The veteran had several periods of active duty for training in the United States Coast Guard from June 1975 to September 1978. This matter comes to the Board of Veterans' Appeals (Board) from an October 1992 decision by the Department of Veterans Affairs (VA) Medical Center (VAMC) in Milwaukee, Wisconsin, which denied the veteran's claim for payment of costs associated with the installation of a stair glide system in his home. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that VA should be financially responsible for the costs associated with the installation of a stair glide system in his home. He says he needs this system to have access to his basement, so that he can check his furnace and breaker boxes, use exercise equipment (weights), and in case of inclement weather (tornadoes, etc.). He points out that statements from his treating physician, as well as from a VA social worker who visited his home to review his case, lend support to his claim. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991), has reviewed and considered all of the evidence and material of record in the veteran's claims file. Based on its review of the relevant evidence in this matter, and for the following reasons and bases, it is the decision of the Board that it lacks jurisdiction over the subject matter of the claim; therefore, as a matter of law, the case must be dismissed. FINDING OF FACT In an October 1992 decision, the Acting Chief of the Prosthetic and Sensory Aids Service at a VAMC determined that the veteran does not need a stair glide system in his home. CONCLUSION OF LAW The current appeal does not involve a question within the appellate jurisdiction of the Board. 38 C.F.R. § 20.101(b) (1994). REASONS AND BASES FOR FINDING AND CONCLUSION I. Factual Background The veteran is service connected, and rated 100 percent disabled, for the debilitating effects of multiple sclerosis. He does not have use of either lower extremity, and he has significant impairment in both upper extremities and in his speech. He is also entitled to special monthly compensation on account of these disabling residuals. He has been awarded specially adapted housing in the past (May 1983), when he lived at his previous residence, on account of loss of use of his lower extremities. During the course of his appeal, the veteran submitted written statements listing reasons why he believes a stair glide system in his home is medically necessary. He said he would need to get into his basement to lift weights and check utilities, such as furnace and breaker boxes, and to get to a safe area in case of inclement weather, such as tornadoes. He pointed out that he lives with his parents and that both of them are up in age (he says his father is also disabled and service connected). The veteran's treating physician, James E. Burwitz, M.D., reported in April and June 1992 statements that the veteran has not been able to work since 1978, due to his multiple sclerosis, and that he is wheelchair bound. He listed reasons why he believed the veteran needed access to his basement (which are identical to those identified by the veteran). He believed the most important reason for the veteran having a stair glide system in his home was in case of severe weather, such as tornados, because the basement area is generally regarded as the safest place to be. In September 1992, a VA social worker visited the veteran's home to survey the premises and make a determination as to whether a stair glide system was a necessary part of the veteran's outpatient care. In his report, he initially indicated that he believed that the veteran's request was a legitimate one, considering issues of safety and general quality of life, and that the veteran's mother (as his caretaker) would also benefit if this device were to be installed. However, after seeing the amount of weight lifting equipment that would be used by the veteran, the social worker changed his mind (see November 1992 Report of Contact). He determined that there was ample room for the weights on the main floor of the house. In October 1992, after reviewing the medical statements from the veteran's treating physician, the report from the VA social worker, and other relevant evidence on file, the Acting Chief of Prosthetic and Sensory Aids Service at the VAMC determined that the veteran does not need a stair glide system in his home. II. Legal Analysis The Board's appellate jurisdiction extends to questions of eligibility for hospitalization, outpatient treatment, and nursing home and domiciliary care; for devices such as prostheses, canes, wheelchairs, back braces, orthopedic shoes, and similar appliances; and for other benefits administered by the Veterans Health Administration. Medical determinations, such as determinations of the need for and appropriateness of specific types of medical care and treatment for an individual, are not adjudicative matters and are beyond the Board's jurisdiction. 38 C.F.R. § 20.101(b) (1994). According to the above-cited regulation, questions involving medical matters, such as determinations concerning the need for, or appropriateness of, appliances (e.g., a stair glide system) in the home are beyond the purview of the Board's jurisdiction; these matters are instead left to the discretion of the appropriate officials at the VAMC (in this case, the Acting Chief of Prosthetic and Sensory Aids Service). She determined in October 1992 that the veteran was not in need of a stair glide system for his home. Therefore, as a matter of law, his appeal for this benefit must be dismissed. As a final note, it should be pointed out that personnel at the VAMC considered the veteran's eligibility for a stair glide system in his home under other categories. For example, officials at the VAMC considered whether the veteran was eligible under 38 U.S.C.A. § 1717(a)(2) (West 1991) (concerning home improvements and structural alterations--HISA), but he had already used his HISA entitlement; officials at the VAMC also considered granting the benefit sought under 38 U.S.C.A. § 2101 (specially adapted housing), but the veteran had already exhausted this category of eligibility while living in his previous residence. ORDER The present appeal is dismissed for lack of jurisdiction over the subject matter. J. E. DAY Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West 1991), a decision of the Board of Veterans' Appeals granting less than the complete benefit, or benefits, sought on appeal is appealable to the United States Court of Veterans Appeals within 120 days from the date of mailing of notice of the decision, provided that a Notice of Disagreement concerning an issue which was before the Board was filed with the agency of original jurisdiction on or after November 18, 1988. Veterans' Judicial Review Act, Pub. L. No. 100-687, § 402 (1988). The date which appears on the face of this decision constitutes the date of mailing and the copy of this decision which you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals.