September 28, 1979 MP-1, Part II

Chapter 3

CHAPTER 3. BENEFICIARY TRAVEL MANAGEMENT

1.  GENERAL

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a.  Purpose. To prescribe policies and procedures for travel at
    Government expense of authorized VA beneficiaries and their
    attendants.

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b.  Legal Basis. The authority for payment of travel and transportation
    expenses incident to travel of claimants and beneficiaries and their
    nonemployee attendants is 38 U.S.C. 111, Executive Order 11302, as
    amended by Executive Orders 11429 and 11609, sec. 7(b) (app. A), and
    VA Regulations 6100, 6101, 6102, 10000 series and 14104.

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c.  Staff Responsibility. The \[Director, Management Services\] is
    responsible for:

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1.  Formulating and continually evaluating agencywide plans, policies
    and procedures pertaining to beneficiary travel management.

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2.  Maintaining liaison with the Office of Management and Budget \[, the
    General Accounting Office, the General Services Administration, the
    Department of Transportation , and various organizations of
    veterans\] on all beneficiary travel management matters.

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d.  Safeguarding Travel Documents Furnished Beneficiaries

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1.  When a beneficiary is admitted for a period of hospitalization,
    domiliciary care, etc., and has in his \[or her\] possession
    portions of tickets which may be used for return travel upon
    discharge, they will be held in suspense pending \[ \] release.

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2.  A suspense date will be established to provide that if a beneficiary
    remains at a station longer than the valid period during which the
    tickets can be used, the tickets will be sent to the Fiscal activity
    in time for them to be redeemed.

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3.  Unused portions of tickets which will not be used or needed for the
    return trip of a beneficiary, or those to be redeemed, will be
    forwarded to the Fiscal activity for recovery of their value.

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e.  Meals for Volunteers at Outpatient Clinics

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1.  In Decision B-145430, dated May 9, 1961, the Comptroller General
    agreed that VA may provide meals to volunteers at outpatient clinics
    when their scheduled assignment extends over an established meal
    period. This applies where no VA facilities are available to furnish
    meals without charge.

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2.  VA Form \[60\]-3266 .Request for Meal or Lodging, will be used to
    obtain such meals. The meal rates to be authorized will be those
    established for beneficiaries (see par. 4d).

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f.  Travel From Unauthorized Points

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1.  A travel authorization may be amended to permit return travel to a
    point other than the one from which the \[beneficiary\] proceeded,
    if there is no additional cost to the VA. Return travel
    authorizations of hospitalized patients may also be amended even if
    the travel cost exceeds that of the incoming trip when consistent
    with VA Regulation 6100(F).

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2.  When through administrative error the original travel authorization
    provided for travel at Government expense from one point but it was
    subsequently found that such travel should have been authorized from
    a different point where the \[beneficiary\] was actually located,
    and from which point travel at Government expense could have been
    properly authorized, the travel authorization may be amended to
    cover the furnishing of the transportation intended originally (61
    Sol. 130). The reimbursement voucher will be supported by a
    statement of circumstances resulting in the issuance of the
    erroneous authorization. This does not apply where a beneficiary
    failed to advise the VA of a change of address.

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3.  When through administrative error the original travel authorization
    did not provide for travel at Government expense but it was found
    that such travel should have been authorized, the travel
    authorization will be amended to cover the furnishing of the
    transportation intended originally. The reimbursement voucher will
    be supported by a statement of circumstances resulting in the
    issuance of the erroneous authorization.

September 28, 1979 MP-1, Part II

Chapter 3

g.  Travel of Beneficiaries Who are Nonresidents of the Area in Which
    the VA Health Care Facility Is Located. Nonresidents (visitors to
    city, truckdrivers, salespeople\], etc.) of an area in which a
    \[health care facility\] is located who are admitted to a VA health
    care facility\] in an emergency and subsequently discharged will not
    be allowed expenses of travel to a point at random in the United
    States. Travel at VA expense allowed in such instances is that from
    the \[health care facility\] to the place from which the beneficiary
    traveled to the \[health care facility\] for admission.

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h.  Prescribed Forms and Form Letters for Authorizing and Controlling
    Beneficiary Travel. These are listed in appendix B.

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i.  Travel by Charter and Contract Services. Where a group of persons
    will travel at the same time and on the same itinerary,
    consideration will be given to the use of charter or contract
    services by use of SF 1169.

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1.  Where charter services are ordered from a carrier, its terms will be
    stated in writing. The statement will be prepared in duplicate and
    signed by the VA Official designated to authorize travel (app. C)
    and the carrier's representative. The original will be given to the
    carrier and the duplicate to the Fiscal activity concerned.

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2.  Where contract services are ordered from a carrier, its terms will
    be stated in writing. The agreement will be prepared in duplicate,
    assigned a VA contract number, and signed by the VA official
    designated to authorize travel and the carrier's representative. The
    original and copy will be forwarded to the concerned Fiscal
    activity. The governing contract number and date will be shown in
    the "Fiscal Data" block of SF 1169.

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3.  No charter or contract services for air transportation will be made
    with a supplemental or unscheduled carrier unless prior information
    has been obtained from the Federal Aviation \[Administration\],
    Washington, D.C., or their Regional or General Aviation District
    Office in the field, that the carrier is complying with their safety
    standards. Requests for such information will identify the carriers,
    show the services desired, and will be submitted as follows:

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a.  Requests involving carriers (air taxi operators) operating airplanes
    whose gross weight is under 12,500 pounds will be cleared with the
    nearest Federal Aviation \[Administration's\] Regional or General
    Aviation District Office.

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b.  Requests involving carriers operating airplanes whose gross weight
    exceeds 12,500 pounds will be submitted to VA Central Office through
    departmental channels. The Office of Management \[Services (64)\]
    will coordinate such requests with the Federal Aviation
    \[Administration\] and advise the department concerned of their
    decision.

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j.  Delegation of Authority To Sign Transportation, Meal and Lodging
    Requests

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1.  Field station heads, Chief Medical Administration Officers,
    \[Director\], VA Prosthetics Center; Chiefs, Medical Administration
    Services, or their designees are authorized to countersign
    transportation, meal and lodging requests. This authority will not
    be delegated to the Fiscal activity nor to persons not employed by
    the VA.

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2.  Field station heads may also designate persons to sign SF 1169, U.S.
    Government Transportation Requests, for travelers when they
    determine it is in the interest of more economical and efficient
    procurement of passenger transportation. \[ \]

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2.  AUTHORIZATION AND APPROVAL OF TRAVEL

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a.  Authorizing and Approving Officials

The officials delegated authority to authorize or approve travel and
transportation at Government expense of applicants, claimants,
beneficiaries and attendants are listed in appendix C.

b.  Travel Authorizations

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1.  VA Form \[60\]-3542c, Notice to Report

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a.  It will be used to authorize travel of beneficiaries at Government
    expense to and from VA \[health care facilities\] for examination or
    treatment

September 28, 1979 MP-1, Part II

Chapter 3

or for \[health care facility\] admission.

b.  Cash reimbursement for travel under above authority will be in
    accordance with paragraph 8, except that VA Form \[60\]-3542d,
    Voucher for Cash Reimbursement of Mileage Allowance, will be used.

© For detailed procedures on authorization and reimbursement for such
travel, see DM&S Manual M-1, part I, chapter 25.

2.  VA Form 10-1174, VA Outpatient Medical Treatment Information Card

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a.  Travel to obtain a medical services may be authorized at Government
    expense when beneficiaries are issued VA Form 10-1174.

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b.  Reimbursement for travel under the above authority will be in
    accordance with paragraph 8, except that the beneficiary will make a
    one-time claim, and VA Form 10-7088, Fee Medical Services Card, will
    be used for processing.

© For detailed procedures on authorization and reimbursement for such
travel, see DM&S Manual M-1, part I, chapter 18.

3.  VA Forms \[60\]-3542, \[60\]-3542-1, and \[60\]-3542b, Authorization
    to Report-Voucher for Mileage Allowance. These forms will be used to
    authorize travel of beneficiaries at Government expense in those
    instances not provided for in subparagraphs (1) and (2) above and in
    paragraph 3, subparagraphs e and h.

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c.  Facsimile Signatures. In lieu of \[a\] personally signed signature
    of the authorizing official, a facsimile signature may be used in
    authorizing beneficiary travel.

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d.  Records of Travel Authorizations. Local management will establish
    the necessary controls to meet station needs.

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e.  Advance Authorization Required. Travel of beneficiaries and their
    nonemployee attendants will be authorized in advance except as
    provided in subparagraph f below. Oral authorization issued for
    emergent conditions will subsequently be confirmed in writing.

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f.  Travel Without Prior Authorization. Field station heads and their
    designees may approve payment for beneficiary travel performed
    without prior authorization in those cases meeting the criteria
    established in VA Regulation 6101(A). In other cases, the department
    head concerned may, upon recommendation of the field station head,
    approve payment for such travel upon a finding that failure to
    secure prior authorization was justified.

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3.  TYPES OF TRAVEL

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a.  Mileage Basis. \[See par. 8b.\]

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b.  Local

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1.  Field station heads will administratively determine what area
    constitutes 'local travel." This determination will govern as to
    when local transportation tickets or tokens will be furnished to
    beneficiaries who are authorized to travel to Government expense.

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2.  If available, local transportation tokens and tickets will be
    procured and maintained by designated personnel for use of
    authorized beneficiaries. Requests for quantities of tokens or
    tickets for such use will be made on VA Form \[60\]-3079, Request
    for Tokens or Tickets to the official who is authorized to issue
    tokens and tickets.

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3.  The Travel activity will:

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a.  Furnish the required number of local transportation tokens or
    tickets, including necessary coins for zone fares, to beneficiaries
    for all authorized local travel.

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b.  Not furnished tokens or tickets to beneficiaries proceeding at their
    own expense subject to reimbursement on a mileage or actual expense
    basis.

(c ) When beneficiaries report, recover my unused tokens or tickets (not
required for the return trip) and enter the number recovered on the
travel authorization and on VA Form \[60\]-4350, Accountability Record
for Tokens or Tickets.

d.  When beneficiaries fail to report, take no action to recover tokens
    or tickets issued.

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4.  When no tokens or tickets are available and beneficiaries pay cash
    for their local travel, they may be reimbursed in cash for the cost
    of their round trip local fares before they leave the station. This
    also applies where a field station head determines it is more
    economical to pay cash for authorized local travel than to issue
    tokens and tickets.

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5.  Beneficiaries may be allowed to use their own tokens or tickets for
    authorized local travel and be furnished the required number of
    replacement tokens or tickets or be paid in cash for the trips
    before they leave the station.

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6.  Seriously handicapped beneficiaries may be authorized exclusively
    local travel on a mileage or actual expense basis when travel by
    local public carrier is medically inadvisable or dangerous.

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7.  When token or tickets are furnished beneficiaries with their
    authorization to report, the date and quantity issued to each
    beneficiary will be recordered on VA Form \[60\]-4530.

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c.  Bus, Train, or Boat. When a beneficiary indicates he \[or she\]
    wants to travel by bus, train, or boat and furnishes the name of the
    carrier (or carrier is known), SF 1169, \[U.S. Government\]
    transportation Request, will be used to obtain the necessary
    transportation **except as provided in paragraph 4c(5)(d). (See II
    00-81-30)**

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d.  Airplanes

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1.  Beneficiary travel by airplane may be authorized or approved when:

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a.  Other means of transportation are not available.

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b.  Travel by other means would result in hardship to \[the
    beneficiary\] due to change in his \[or her\] condition.

(c ) Delay in reporting for examination , treatment, or hospitalization
would cause serious complications.

d.  It is more economical than other means of trasportation.

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2.  Where travel by airplane was not authorized or approved but
    beneficiary traveled by airplane, reimbursement may be allowed.
    However, the amount of reimbursement cannot exceed the overall cost
    (including any necessary meals and lodging) which would have been
    incurred had the travel been performed by the authorized means.

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3.  In the authorization and use of airplanes by beneficiaries, the
    provisions of \[MP-1, Pt. II,\] chapter 2, paragraphs 8c(2) and 8e
    apply.

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e.  Hired Car

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1.  General. The basis for authorizing use of a hired car (includes
    taxicabs,) is the need of the beneficiary for such conveyance
    because of his \[or her\] physical or mental condition,
    unavailability of other transportation, or necessity for expeditious
    transportation. Unless properly authorized, owners of vehicles may
    not classify them as hired cars merely to secure greater
    reimbursement than they would otherwise be eligible to receive. A
    car may not be hired from a relative of the beneficiary or a
    Government employee. A relative is a spouse, parent, son, daughter,
    brother, sister, uncle, aunt, niece, or nephew by blood or marriage.
    A car may be hired from any other party, whether a sheriff, service
    officer or private individual.

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2.  Authorizing and Approving Officials. See appendix C.

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3.  Authorization and Reimbursement Form. VA Form 10-2511, \[Authority\]
    and Invoice for Travel by Ambulance or Other Hired Vehicle, will be
    used for authorizing travel by hired car and for reimbursement of
    hired car service. When the quantity of hired car services to be
    purchased during a monthly period from any one vender (whether
    contract or noncontract) is sufficient to warrant use of a blanket
    purchase agreement, and the vendor so agrees, the procedures
    described in paragraph 3h(7) may be used.

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4.  Advance Authorization

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a.  When an authorizing official approves travel by hired car, \[the
    official\] will instruct the Travel activity to prepare VA Form
    10-2511.

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b.  When use of hired cars is authorized in advance, there is no
    established maximum reimbursement rate. However, payment is
    contingent upon these factors:

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1.  Travel must be performed by a usually traveled route.

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2.  Hired car cannot be the property of a relative or Government
    employee.

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3.  Vendor must state on \[the\] bill that when travel was performed,
    the rate charged did not exceed the prevailing rate in the
    community.

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5.  No Advance Authorization

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a.  Used for Beneficiary's Convenience. When prior authorization for
    travel was issued and a hired car was not authorized but used for
    the beneficiary's convenience, a reasonable fee (commensurate with
    the usual fee prevailing the community) may be allowed if conditions
    in subparagraph (4)(b) [1]{.underline} through [3]{.underline} above
    are met. However, the maximum amount that may be allowed cannot
    exceed the cost of the authorized travel (plus any necessary meals
    and lodgings) by common carrier.

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b.  Change in Patient's Condition. Where prior authorization for travel
    was issued before departure of the beneficiary but, because of an
    emergency arising either before compliance with the authorization or
    during travel, a hired car is used, payment may be made in
    accordance with subparagraph (4)(b) above. The original travel
    authorization or certified copy thereof must contain a statement
    signed by an authorizing official that use of a hired car was
    necessary and is approved.

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6.  Emergency Authorization. When due to an emergency, authorization for
    use of a hired car is given by telephone, the authorizing official
    will prepare VA Form 10-2829, Telephonic Authorization, or VA Form
    119, Report of Contact, and send it to the Travel Activity. It will
    prepare a \[confirming\] VA Form 10-2511, and complete the statement
    in item 7 reading: "Confirms Prior Authorization, (if applicable),
    dated \_\_\_\_\_\_\_\_\_\_\_."

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7.  Use of Driver as Attendant. Where necessary, the driver of a hired
    car may be authorized to serve as an attendant to a beneficiary
    requiring such service. Then the usual attendant fees and expenses
    are allowable. A chauffeur may not be paid an attendant's fee and
    mileage allowance in lieu of actual expenses of travel unless \[so\]
    authorized to serve as an attendant. Attendant fees are not payable
    to a relative of the beneficiary escorted.

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8.  Payment for Hired Car Service. See paragraph 9c.

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f.  Taxicabs

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1.  In addition to use of a hired car (par. 3e(1)), taxicabs may also be
    used when necessary to provide transportation between (a) a
    beneficiary's home and the closest common carrier terminal; (b) an
    isolated point and a place where common carrier facilities are
    available; (c ) a common carrier terminal and a final destination;
    and (d) common carrier terminals during journey and if local
    transportation facilities, i.e., bus, streetcar, subway, etc., are
    not available or if travel is not on a mileage basis.

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2.  Reimbursement for travel by taxicab may not exceed the prevailing
    rate in the community for such service, plus tip. The amount of the
    tip allowed is 15 cents for fares of \$1 or less or 15 percent of
    the fare (increased to the next multiple of 5 cents) when it exceeds
    \$1.

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3.  When the quantity of taxicab services to be purchased during a
    monthly period from any one vendor (whether contract or noncontract)
    is sufficient to warrant use of a blanket purchase agreement, and
    the vendor so agrees, the procedures described in paragraph 3h(7)
    may be used.

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g.  Actual Expense Basis. When a beneficiary has indicated preference
    for travel on an actual expense basis or claims such reimbursement
    for his \[or her\] travel such travel or reimbursement may be
    authorized. Reimbursement of expenses of such travel will be as
    provided in paragraph 8\[c\].

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h.  Ambulance

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1.  General. The use of ambulance service must be authorized or approved
    by an official named in appendix C. Travel by ambulance at
    Government expense will be authorized on VA Form 10-2511,
    Authority\] and Invoice for Travel by Ambulance or Other Hired
    Vehicle. VA Form 10-2511 will be issued when an authorizing official
    determines that use of ambulance service is necessary because of the
    beneficiary's condition. Authorizing officials will liberally
    interpret the medical indications for ambulance transportation. Only
    where there was a misrepresentation of facts by the attending
    physician, the beneficiary, or his \[or her\] representative, will
    there be a reversal of the authority granted.

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a.  If unconditional authorization for ambulance transportation is given
    to an ambulance company and service is rendered in good faith,
    reimbursement for such service should be made even though the
    beneficiary is or is not admitted to the \[health care facility\],
    unless there is evidence of misrepresentation of facts. If after
    reimbursement has been made, developments indicate there has been
    misrepresentation of facts either on the part of the beneficiary,
    \[the\] physician or representative, then the beneficiary will be
    billed for either the amount paid to the ambulance company or the
    difference between the amount paid to the ambulance company and the
    amount properly payable, if any, based on travel performed on a
    mileage or actual expense basis.

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b.  A conditional authorization for ambulance transportation should be
    issued only when there is reasonable doubt that an application is a
    \[beneficiary\].

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2.  Authorizing and Approving Officials. See Appendix C.

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3.  Maximum Allowable Ambulance Service Fees. Field station heads;
    Chief, Medical Administration Services; and Chief Medical
    Administration Officers, will establish the maximum allowable fees
    for ambulance service. Such fees may not exceed those charged the
    general public in the community for the same service. Where
    ambulance service is obtained from ambulance companies at lesser
    fees (by contract or otherwise), such lesser fees will apply.

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4.  Use of \[Health Care Facility\] Ambulances. Field station heads will
    restrict the use of \[health care facility\] ambulances (VA owned or
    GSA rental) to their established local zone. Essentially, \[health
    care facility\] ambulances are for use in transporting beneficiaries
    (from neighboring communities) requiring emergency treatment or
    admission. Commercial other than \[health care facility\] ambulances
    should be used for distances beyond the local zone. On
    \[interfacility\] transfers of beneficiaries, common carrier
    transportation should be used when available and when determined
    medically and economically feasible.

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5.  Authorization for Travel by Ambulance

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a.  Advance Authorization. The use of ambulance service for the
    transportation of beneficiaries must be used in advance, except as
    provided in VA Regulation 6101.

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b.  Telephone Authorization. When authorization for use of ambulance
    service is given by telephone, the authorizing official will record
    the information on VA Form 10-2829, Telephonic Authorization, or VA
    Form 119, Report of Contact. The form will contain all pertinent
    information required in authorizing emergency \[health care
    facility\] admission by telephone and will clearly indicate whether
    transportation by ambulance is or is not authorized. The authorizing
    official will forward the completed VA Form 10-2829 or 119 to the
    Travel activity which will, if ambulance service is indicated,
    prepare a \[confirming\] VA Form 10-2511.

(c ) Emergency Authorization. When a \[beneficiary\] or his \[or her\]
representative requests emergency ambulance, the authorizing official
will obtain all necessary information on the case. After weighing the
facts, \[the official\] will determine if ambulance service is needed
and grant a definite authorization, if warranted.

\(d\) Authorization by Veterans Benefits Counselors at VA Offices.

1.  When a request for ambulance service is made to a veteran benefits
    counselor at a VA office, he \[or she\] will obtain all available
    information on the case. After weighing the facts, and ascertaining
    that a bed is available at the nearest suitable VA \[health care
    facility\], he \[or she\] will make \[a\] final decision on the need
    for ambulance service and grant a definite authorization (if
    warranted) provided the attending physician has indicated the
    \[beneficiary\] may be moved by ambulance. The veterans benefits
    counselor will immediately advise (by the most expeditious means)
    the receiving \[health care facility\], giving the official
    contacted, the \[beneficiary's\] name, identification number,
    address, diagnosis given by the attending physician, name and
    address of ambulance company, point and time of departure, and
    agreed mileage rate. \[A confirming\] VA Form 10-2511 will then be
    prepared and processed by the receiving \[health care facility\].

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2.  Where beds are allocated in other Government hospitals for treatment
    of \[beneficiaries\] or where circumstances indicate the need for
    hospital treatment in a contract or noncontract hospital, the
    veterans benefits counselor will develop the need for ambulance
    service. After ascertaining that a bed is available he \[or she\]
    will make necessary arrangements for ambulance transportation and so
    advise the authorizing official (or designee) of the VA station
    having jurisdiction. He \[or she\] will then direct the patient as
    instructed by the authorizing official (or designee) and provide the
    station of jurisdiction information needed for preparation and
    issuance of VA Form 10-2511.

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6.  Attendant Service During Ambulance Travel. Where an attendant is a
    member of an ambulance crew, do not include authorization for an
    attendant on VA Form 10-2511. Also, do not issue separate
    authorization for attendant service during ambulance travel unless
    directed by an authorizing official.

NOTE: *Standards for emergency ambulance services developed by the
Committee on Trauma, and approved by the American College of Surgeons'
Board of Regents, February 1967 provides: "At least two trained persons,
a driver and attendant, or two driver-attendants, should man each
ambulance dispatched." A similar condition is included in VA contracts
for ambulance services and is stated as follows: "The prices quoted
include the services of a qualified driver and an attendant on any
assignment where a patient is transported in the performance of this
contract."*

7.  Preparedness of VA Form 10-2511, Authority and Invoice for Travel by
    Ambulance or Other Hired Vehicle

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a.  VA Form 10-2511 will be prepared in sufficient copies to insure
    receipt of original by beneficiary (or ambulance company), plus
    other copies needed for fiscal and station needs. If there is no
    contract for ambulance service or the name of the ambulance company
    is not known, show \[the following\] in the "Rates Authorized"
    block: "Ambulance service charges may not exceed those customarily
    charged the general public in the community for the same service."

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b.  When the quantity of ambulance services to be purchased during a
    monthly period from any one vendor (whether contract or
    non-contract) is of sufficient volume to warrant use of a blanket
    purchase arrangement, and the vendor so agrees, a single VA Form
    10-2511, prepared in original and copies, as locally required, may
    be submitted to the vendor on the first workday of each month to
    authorize the estimated number of patient movements required during
    the month.

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1.  The "Remarks" block of VA Form 10-2511, will show the estimated
    number of patient movements during the period, and the expected
    total costs.

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2.  Appropriate local procedures will be developed for receiving
    delivery tickets or similar notifications from vendors about
    completed patients movements. A delivery ticket (or similar
    notification) will show the patient's name and identification
    number; trip origin and destination points; and flat fee and/or
    mileage charges. This will provide the daily information needed for
    budgetary control during the month and, on being attached to the
    vendor's invoice (VA Form 10-2511) submitted at the end of the
    month, serve as confirmation documents.

© A copy of each VA Form 10-2511 covering estimated purchases of
ambulance services under blanket purchase arrangements will be
transmitted to the Fiscal activity immediately after approval. The
Fiscal activity will review the information in the "Remarks" block of VA
Form 10-2511. The estimated monthly cost of ambulance services will be
recorded as an obligation on VA Form 4-1358 established and maintained
in accordance with MP-4, part V, paragraph, 3C.05a. Copies of delivery
tickets or similar notifications about concluded patient movements
received from vendors will be forwarded daily to the Fiscal Activity.
After posting, the copies will be maintained in a pending file, with the
related VA Form 10-2511, until the monthly invoice is received from the
vendor. On receipt of the invoice, the delivery ticket or similar
notifications accumulated will be used as references to determine that
the charges included in the invoice represent the services supplied
during the period.

8.  Reimbursement for Ambulance Service. See paragraph 9b.

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4.  TRANSPORTATION, MEAL AND LODGING REQUESTS

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a.  General. When a beneficiary indicates \[a desire for\] Government
    transportation, meal, and lodging requests or when administrative
    determination prescribes their use, the Travel activity will:

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1.  Normally schedule the travel by the most economical the travel by
    the most economical means and issue the necessary requests.

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2.  Enter the obligation number and decimal suffix assigned to the
    covering travel authorization on all transportation, meal, and
    lodging requests.

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3.  Enter the serial numbers of all request forms. Send the monetary
    value of tokens or tickets furnished for local transportation on
    travel authorization.

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b.  Safeguarding and Accounting

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3.  The original SF 1169 will be sent to the beneficiary and the
    duplicate (SF 1169a) to the Fiscal activity.

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4.  Transportation requests will be used to procure quantities of
    tickets for the transportation of travelers for use in any one
    60-day period of a fiscal year if: (a) there is a continuing
    substantial volume of individual travel via the same mode and class
    of transportation between one origin and one destination and (b)
    each one-way single fare for such transportation does not exceed
    \$50 with a corresponding maximum of \$100 for the round trip fare.
    Field stations will determine whether the volume of such travel
    warrants its utilization. Each transportation request (SF 1169)
    issued for the procurement of such tickets will be so identified by
    entering "BULK PURCHASE" in the "for use of" block of SF 1169, and
    tickets so procured will bear the words "GOVERNMENT" and "NOT
    REDEEMABLE FOR CASH EXCEPT BY THE U.S. GOVERNMENT". VA Form
    \[60\]-4530 will be used to maintain records of receipt and issuance
    of the tickets procured. The tickets will be kept in a locked
    receptable.

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5.  Transportation requests will not be used to:

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a.  Procure taxicab, airport limousine, intracity transit, or so-called
    drive yourself type or other forhire automobile service.

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b.  Pay for road or bridge toll charges.

© Obtain transportation for an escort transporting an employee's remains
by rail when the carrier's charge for transporting the body is the cost
of two first class fares since the cost of the third fare cannot be paid
by the Government.

d.  Request for Meal or Lodging, VA Form \[60\]-3266

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1.  \[The daily rate for three meals and a single night's lodging is
    \$35. This is a benchmark rate and does not represent either a
    minimum or a maximum rate payable. Field station heads are required
    to establish an appropriate rate based on the benchmark \$35 rate
    that will provide for adequate meals and satisfactory and
    respectable lodgings within their local service area. The \$35 rate
    may be used where the field station head determines that it is
    adequate and appropriate: *however, where the field station head
    finds it to be either excessive or inadequate for the local service
    area, he or she must establish an appropriate rate and notify the
    applicable department head of the rate determination.* A copy of the
    notification will be furnished to the Director, Management Services
    (64).\]

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2.  VA Form \[60\]-3266, will be prepared in duplicate.

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a.  On VA Form \[60\]-3266 drawn in favor of a named contractor, the
    value of the meal or lodging will be the contract price.

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b.  On VA Form \[60\]-3266 drawn in favor of "any eating place" or "any
    lodging house", the value of the meal or lodging will show "not to
    exceed \$\_\_\_\_\_" (enter amount as determined by field station
    head).

© On VA Form \[60\]-3266 drawn in favor of commercial aircraft, dinning
cars, or railroad station restaurants-, the value of the meal will be as
prescribed below:

+----------------------------+--------------+-----------+-------------+
|                            | Morning      | Noon      | Evening     |
|                            |              |           |             |
|                            | Meal         | Meal      | Meal        |
+----------------------------+--------------+-----------+-------------+
| Commercial aircraft, and   | > \$2.00     | > \$2.75  | \$3.00      |
| dining car on              |              |           |             |
|                            |              |           |             |
| train or steamer           |              |           |             |
+----------------------------+--------------+-----------+-------------+
| Railroad station           | > 2.00       | > 2.50    | 3.50        |
| restaurant                 |              |           |             |
+----------------------------+--------------+-----------+-------------+

3.  The signed original VA Form \[60\]-3266 will be sent to the
    beneficiary and the duplicate (VA Form \[60\]-3266a) to the Fiscal
    activity.

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e.  Issuance of Meal and Lodging Requests, VA Forms \[60\]-3266, to
    Beneficiaries Not in a Travel Status

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1.  A beneficiary held over for the convenience of the VA is not in a
    travel status. He \[or she\] may be furnished meals and lodging, for
    such holdover period, which are separate from those necessary for
    travel and have no relation to a claim for reimbursement. Meal and
    lodging requests may be furnished for the night and morning
    preceding the \[beneficiary's\] appointment if the necessity for the
    layover prior to appointment has been medically or administratively
    determined. Required meal and lodging requests will be forwarded to
    the beneficiary with the travel authorization. A beneficiary who was
    requested to report in the morning for an examination without
    breakfast may be furnished a meal or ticket in lieu of the breakfast
    he \[or she\] was required to forego.

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2.  Beneficiaries may be authorized to pay cash for above meals and
    lodgings and claim reimbursement therefor on their travel expense
    vouchers. Reimbursement would be for actual cost of meal or lodging
    but not in excess of established station rates (see subpar. d). No
    receipts are required.

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f.  Request for Reduced Rate Transportation, VA Form \[60\]-3068

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1.  Field station heads or personnel they designate are authorized to
    approve the issuance of VA Form \[60\]-3068 to beneficiaries and
    their nonemployee attendants who are:

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a.  Authorized to report to a VA \[health care facility\] for treatment
    or domiciliary care, or to a non-VA hospital for treatment at VA's
    expense.

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b.  Discharged from a VA \[health care facility\] or non-VA hospital.

© On "Authorized absence" from a VA \[health care facility\] or non-VA
hospital.

*NOTE: VA Form \[60}-3068 will not be issued to beneficiaries (and their
non-employee attendants) who are eligible to receive transportation at
VA expense.*

2.  VA Form \[60\]-3068 will be prepared in original only. No erasures
    or alterations are allowed. If an error is made in preparation of VA
    Form \[60\]-3068 it will be cancelled and a new one issued.

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3.  Reduced fare tickets will be sold only upon presentation on VA Form
    \[60\]-3068 to the ticket agent of the carrier on whose line the
    travel will begin.

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4.  Tickets sold at reduced fare are subject to such conditions are
    determined by the carriers in their instructions to their agents
    concerning time limitations, stopover, and baggage privileges, and
    the like.

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5.  Reduced rate requests will not be honored or round trip tickets.
    Therefore, two VA Forms \[60\]-3068 will be issued to patients going
    on "authorized absence", one for the outward trip and one for the
    return trip. Exception: Where unusual circumstances (e.g., different
    carriers or slight deviation from direct route) require more than
    two requests, any additional requests necessary may be issued.
    Requests are valid for 90 days from date of issue.

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6.  Reduced fare tickets are valid for use between all points in the
    United States on lines of all carriers which grant such concessions
    in fares, except they will be sold for:

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a.  Any trip terminating in the New England rates.

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b.  Travel between two stations in Pennsylvania.

© Any trip on AMTRAK passenger trains.

7.  Beneficiaries who are issued reduced rate requests will be furnished
    letters or cards of identification supporting the endorsement on the
    requests.

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8.  Reduced rate requests for patients in a non-VA hospital and their
    attendants will be furnished by the VA regional office or \[health
    care facility\] in whose area the hospital is located upon
    application of the commanding officer or superintendent. The forms
    will be completely filled out (except for the beneficiary's
    signature), by the VA station and forwarded to the \[health care
    facility\] for delivery to (and signature by) the beneficiary.

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g.  Spoiled or Canceled Requests. Requests spoiled by preparation,
    canceled for any reason or prepared for issuance but unused will be
    marked "Canceled" across the face of the form and accountability
    records noted accordingly. Canceled forms will be disposed of as
    prescribed in records disposal authority.

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h.  Lost, Unused, or Fraudulently Used Requets

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1.  When a transportation, meal or lodging request is lost, the Travel
    activity will:

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a.  Immediately notify the carrier, or vendor of the serial number of
    the lost request and ask \[that it not be honored.\]

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b.  Immediately notify the Fiscal activity of the serial number of the
    request, and circumstances surrounding its loss.

© If claim for reimbursement is made and a lost request form is
involved, a statement will be prepared of the facts of the loss and
attached to the reimbursement voucher. Requests subsequently found will
be sent to the Fiscal activity with a written explanation.

d.  Cancel returned requests. Where they are not returned and a definite
    statement is obtained from \[the\] beneficiary that requests were
    lost or destroyed, cancel the requests.

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3.  If evidence indicates requests were fraudulently used, refer the
    complete case to the Fiscal activity.

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4.  Where meal and lodging requests issued for use at restaurants,
    lodginghouses, etc., are not used within the validity period and
    signed statements are received from the proprietor or contractor
    that the requests have not been presented \[ \] and a claim therefor
    will not be submitted, cancel the requests on the basis of these
    statements. So notify the Fiscal activity and send it the
    statements.

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5.  Cancel all requests \[which remain\] outstanding \[for\] 120 days
    subsequent to date of issue.

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6.  Where the beneficiary returns unused requests and indicates he \[or
    she\] paid for the meals or lodgings from \[ \] personal funds,
    because of refusal of the eating place or lodginghouse to accept the
    meal or lodging request, he \[or she\] may be reimbursed for such
    costs. However, the amount of reimbursement may not exceed the
    established station rates for meals and lodgings (see subpar. d
    above).

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5.  TRANSPORTATION OF REMAINS OF A BENEFICIARY

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a.  Authorizing Transportation. When the cost of the transporting the
    remains of a beneficiary is authorized at Government expense,
    shipment will be arranged in accordance with MP-2, subchapter G,
    section 108-40.153.

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b.  Use of SF 1169, U.S. Government Transportation Request. When a
    shipment is by baggage car, SF 1169 will be used. If the carrier's
    charge for such equipment is the cost of two one-way first-class
    tickets, an escort may be authorized to travel on one of the two
    fares required. However, if a third first-class ticket is required
    for the escort the cost of such ticket cannot be paid by the
    Government.

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6.  BENEFICIARY'S TRAVEL OBLIGATION

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a.  Daily Notification of Obligations. The Travel activity will send
    daily to the Fiscal activity a copy of beneficiary travel
    authorizations, memorandum copies of transportation, special
    transportation, meal and lodging requests issued or canceled during
    the day or returned unused, together with any unused tickets
    received.

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b.  Cancellation of Obligations. When a beneficiary, who was authorized
    to travel at Government expense, failed to report, the suspense copy
    of the authorization will be marked "CANCELLED" and annotated to
    show the date of the action and the initials of the travel clerk.
    The Fiscal activity will be notified of the cancellation. (These
    procedures do not apply where the beneficiary was directed to report
    to the station initiating the authorization since funds have not
    been obligated on the basis of the individually issued
    authorization.) If transportation, meal or lodging requests were
    furnished, recovery actions will be taken as provided in paragraph
    4h.

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c.  Reinstatement of Canceled Obligations. When a beneficiary's
    reimbursement claim is found to apply to a previously canceled
    obligation, the Travel activity will determine that the beneficiary
    actually reported. If claim is made on original authorization,
    signed by the beneficiary, the authorization will be marked
    "REINSTATE," and the entry annotated to show the date and the
    initials of the travel clerk. The previously made "CANCELLED" entry
    will be lined out. A new obligation number will not be assigned. The
    reinstated authorization will be forwarded to the Fiscal activity
    for processing for payment.

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7.  NONEMPLOYEE ATTENDANT TRAVEL

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a.  General

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1.  A nonemployee attendant may be authorized to accompany a beneficiary
    when an authorizing official (see app. C) determines that an
    attendant is necessary because of the beneficiary's physical or
    mental condition.

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2.  The basic fee (see subpar. d below) to be paid a nonemployee
    attendant will be clearly stipulated in advance of the travel. In
    addition to the fee, a nonemployee attendant is entitled to
    necessary expenses of travel (i.e., mileage or actual expense basis
    or by use of Government transportation, meal and lodging requests.)

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3.  The use of a physician or nurse attendant will be authorized only
    when required to accompany the patient for a professional reason.

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4.  Relatives of beneficiaries may act as attendants, provided in
    medical judgment their services will be safe, convenient and in
    other respects advisable. However, while relatives assigned as
    attendants may be authorized necessary expenses of travel, i.e.,
    mileage, actual expense basis, or transportation, meal and lodging
    requests, they will not be authorized a fee. The authorization will
    so state. A relative is a spouse, parent, son, daughter, brother,
    sister, uncle, aunt, niece, or nephew of the beneficiary by blood or
    marriage.

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5.  Where a nonemployee attendant escorts a beneficiary who was held
    over for the convenience of the VA or otherwise (see par. 4e), he or
    she may be furnished the same meals or lodgings to which the
    beneficiary is entitled. These would have no relation to nonemployee
    attendant's claim for authorized travel expenses and fees.

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b.  Authorization Form. VA Form \[70-2509\], Authorization for
    Non-Employee Attendant (Voucher for Reimbursable Expenses and
    Attendant Fees), will be used to authorize the services of a
    nonemployee attendant on either a definite or conditional basis.

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c.  Mode of Travel. A nonemployee attendant will be authorized to travel
    by the same mode as that of the beneficiary to be escorted.

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d.  Authorized Fees. The authorized fees herein are the maximum not the
    minimum. Less than the maximum fees will be authorized when
    satisfactory service can be obtained at lower fees in the community.
    Maximum rates may be exceeded only where justified to and approved
    by the department head concerned. Exception: In Department of
    Medicine and Surgery, this approval authority is delegated to the
    ACMD for Administrative. The maximum authorized fees are:

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1.  Nonemployee Attendants. Not to exceed \$12 per day or fraction
    thereof.

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2.  Registered Nurses Employed as Nurse Attendants. Not to exceed \$20
    per day or fraction thereof.

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3.  Private Physicians Employed as Physician Attendants. Not to exceed
    \$25 per day or fraction thereof.

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e.  Reimbursement for Travel

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1.  VA Form \[70-2509\] will normally be used in submitting claim for
    reimbursement for an attendant's traveling expenses and allowable
    authorized fees for his or her services. All necessary items on VA
    Form \[70-2509\] will be completed and signature obtained.

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2.  Traveling expenses of both the attendant and the beneficiary must be
    reimbursed on the same basis. However, when two or more patients are
    being transferred and each patient is accompanied by a nonemployee
    attendant, and all travel in one automobile only the driver or the
    driver nonemployee attendant will be authorized mileage. The other
    nonemployee attendant(s) will be authorized actual expenses of
    travel (including fee), except on meals and lodgings, station rates
    will prevail.

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3.  An attendant may claim and be paid in cash for mileage for incoming
    and return travel to the point from which he or she proceeded and
    for his or her fee prior to completion of the return trip. The fee
    will cover the time required to complete the assignment.

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4.  Payment for travel performed by a nonemployee attendant on a
    conditional authorization may be approved by an authorizing official
    only after the beneficiary reports.

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5.  If an attendant claims reimbursement for the expenses of the
    beneficiary as well as his or her own, the voucher must be supported
    by a true copy of the beneficiary's travel authorization and a VA
    Form \[70-1207\], Waiver of Right To Claim Reimbursement for Travel,
    executed by the beneficiary of any right to claim reimbursement for
    his or her travel. If the attendant was specifically authorized to
    pay the expense of an incompetent beneficary, a waiver will not be
    required.

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6.  A beneficiary conveyed in a hired car authorized and paid for by the
    VA usually incurs no actual expenses of travel and therefore is not
    due reimbursement. Also, neither is the nonemployee attendant who
    accompanies the beneficiary in the hired car. Reimbursement, however
    may be made where a beneficiary or his or her nonemployee attendant
    incurred actual expenses of travel, such as lodgings or subsistence
    expenses.

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8.  REIMBURSEMENT FOR BENEFICIARY TRAVEL.

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a.  Policy

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1.  38 U.S.C. 111 provides the basic authority for reimbursement of
    travel expenses incurred by beneficiaries for travel performed to or
    from a VA facility or other place for the purpose of vocational
    rehabilitation, required educational counseling, examination,
    treatment, or care. Under that authority, beneficiary travel expense
    reimbursement may be authorized for the following categories of VA
    beneficiaries:

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a.  Persons receiving benefits for or in connection with a
    service-connected disability.

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b.  Veterans receiving pension under the provisions of 38 U.S.C. 521.

© Any beneficiary whose annual family income, as determined under the
provisions of 38 U.S.C. 503, is less than or equal to the maximum annual
base rate of pension which would be payable if he or she were eligible
for pension under 38 U.S.C. 521.

2.  Travel expenses of all other claimants will not be authorized unless
    the claimant can present clear and convincing evidence \[in a form
    prescribed by the Administrator\] to show that he or she is unable
    to defray the cost of transportation, or when medically indicated
    ambulance transportation is claimed and an appropriate authorizing
    official has been determined administratively that the claimant is
    unable to bear the cost of such transportation.

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3.  Beneficiaries categorized in subparagraph (1)( c) above requesting
    travel payment or reimbursement will be required to substantiate
    eligibility annually at the time of the first visit after June 1 in
    a given year, or at the time of the first visit in the case of a new
    patient. This eligibility will be substantiated in the following
    manner before payment or reimbursement will be made.

\[(a) VA Form 70-2323, Certification of Inability To Pay Transportation
Costs, will be used to determine whether the beneficiary is eligible for
travel expense reimbursement. The beneficiary should be asked to
complete the form in full. If a particular item is not applicable the
beneficiary should so indicate by entering "N/A" in that item. The form
is not complete until the beneficiary signs and dates the certification
and the VA employee signs the form as the witness.

b.  The determination as to the eligibility of the beneficiary for
    travel expense reimbursement will be based upon the total gross
    annual family income and the number of dependents indicated on the
    form. The beneficiary will be determined to be eligible only when
    the annual gross family income is less than or equal to the maximum
    annual rate of pension established under the provisions of 38 U.S.C.
    521 for the beneficiary's dependent status. Effective rates of
    pension are published in 38 CFR 3.23. Once the determination is made
    the completed form will be filed in the Consolidated Health Record
    as a reference for any future claims for reimbursement until the
    next annual certification.\]

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b.  Mileage Basis

\(1\) Reimbursement for the cost of travel by privately owned
conveyance, in any amount in excess of the cost of such travel by public
transportation, plus the costs of authorized meals and lodgings incurred
while en route, shall not be made unless: public transportation is not
reasonably accessible, or a claimant's physical or mental condition is
such that it is medically determined that use of public transportation
is inadvisable.

2.  In no event will payment be made in excess of the actual expense
    incurred by the beneficiary as certified by the beneficiary by
    signature on a voucher form.

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3.  For the purposes of beneficiary travel, public transportation is
    defined as being the form of transportation customarily serving the
    general public in a VA facility service area, usually on a scheduled
    basis, in exchange for a fee. Such fee will constitute the public
    transportation rate for that VA facility service area. Where public
    transportation is available in a facility service area, all
    reimbursements shall be based upon the established public
    transportation rate. On the other hand, even where such public
    transportation is available beneficiaries may travel to the VA
    facility by privately owned conveyance and, if eligible, be
    reimbursed on amount equal to the established public transportation
    rate, or 11 cents per mile, whichever is less.

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4.  When public transportation is not reasonably accessible
    (determination to be made by Directors of VA facilities) or its use
    is medically advisable, eligible beneficiaries may be reimbursed for
    the cost of authorized travel to and from a VA facility, or other
    authorized place, by privately owned conveyance at a rate of 11
    cents per mile, unless the provisions of subparagraph (5) below are
    for application. Public transportation will be considered not
    reasonably accessible if its use will require delays that involve
    added expense or prevent timely completion of required services. In
    addition, a claimant may be reimbursed for actual costs of
    authorized meals and lodgings when required due to length of trip,
    or when overnight stay is necessary in connection with a benefit
    received. Otherwise, reimbursement on a mileage basis, when
    appropriate, will be all-inclusive, except for actual costs of ferry
    fares, bridge, road and tunnel tolls.

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5.  Notwithstanding the above, certain travel by privately owned
    conveyance when use of public transportation is precluded will be
    deemed to be travel for the convenience of the Government, and the
    claimant will be reimbursed at a rate of 17 cents per mile. Travel
    by privately owned conveyance when public transportation is not
    reasonably accessible or is medically inadvisable will be deemed to
    be required of the beneficiary and therefore considered to be for
    the convenience of the Government, in the following situations only:

When a beneficiary must report to a VA facility or other authorized
place for:

a.  Vocational rehabilitation or required counseling under chapter 34 or
    35.

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b.  Examinations related to compensation, pension, or insurance,
    including observation and examination (O and E) but excluding
    original examinations, claims for increases, and appeals except in
    those cases where any medial examination or hospitalization has been
    directed to be performed by the Board of Veterans' Appeals.

© Research purposes.

6.  Mileage allowance claims of beneficiaries (or persons or
    organizations that actually paid the expenses of travel) will be
    prepared on the "Voucher for Mileage Allowance" section of the form.
    In addition to the mileage allowance, reimbursement will be allowed
    for the actual cost of any ferry fares, and bridge, road and tunnel
    tolls. Where no expense has been incurred by the beneficiary for his
    or her travel, no reimbursement may be made to the beneficiary
    (e.g., beneficiary accompanied by an attendant, traveled in
    attendant's personally owned automobile, and incurred no actual
    expenses of travel, including lodging and subsistence).

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7.  Complete the "Voucher for Mileage Allowance" section of the form,
    obtain beneficiary's signature and submit to agent cashier. On VA
    Form \[70-3542d\], beneficiary's signature will be obtained at time
    of payment. If a beneficiary does not report to the agent cashier
    and claim reimbursement, the matter will have the status of no claim
    received.

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8.  Standard highway mileage guides will be used for computing mileage.
    If travel began or ended at a point for which mileage is not given
    in the guide, reasonable allowance will be made for the distance
    between the actual point of origin or destination and the nearest
    map point for which mileage can be computed for the remainder of the
    journey.

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9.  Where a beneficiary traveled on a mileage basis and is admitted for
    a period of hospitalization, he or she may be paid immediately for
    the incoming trip only. However, if practical and a field station
    head so determines, payment may be deferred until the beneficiary is
    discharged at which time he or she may be paid for the round trip on
    a mileage basis.

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c.  Actual Expense Basis. SF 1012 will be used for reimbursement claims
    for travel on an actual expenses basis of beneficiaries and persons
    or organizations that actually paid the beneficiary's travel
    expenses. SF 1012 and supporting documents will be completed to
    include all required administrative statements, signatures, dates of
    performance of travel, etc. Receipts will be furnished for sleeping
    accommodations and for each additional item of expense over \$5. The
    completed SF 1012 with supporting documents will be sent to the
    Fiscal activity. Payment on an actual expense basis cannot exceed
    the rate established by the field station head (see par. 4d) for
    three meals and one night's lodging plus round trip travel by bus or
    train, and local transportation.

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d.  Payment to Persons or Organizations Who Paid for Beneficiary Travel.
    Where reimbursement of expense incurred for authorized travel of a
    beneficiary is claimed by a person (or organization) other than the
    person authorized to perform the travel, the authorized beneficiary
    must waive on VA Form \[70-1207\] all right to claim reimbursement
    for the expenses in favor of the person or organization making the
    claim. VA Form \[70-1207\] will be attached to the voucher claim
    before submitting to the Fiscal activity.

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e.  Recovery of Unused Transportation, Meal and Lodging Requests. Where
    a beneficiary was issued such requests for travel, but on reporting
    it was found that they were not used they will be recovered, marked
    "CANCELLED" and forwarded to the Fiscal activity with the daily
    notification. Such cancellation will also be noted on the copies of
    VA Form \[70-3542\]. The Travel activity will then process the
    voucher for reimbursement on a mileage basis or on an actual expense
    basis as requested by the beneficiary.

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f.  When Travel Vouchers, SF 1012, Are Required. SF 1012 will be used
    for the following types of beneficiary and nonemployee attendant's
    travel expense claims:

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1.  Actual expense basis:

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2.  Attendant fee when not claimed on VA Form \[70-2509\].

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3.  Attendant service properly approved as being necessary subsequent to
    performance of authorized travel when not claimed on VA Form
    \[70-2509\].

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4.  Travel claim which must be supported by other documentation.

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g.  Receipt of Unsigned Forms for Travel Expenses. They will be returned
    to beneficiary for signature by FL \[70-10\].

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9.  PAYMENT OF VENDORS CLAIMS

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a.  General

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1.  VA Forms \[70-3266\] received from vendors and banks and invoices or
    bills received for ambulance or hired car services will be checked
    for completion. If any required items were omitted, the forms,
    invoices, or bills will be returned to vendor for completion.