67

Overview of the Department of Veterans Affairs

Chapter 5

OVERVIEW OF THE DEPARTMENT OF 

VETERANS AFFAIRS 

NICOLE M. KEESEE, MS*

INTRODUCTION

DEPARTMENT DESCRIPTION

VETERANS HEALTH ADMINISTRATION

VETERANS BENEFITS ADMINISTRATION

NATIONAL CEMETERY ADMINISTRATION

BENEFITS PROVIDED BY OTHER AGENCIES

WHAT EVERY VETERANS AFFAIRS BENEFICIARY NEEDS TO KNOW

WHAT MILITARY HEALTHCARE PROVIDERS NEED TO KNOW

SUMMARY

ATTACHMENT: RESOURCES FOR VETERANS

*Colonel, US Army; Office of The Surgeon General/Veterans Affairs Central Office Seamless Transition Office, 810 Vermont Avenue, NW, VACO 10D1, 

Washington, DC 20420
68

Care of the Combat Amputee

INTRODUCTION

service personnel, veterans, their family members, and 

survivors. On October 13, 1987, Representative Jack B 

Brooks introduced HR 3471 declaring the VA an executive department. A little over a year later, President 

Ronald Reagan signed the bill, which became Public 

Law 100-527. President George Bush heralded the new 

department’s activation on March 15, 1989, declaring, 

“There is only one place for the veterans of America, 

in the Cabinet Room, at the table with the President 

of the United States of America.”2 Of the 14 Cabinet 

departments, the VA is the second largest, surpassed 

only by the Department of Defense. The president, 

with the Senate’s advice and consent, appoints the 

VA secretary.

Navigating the VA system in pursuit of legislated 

benefits and entitlements can be a daunting task. No 

instructional “VA 101” course is available to educate service members, and the majority of military 

healthcare providers have no knowledge of veteran 

and service member benefits, let alone how to apply 

for them. Today all service members should be made 

aware of the VA’s transformation: no longer is the VA 

caring only for the nation’s veterans, but it is also 

providing benefits to active duty service members 

and starting initiatives to serve family members. 

This chapter provides an overview of VA benefits 

and programs.

The Plymouth colony Pilgrims enacted the first veteran’s benefit over 300 years ago, providing pecuniary 

pensions for their disabled war veterans in the 1636 

war with the Pequot Indians. Over 100 years later, to 

increase the ranks of the Continental Army over the 

course of the Revolutionary War, the 1776 Continental 

Congress enacted the first pension law granting half 

pay for life in cases of loss of limb or other serious 

disability. However, the Continental Congress did not 

have the authority or financial backing to fund the new 

law, so states paid the pensions and provided public 

land grants to veterans.

On July 21, 2005, the US Department of Veterans 

Affairs (VA) celebrated its 75th anniversary. With 

a budget of $63.5 billion,1 the VA is the most comprehensive veterans’ benefits system in the world, 

serving over 26 million veterans of the US armed 

services (Army, Navy, Marine Corps, Air Force, Coast 

Guard) and other beneficiary populations. About 

one third of Americans (70 million) are eligible for 

VA benefits.1 Slightly less than half of all Americans 

who ever served during wartime are alive today, 

and nearly 80% of today’s veterans served during a 

period of war. 

The VA is a Cabinet-level, government-run, singlepayer healthcare system responsible for administering 

benefits programs whose beneficiaries are active duty 

DEPARTMENT DESCRIPTION

The VA has the federal government’s second largest 

civilian work force, including approximately 15,000 

physicians, 4,500 pharmacists, 1,000 dentists, 38,000 

nurses, and 4,800 master’s prepared social workers. 

The department operates in all 50 states, Puerto Rico, 

the Philippines, Guam, and Washington, DC, and owns 

more than 4,000 buildings and 27,000 acres of land. Of 

approximately 198,000 employees, 30% are veterans 

and 15,000 are members of the reserve and National 

Guard forces. 

Mission

The VA draws its mission statement from President Abraham Lincoln’s second inaugural address: 

“to care for him who shall have borne the battle and 

for his widow and his orphan.”3 Veteran benefits 

are determined by a number of variables over any 

given period of time. Benefits one veteran receives 

may not be the same as those another veteran receives. 

Organization

The VA comprises a central office (VACO) located 

in Washington, DC; facilities throughout the nation 

and abroad; and three administrations that provide 

for the delivery of services and benefits: the Veterans 

Health Administration (VHA), the Veterans Benefits 

Administration (VBA), and the National Cemetery 

Administration (NCA). The head of each administration reports to the secretary through the deputy 

secretary. These administrations give centralized 

program direction to field facilities that provide 

diverse program services to their beneficiaries. 

Furthermore, each administration has central office 

components supporting operations. Seven assistant 

secretaries advise and support the secretary and 

the administrations, and 11 staff offices provide 

specific assistance to the secretary (Figure 5-1).4 The 

VA structure uses a centralized policy-directed/

decentralized execution approach to govern daily 

operations.
69

Overview of the Department of Veterans Affairs

Chief of Staff Secretary

Deputy Secretary

General Counsel

Inspector General

Veterans Service Organizations Liaisons

Center for Minority Veterans

Center for Women Veterans

Center for Faith-Based and 

Community Initiatives

Office of Small & Disadvantaged 

Business Utilizations

Chairman, Board of Veterans’ Appeals

Office of Employment Discrimination 

Complaint Adjudication

Office of Regulation Policy and 

Management

Office of Construction & Facilities

Management

Under Secretary for Health,

Veterans Health Administration

DAS for 

Budget

DAS for 

Finance

DAS for 

Acquisitions &

Material 

Management

Under Secretary 

for Information &

Technology

Principal DAS

For OI&T

OCIO for Info

Protection &

Risk 

Management

OCIC for IT

Enterprise,

Strategy, 

Policy, Plans

& Programs

OCIO for IT

Resource

Management

OCIO for 

Enterprise

Development

OCIO for 

Enterprise

Operations &

Infrastructure

Assistant

Secretary for 

Policy & 

Planning

Principal DAS 

for P&P

DAS for 

Policy

DAS for 

Planning and 

Evaluation

Assistant

Secretary

for Operations

Security & 

Preparedness

Principal DAS 

for OSP

DAS for 

Security

& Law 

Enforcement

DAS for 

Emergency

Management

Under Secretary for 

Benefits, Veterans

Benefits Administration

Under Secretary for 

Memorial Affairs, National 

Cemetery Administration 

Assistant Secretary

for Human 

Resources

& Administration 

Principal DAS

for HR&A

DAS for

Administration

DAS for HR

Management

DAS for 

Diversity

Management

& EEO

DAS for 

Readiness

Management

DAS for Labor

Management

Resolution

Assistant

Secretary 

for Public &

Intergovernmental

Affairs

DAS for 

Public Affairs

DAS for InterGovernmental 

Affairs

Assistant

Secretary 

for Congressional 

& Legislative

Affairs

DAS for 

Congressional

& Legislative 

Affairs

Under Secretary 

for Management

Principal DAS

for Management

Figure 5-1. Department of Veterans Affairs organizational chart.

Reproduced from: Department of Veterans Affairs. 2007 Organizational Briefing Book. Washington, DC: VA Office of Human 

Resources and Administration; 2007.
70

Care of the Combat Amputee

VETERANS HEALTH ADMINISTRATION 

Veterans Integrated Service Networks

During the past 7 years, VHA’s organization 

changed from a structure with a small number of 

regional directors remotely supervising numerous, 

complex activities, to a system of 21 veterans integrated 

service networks (VISNs), which provide close and 

continuing hands-on supervision and leadership to 

US Code title 38 authorizes medical care to eligible 

VA beneficiaries. The VHA administers and operates 

the VA medical care system, which is the nation’s largest integrated healthcare system, providing care to over 

5.6 million (FY 2007) unique patients and handling 54 

million outpatient visits in 2006. The VA’s 2007 healthcare budget was more than $34 billion, and the 2008 

budget was expected to be almost $40 billion.5

21

21

20

18

19

22

21

17

23 12

16

9

7

8

10

11 4

5

6

2

3

15

1

20

Figure 5-2. Veterans integrated service network (VISN) map. Note: VISNs 13 and 14 do not exist.

VISN 1: VA New England Healthcare System

VISN 2: VA Healthcare Network Upstate New York

VISN 3: VA NY/NJ Veterans Healthcare Network

VISN 4: VA Healthcare 

VISN 5: VA Capitol Healthcare Network

VISN 6: VA Mid-Atlantic Healthcare Network

VISN7: VA Southeast Network

VISN 8: VA Sunshine Healthcare Network

VISN 9: VA Mid South Healthcare Network

VISN 10: VA Healthcare System of Ohio

VISN 11: Veterans in Partnership

VISN 12: VA Great Lakes Healthcare System

VISN 15: VA Heartland Network

VISN 16: South Central VA Healthcare Network

VISN 17: VA Heart of Texas Healthcare Network

VISN 18: VA Southwest Healthcare Network

VISN 19: Rocky Mountain Network

VISN 20: Northwest Network

VISN 21: Sierra Pacific Network

VISN 22: Desert Pacific Healthcare Network

 VISN 23: VA Midwest Healthcare Network

Reproduced from: Media Net. Veterans Affairs intranet site. Available at: http://vaww.mam.lrn.va.gov/MediaNet04. Accessed May 16, 2008.
71

Overview of the Department of Veterans Affairs

local VA facilities (Figure 5-2).

6

 The current system’s 

goal is to deliver the right care in the right place at the 

right time. The transformation resulted in a change in 

the ratio of outpatient visits to inpatient admissions 

from 29:1 in 1995 to more than 100:1 in 2006.

Mission

The VHA’s mission is to serve the needs of America’s veterans by providing primary care, specialized 

care, and related medical and social support services. 

The VHA provides a broad spectrum of medical, surgical, and rehabilitative healthcare in all its forms, as 

well as conducting medical research. VHA manages 

the largest medical education and health profession 

training programs in the United States. VHA facilities are affiliated with more than 105 medical schools, 

55 dental schools, and more than 1,200 other schools 

across the country. Each year VHA medical centers 

train about 83,000 health professionals. More than 

half of all physicians practicing in the United States 

had some of their professional education in the VA 

healthcare system. 

As of June 2007, approximately 1.4 million service 

members have served in Iraq and Afghanistan since 

the beginning of hostilities. Of 837,458 veterans who 

became eligible for VA healthcare from fiscal year 

(FY) 2002 to FY 2008 (1st quarter), 39% (324,846) of 

the total separated veterans of operations Iraqi Freedom and Enduring Freedom (OIF/OEF) obtained VA 

healthcare (cumulative total). Of the 324,846 evaluated 

OIF/OEF patients, 96% (311,730) have been seen as 

outpatients and not hospitalized, and 4% (13,116) have 

been hospitalized at least once in a VA medical facility. 

Of 414,588 former active duty troops, 40% (165,578) 

have sought VA healthcare (cumulative total since 

FY 2002). Of 422,870 reserve/National Guard members, 38% (159,268) have sought VA healthcare. These 

324,846 OIF/OEF veterans (Table 5-1) evaluated by 

VA over approximately 6 years represent about 6% of 

the 5.5 million individual patients who received VHA 

healthcare in any 1 year (the 2007 total VHA patient 

population was 5.5 million).7

Changes in the Veteran Population

The current OEF/OIF VA population is very different from the general VHA population. The median age 

of the general VA population is 65 (FY05), whereas the 

median age of the OIF/OEF population is 28.6 (active 

duty) and 35.0 (reserve/Guard). Of the general VA 

population, 95.2% are male and 4.8% are female. Of 

the OEF/OIF population, 87% are male and 13% are 

female. The five leading diagnoses of all VHA users 

(2006) are hypertension; diabetes; lipids-related (ie, 

fatty acids, cholesterol, estrogen, and other related 

compounds); adjustment reaction; and ischemic heart 

disease. In contrast, the five leading diagnoses for 

OEF/OIF veterans are musculoskeletal, mental health, 

digestive (dental), ill-defined, and nervous system/

sensory disorders. The VA is making adjustments to 

meet the new demands of the OEF/OIF beneficiary 

population: a major expansion of mental health services, implementation of a suicide hotline, development 

of a polytrauma care network, significant increase in 

women’s health services, the addition of OEF/OIF care 

cooordination at each VA medical center, and, the addition of OEF/OIF polytrauma/traumatic brain injury 

individual care coordinators.7

Assistive Technology

The VA is dedicated to restoring the capabilities of 

disabled veterans to the greatest extent possible. VA 

has an integrated delivery system designed to provide 

medically prescribed prosthetic and sensory aids, devices, assistive aids, repairs, and services to disabled 

individuals to facilitate treatment of their medical 

conditions. The VA Prosthetic and Sensory Aids Service 

(PSAS) is the healthcare provider and case manager 

for assistive aids and prosthetic equipment needs of 

disabled veterans. The service’s goal is to provide 

TABLE 5-1

CHARACTERISTICS OF OPERATIONS IRAQI 

FREEDOM AND ENDURING FREEDOM 

VETERANS

Category Percentage (%)

Sex Male 88

Female 12

Branch Air Force 12

Army 65

Marine Corps 12

Navy 11

Rank Enlisted 92

Officer 8

Unit Type Active duty 51

Reserve/Guard 49

Age <20 7

20–29 51

30–39 23

> or = 40 19

Total: 324,846
72

Care of the Combat Amputee

seamless service from prescription through procurement, delivery, training, replacement, and repair. Care 

providers who prescribe an aid or a device to veterans 

enrolled in the VA system are eligible for PSAS services. 

Other products and services disabled veterans receive include wheelchairs and scooters; braces; shoes 

and orthotics; oxygen and respiratory equipment; 

other medical equipment and supplies (beds, lifts, 

computer equipment, telehealth products); adaptive 

sports and recreation equipment; and surgical implants 

(pacemakers, cardiac defibrillators, stents, dental 

devices). PSAS also has programs providing home 

improvements and structural changes, automobile 

adaptive equipment, and a clothing allowance to eligible veterans with service-connected disabilities. The 

Prosthetics Clinical Management Program coordinates 

national integrated product teams—interdisciplinary 

workgroups consisting of clinical and administrative 

subject-matter experts who develop clinical practice 

recommendations for prosthetic devices and national 

contracts to purchase them. As of April 2008, VA had 

61 accredited orthotic-prosthetic laboratories staffed 

by 185 employees, 139 of whom are certified by either 

the American Board for Certification in Orthotics, 

Prosthetics and Pedorthotics or the Board of Orthotist and Prosthetist Certification. Additionally, 18 of 

these laboratories have also earned certification from 

the National Commission on Orthotic and Prosthetic 

Education, which enables them to participate in residency programs from the nine prosthetic and orthotic 

programs in US universities and colleges.

PSAS staff provide prescribed devices, consult in 

clinics, and custom fabricate, fit, and repair artificial 

limbs and braces or order them from commercial 

vendors. They and other medical specialists in various disciplines form amputee clinic teams who see 

the veteran regularly after fitting to ensure the proper 

functioning of the artificial limb as well as the integration of body, mind, and machine. VA PSAS staff work 

alongside Army healthcare providers at the Center 

for the Intrepid, Fort Sam Houston, Texas. At Walter 

Reed Army Medical Center in Washington, DC, VA’s 

vocational rehabilitation and employment program 

provides voice-recognition computers so Iraq war soldiers who have lost a hand can learn computer skills. 

Continuing to increase collaboration and implement 

resource-sharing initiatives, both DoD and VA can 

further improve facility utilization, provide greater 

access to care, and reduce the federal cost of providing 

healthcare services to beneficiaries. VA also collaborates with non-DoD organizations. The VA Medical 

Center’s Center for Restorative and Regenerative 

Medicine and Brown University, in Providence, Rhode 

Island, and the Massachusetts Institute of Technology 

are collaborating to create artificial limbs that function 

almost like biological ones. 

No less important than new prosthetic component 

technology is the overall care an amputee receives during rehabilitation. The model for care has changed over 

the years to improve services to VA patients that go 

beyond teaching amputees to walk or use a prosthetic 

arm and hand. Continuing care and long-term support 

from VA multidisciplinary teams enable patients to 

improve their functioning months or years after their 

injuries or amputation. To contact the VHA prosthetics 

central office, call (202) 254-0440, or go to the Web site: 

www.prosthetics.va.gov.

Healthcare Programs

The VA offers a spectrum of healthcare services to 

veterans enrolled in its healthcare system. Each program has specific admissions and eligibility requirements. To determine eligibility, contact the nearest 

VA medical facility. The following is a list with brief 

descriptions of VA programs. 

Long-Term Care 

More than 90% of VA’s medical centers provide 

home- and community-based outpatient long-term 

care programs. This patient-focused approach supports the wishes of most patients who want to live at 

home in their own communities for as long as possible.8

Noninstitutional Care

Veterans can receive home-based primary care, 

contract home healthcare, adult day healthcare, homemaker and home health aide services, home respite 

care, home hospice care, and community residential 

care. VA’s extended care patient population receives 

care in the following noninstitutional settings:

	 •	 Home-based primary care. Provides longterm primary medical care to chronically ill 

veterans in their own homes under the coordinated care of an interdisciplinary treatment 

team. This program has led to guidelines for 

medical education in home care, use of emerging technology in home care, and improved 

care for veterans with dementia and the families who support them. 

	 •	 Contract home healthcare. Professional home 

care services, mostly nursing services, are 

purchased from private-sector providers at 

every VA medical center. The program is com-
73

Overview of the Department of Veterans Affairs

monly called “fee basis” home care (when the 

VA cannot provide care within its healthcare 

system, the VA will pay for healthcare services 

obtained from local community providers, 

depending on eligibility criteria). 

	 •	 Adult day healthcare. Provides health maintenance and rehabilitative services to veterans 

in a group setting during daytime hours. 

	 •	 Homemaker and home health aide program. 

Provides health-related services for veterans 

with service-connected disabilities needing 

nursing home care in the community (public 

or private) but case managed directly by VA 

staff. 

	 •	 Community residential care. Provides room, 

board, limited personal care, and supervision 

to veterans who do not require hospital or 

nursing home care but are not able to live 

independently because of medical or psychiatric conditions, and who have no family to 

provide care. Medical care is provided to the 

veteran primarily on an outpatient basis at VA 

facilities. 

	 •	 Respite care. Temporarily relieves the spouse 

or other caregiver from the burden of caring 

for a chronically ill or disabled veteran at 

home. The 1999 Veterans Millennium Healthcare and Benefits Act expanded respite care to 

home and other community settings. Respite 

care is usually limited to 30 days per year. 

	 •	 Home hospice care. Provides comfort-oriented and supportive services in the home for 

persons in the advanced stages of an incurable disease. The goal is to achieve the best 

possible quality of life through relief of suffering, control of symptoms, and restoration or 

maintenance of functional capacity. Services 

are provided by an interdisciplinary team of 

healthcare providers and volunteers. Bereavement care is available to the family following 

the death of the patient. Hospice services are 

available 24 hours a day, 7 days a week. 

	 •	 Telehealth. For most of VA’s noninstitutional 

care, this technology can play a major role in 

coordinating veterans’ total care with the goal 

of maintaining independence. Telehealth offers the possibility of treating chronic illnesses 

in a cost-effective manner while contributing 

to the patient satisfaction generally found 

with care available at home.

	 •	 Geriatric evaluation and management. Older 

veterans with multiple medical, functional, or 

psychosocial problems and those with particular geriatric problems receive assessment 

and treatment from an interdisciplinary team 

of VA health professionals. These services are 

provided on inpatient units, in outpatient clinics, and in geriatric primary care clinics. 

	 •	 Geriatric research, education, and clinical

centers. These centers increase basic knowledge of aging for healthcare providers and 

improve the quality of care through development of improved models of clinical services. 

Each center has an identified focus of research 

in the basic biomedical, clinical, and health 

services areas, such as the geriatric evaluation 

and management program. Medical and associated health students and staff in geriatrics 

and gerontology are trained at these centers. 

Nursing Homes

VHA provides nursing home services to veterans 

through three national programs: homes owned and 

operated by VA, state veterans’ homes owned and 

operated by the states, and the community nursing 

home program. 

	 •	 VA nursing homes. Typically admit residents 

requiring short-term skilled care or those who 

have a 70% or greater service-connected disability.

	 •	 State veterans’home program. A cooperative 

venture between the states and VA whereby 

the states petition VA for matching construction grants and the state, the veteran, and VA 

pay a portion of the per diem. The per diem is 

set in legislation. State veterans’ homes accept 

all veterans in need of long-term or shortterm nursing home care. Specialized services 

offered are dependent upon the each home’s 

capability.

	 •	 Community nursing home program. VA 

medical centers maintain contracts with 

community nursing homes though every VA 

medical center. The purpose of this program 

is to meet the nursing home needs of veterans 

who require long-term nursing home care in 

their own community, close to their families.

Domiciliary Care

Domiciliary care is a residential rehabilitation 

program that provides short-term rehabilitation 

and long-term health maintenance to veterans who 

require minimal medical care as they recover from 

medical, psychiatric, or psychosocial problems. Most 

domiciliary patients return to the community after a 
74

Care of the Combat Amputee

period of rehabilitation. Domiciliary care is provided 

by VA and state homes. VA also provides a number of 

psychiatric residential rehabilitation programs, including assistance for veterans coping with posttraumatic 

stress disorder and substance abuse, and compensated 

work therapy or transitional residences for homeless 

veterans with chronic mental illness and veterans 

recovering from substance abuse. 

Community-Based Outpatient Clinics

Former Undersecretary for Health Kenneth W Kizer 

realigned the VA healthcare delivery system from a 

traditional acute care hospital system to an integrated 

delivery system employing principles of managed 

care. An important component of the realignment 

was the initiative to implement a nationwide system 

of community-based outpatient clinics to improve 

veterans’ access to primary healthcare. In 2007 VA had 

887 community-based outpatient clinics and plans to 

open 38 more in 22 states. The new facilities will become operational by October 2008. A complete listing 

of the community clinics can be found on the VA Web 

site or in the benefits booklet.

Emergency Medical Care in External Facilities

VA may reimburse or pay for medical care provided 

to enrolled veterans by non-VA facilities only in cases 

of medical emergencies where VA or other federal 

facilities were not feasibly available. Other conditions 

also apply. To determine eligibility or initiate a claim, 

contact the VA medical facility nearest to where the 

emergency service was provided.

National Rehabilitation Special Events

VA sponsors a number of special events as part of 

the comprehensive rehabilitation provided to veterans. 

For information on eligibility and participation, or 

to be a volunteer, contact the VA national advisor at 

the following Web site: www.va.gov/opa/speceven/

index.asp.

Vet Centers

Vet Centers are VHA outreach offices located in 

communities where large veteran and family member 

populations reside. The VHA’s Readjustment Counseling Service governs the Vet Center network, which 

consists of 232 centers (with plans for expansion). All 

centers have an OEF/OIF outreach specialist, and most 

have at least one combat veteran on staff. 

Veterans who served in any combat zone (Vietnam, 

Southwest Asia, OEF, OIF, etc) and received a military 

campaign ribbon, and their family members, are eligible for Vet Center services. Active duty service members are not eligible for services, but combat veteran 

family members are eligible for readjustment counseling services for military-related problems. Center staff 

specialize in readjustment counseling, providing a 

wide range of services to help combat veterans make 

a satisfying transition from military to civilian life. 

Services include individual counseling, group counseling, marital and family counseling, bereavement 

counseling, medical referrals, benefits application 

assistance, employment counseling, alcohol and drug 

assessments, information and referral to community 

resources, military sexual trauma counseling and referral, and outreach and community education. 

Vet Center beneficiaries do not incur any fees for 

services. The VA Web site (www.va.gov) publishes a 

listing of all center locations and point of contact information. Vet Center information can also be found 

under government listings in the local telephone 

directory. Center staff are available toll free during 

normal business hours at 1-800-905-4675 (Eastern) and 

1-866-496-8838 (Pacific).

 Spinal Cord Injury

Nearly 44,000 veterans with spinal cord injuries 

(SCIs) are eligible for VA medical care. Many of these 

veterans are eligible not only for healthcare but also 

for monetary or other benefits because they have a 

service-connected disability, meaning a condition that 

occurred or worsened during military service. Veterans 

with SCI service-connected disabilities are also entitled 

to vocational counseling, grants for adapted housing 

and automobiles, a clothing allowance, and payment 

for home and attendant care. Veterans with spinal 

cord injury unrelated to their military service may still 

receive VA medical care because of their catastrophic 

disability. 

Services

A study conducted by a major consulting firm in 

2000 comparing VA’s SCI services to those funded by 

several private and public health insurers showed that 

VA’s coverage was more comprehensive. VA integrates 

vocational, psychological, and social services within 

a continuum of care that addresses changing needs 

throughout the veteran’s life. VA provides supplies, 

offers preventive healthcare and education, and maintains medical equipment for veterans with SCI. 

Services are delivered through a “hub and spoke” 

system of care, extending from 23 regional SCI centers 
75

Overview of the Department of Veterans Affairs

(see Attachment) offering primary and specialty care 

by multidisciplinary teams to the 135 SCI primary care 

teams or support clinics at non-SCI local VA medical 

centers. Each primary care team has a physician, nurse, 

and social worker, and those with support clinics may 

have additional team members. Newly injured veterans and active duty members are referred to a VA 

SCI center for rehabilitation after being stabilized at 

a trauma center. Each year, approximately 400 newly 

injured veterans and active duty members receive 

rehabilitation at VA’s SCI centers. The SCI center 

nearest to a veteran can provide the name of the SCI 

coordinator in the primary care team at the nearest 

VA facility. 

National Recreational Events

Staying active is as important to the physical and 

emotional well-being of people with SCI as it is to other 

people. VA sponsors two annual athletic events that offer camaraderie with other SCI veterans and the opportunity to enjoy and participate in competitive sports. 

These are the National Veterans Wheelchair Games, 

which are cosponsored by Paralyzed Veterans of America, and the National Disabled Veterans Winter Sports 

Clinic, cosponsored by Disabled American Veterans. 

Continuing Education

The Rehabilitation Accreditation Commission has 

accredited all 20 VA SCI centers that provide acute 

rehabilitation. Thirteen of these centers are training 

sites certified by the Accreditation Council on Graduate Medical Education, which accredits postgraduate 

medical training programs in the United States. All 

VA physicians can take an independent study course 

on medical care for patients with SCI, and two SCI 

training programs are held annually for VA healthcare 

professionals. A guide called Yes, You Can!, prepared 

by the VA and published by Paralyzed Veterans of 

America, explains how to handle problems and where 

to turn for help (available at VA SCI centers and from 

Paralyzed Veterans of America).

Blind Rehabilitation Service

The mission of Blind Rehabilitation Service is to 

coordinate a healthcare service delivery system that 

provides a continuum of care for blinded veterans 

extending from their home environment to the local 

VA facility and the appropriate rehabilitation setting. These services include adjustment to blindness 

counseling, patient and family education, benefits 

analysis, comprehensive residential inpatient training, 

outpatient rehabilitation services, provision of assistive 

technology, and research.

Blind Rehabilitation Center

The blind rehabilitation center, a residential inpatient program providing training in comprehensive 

adjustment to blindness, serves as a resource to a 

catchment area usually composed of multiple states. 

The centers offer a variety of skill courses designed 

to help blinded veterans achieve a realistic level of 

independence. These skill areas include orientation 

and mobility, communication skills, activities of daily 

living, manual skills, visual skills, computer access 

training, and social/recreational activities. The veteran 

is also assisted in making an emotional and behavioral 

adjustment to blindness through individual counseling 

sessions and group therapy meetings.

Visual Impairment Services Team Coordinator

The visual impairment services team coordinator is 

a case manager who coordinates all services for legally 

blind veterans and their families. Duties include providing or arranging for the provision of appropriate 

treatment modalities (eg, referrals to blind rehabilitation centers or specialists) to enhance a blinded veteran’s functioning level. Other duties include identifying 

new cases of blindness, providing professional counseling, resolving problems, arranging annual healthcare reviews, and conducting education programs.

Visual Impairment Services Outpatient Program 

The Visual Impairment Services Outpatient Program (VISOR) is an intermediate 9-day rehabilitation 

program located at the Lebanon VA medical center in 

Pennsylvania. It provides comfortable, safe, overnight 

accommodations for visually impaired beneficiaries 

requiring temporary lodging to access program services. VISOR offers skills training, orientation and 

mobility, and low-vision therapy. It is staffed with 

blind rehabilitation specialists and visual impairment service team coordinators who are either social 

workers or certified low-vision therapists. Veterans 

must be able to perform activities of daily living independently, including the ability to self-medicate, to 

qualify for the program. 

Visual Impairment Center to Optimize Remaining 

Sight Program

VHA developed the Visual Impairment Center to 

Optimize Remaining Sight (VICTORS) concept to 
76

Care of the Combat Amputee

complement existing inpatient blind rehabilitation 

centers in caring for veterans with significant visual 

impairment (20/70 to 20/200 or worse visual acuity 

or significant visual field loss). In the VICTORS outpatient program, a multidisciplinary team consisting 

of specialists in optometry, ophthalmology, social 

work, psychology, and low-vision therapy provides 

rehabilitative care. VICTORS provides rehabilitation 

through definitive medical diagnosis, functional 

vision evaluation, prescription of low-vision aids 

and training in their use, counseling, and follow-up. 

Frequently, other necessary patient care services (eg, 

social work, psychology, audiology, and ophthalmology) are provided at the local station. There are 

currently four VICTORS programs, located in Kansas 

City, Missouri; Chicago, Illinois; Northport, New York; 

and Lake City, Florida. 

Blind Rehabilitation Outpatient Specialists

Blind rehabilitation outpatient specialists with 

specialized training teach skills to veterans in their 

homes or in the local VA facility. The specialists have 

advanced technical knowledge and competencies in 

at least two of the following disciplines at the journeyman level: orientation and mobility, living skills, 

manual skills, and visual skills. They possess a broad 

range of knowledge in the aforementioned disciplines, 

including computer access training. The program is 

located in the following areas: Albuquerque, New 

Mexico; Ann Arbor, Michigan; Augusta, Georgia; Bay 

Pines/St Petersburg, Florida; Baltimore, Maryland; 

Boston, Massachusetts; Brooklyn, New York; Cleveland, Ohio; Dallas, Texas; Gainesville, Florida; Hines, 

Illinois; Houston, Texas; Greater Los Angeles, California; North Las Vegas, Nevada; Orlando, Florida; Palo 

Alto, California; Phoenix, Arizona; Portland, Oregon; 

Richmond, Virginia; San Antonio, Texas; San Diego, 

California; San Juan, Puerto Rico; Seattle, Washington; 

Tampa, Florida; Waco, Texas; Washington, DC; West 

Haven, Connecticut; and West Palm Beach, Florida. 

The blind rehabilitation outpatient specialist handbook is available at: www.va.gov/publdirec/health/

handbook/1174-1.html.

Travel Expenses and Refunds

The VA will reimburse veterans for travel costs if 

they meet eligibility requirements. Reimbursement is 

paid and subject to a deductible for each one-way trip 

with a per-month maximum payment. Two exceptions 

to the deductible are travel for compensation and pension examinations and the need for special modes of 

transportation, such as an ambulance or a specially 

equipped van.

Homeless Veterans

VA has programs providing medical care, benefits 

assistance, and transitional housing to more than 

100,000 homeless veterans. VA makes grants for transitional housing, service centers and vans for outreach 

and transportation to state and local governments, 

tribal governments, and nonprofit community and 

faith-based service providers.

Presumptive Conditions Considered for Disability

Compensation

Certain veterans are eligible for disability compensation based on the presumption that their disability 

is service connected.

Prisoners of War 

If the following conditions received a 10% disability 

rating anytime after military service, the conditions are 

presumed to be service connected for former prisoners 

of war: psychosis, anxiety states, dysthymic disorder, 

organic residuals of frostbite, posttraumatic osteoarthritis, heart disease or hypertensive vascular disease 

and their complications, and stroke and residuals of 

stroke. The VA also presumes additional conditions to 

be service connected for veterans imprisoned at least 

30 days: avitaminosis, beriberi, chronic dysentery, helminthiasis, malnutrition (including optic atrophy), pellagra or other nutritional deficiencies, irritable bowel 

syndrome, peptic ulcer disease, peripheral neuropathy, 

and cirrhosis of the liver.

Veterans Exposed to Agent Orange and Other 

Herbicides

Veterans who served in the Republic of Vietnam 

between January 9, 1962, and May 7, 1975, regardless of length of service, were presumed to have 

been exposed to Agent Orange and other herbicides 

used in support of military operations. Presumptive 

conditions for service connection include chloracne 

or other acneform disease similar to chloracne; porphyria cutanea tarda; soft-tissue sarcoma (other than 

osteosarcoma, chondrosarcoma, Kaposi’s sarcoma, or 

mesothelioma); Hodgkin’s disease; multiple myeloma; 

respiratory cancers (lung, bronchus, larynx, trachea); 

non-Hodgkin’s lymphoma; prostate cancer; acute and 

subacute peripheral neuropathy; diabetes mellitus 

(type 2); and chronic lymphocytic leukemia.

Veterans Exposed to Radiation

Presumptive service-connected conditions for 
77

Overview of the Department of Veterans Affairs

veterans exposed to radiation include all forms of 

leukemia (except for chronic lymphocytic leukemia); 

cancer of the thyroid, breast, pharynx, esophagus, 

stomach, small intestine, pancreas, bile ducts, gall bladder, salivary gland, urinary tract (renal pelvis, ureter, 

urinary bladder, and urethra), brain, bone, lung, colon, 

and ovary; bronchiolo-alveolar carcinoma; multiple 

myeloma; lymphomas (other than Hodgkin’s disease); 

and primary liver cancer (unless cirrhosis or hepatitis 

B is indicated).

Gulf War Veterans

Presumptive service-connected conditions for Gulf 

War veterans are undiagnosed illnesses or medically 

unexplained chronic (existing for at least 6 months) 

multisymptom illnesses defined by a cluster of signs 

or symptoms such as chronic fatigue syndrome, fibromyalgia, skin disorders, headache, muscle pain, joint 

pain, neurological symptoms, neuropsychological 

symptoms, symptoms involving the respiratory system, sleep disturbances, gastrointestinal symptoms, 

cardiovascular symptoms, abnormal weight loss, and 

menstrual disorders.

Veterans With Amyotrophic Lateral Sclerosis

More commonly recognized as Lou Gehrig’s disease, amyotrophic lateral sclerosis may be a presumptive condition for service connection for veterans 

who served in operations in Southwest Asia between 

August 2, 1990, and July 31, 1991. The Southwest Asia 

theater of operations includes Iraq, Kuwait, Saudi 

Arabia, the neutral zone between Iraq and Saudi Arabia, Bahrain, Qatar, the United Arab Emirates, Oman, 

the Gulf of Aden, the Gulf of Oman, the Persian Gulf, 

the Arabian Sea, the Red Sea, and the airspace above 

these locations.

Combat Veterans

The 2008 National Defense Authorization Act 

(Public Law 110-181) provides active duty, reserve, 

and National Guard service members deployed to a 

theater of combat operations eligibility for a 5-year, 

cost-free VA healthcare package including nursing 

home care. Eligibility requirements are as follows: (a) 

combat service against a hostile force during a period 

of hostilities after November 11, 1998; or (b) active 

duty service in a theater of combat operations during 

a period of war after the Persian Gulf War; and (c) 

discharge under other than dishonorable conditions; 

and (d) medical condition related to military service. 

The VA defines “hostilities” as a conflict that places 

armed forces members in harm’s way comparable to 

danger inherent in a period of war. Combat veterans 

discharged from active duty between November 11, 

1998, and January 27, 2003, may apply for this benefit 

until January 27, 2011. 

Documents to substantiate combat service include 

(a) service documentation that reflects service in a 

combat theater, (b) combat service medals, or (c) receipt 

of imminent danger or hostile fire pay or tax benefits. 

Active duty, reserve, and National Guard service 

members should register for VA healthcare prior to 

discharge, retirement, or removal from active duty. VA 

personnel assigned duty at military medical facilities 

or military installations can assist service members 

with the registration process.

After receiving DD form 214 (discharge certificate) 

and returning home, the service member or veteran 

must visit the nearest VA medical facility and enroll 

in VA healthcare to receive eligible medical care and 

services. VA healthcare is not rendered until the service 

member or veteran is enrolled. Upon completion of the 

5-year healthcare package, veterans will continue to 

be enrolled although their assigned priority group 

may change based on their income, and they may 

be required to make applicable copayments. Unless 

exempted, veterans may need to disclose their previous year’s gross household income. Disclosure is not 

required; however, disclosure may provide additional 

benefits such as eligibility for travel reimbursement, 

cost-free medication, or medical care for service unrelated to combat. Continued eligibility for subsequent 

care is determined by compensable service-connected 

disability, VA pension status, catastrophic disability 

determination, or the veteran’s financial status. Combat 

veterans are strongly encouraged to apply for enrollment to 

take advantage of the special combat veteran eligibility, even 

if no medical care is currently needed.

Combat veterans may be eligible for a one-time 

treatment for dental conditions. Eligibility criteria for 

this dental benefit are as follows:

	 •	 Active duty of not less than 90 days.

	 •	 Discharge under conditions other than dishonorable.

	 •	 DD form 214 containing a statement the service member did not receive a complete dental 

examination including dental radiographs, 

and did not receive subsequent care dictated 

by the examination.

	 •	 Must be applied for within 90 days of discharge or release. Care can be rendered past 

the 90 days but not past 12 months.

Veterans discharged between August 1, 2007, and January 27, 2008, are eligible for the dental benefit by making application within 180 days of their discharge.9
78

Care of the Combat Amputee

Enrollment

Veterans must apply for enrollment into the VA 

healthcare system. Once enrolled, veterans can receive 

eligible care and services at any VA healthcare facilities 

and are afforded various privacy rights under federal 

law and regulations.10 Exemptions from the enrollment 

process are as follows: 

	 •	 Veterans with service-connected disability of 

50% percent or more.

	 •	 Veterans seeking care for a disability the military determined was incurred or aggravated 

in the line of duty, but which VA has not yet 

rated, within 12 months of discharge.

	 •	 Veterans seeking care for a service-connected 

disability only.

Regardless of exemption, all veterans are advised 

to enroll (Exhibit 5-1). 

Priority Groups

The VA uses a priority system as a way to meet 

healthcare needs within resource constraints. The 

VA assigns each veteran to a priority group based 

on a number of factors: amount of service-connected 

disability, income, private health insurance, and geographical location. The priority group is subject to 

change. Priority groups range from priority 1 (50% 

service-connected disability or more, or unemployable due to service-connected conditions) to priority 

8 (indigent veterans). 

Foreign Medical Program

Veterans traveling or residing abroad who have VArated service connected conditions can obtain healthcare services from the following foreign locations: 

	 •	 In the Philippines: VA Outpatient Clinic, 

Pasay City 1300, Republic of the Philippines; 

e-mail: manlopc.inqry@vba.va.gov.

	 •	 All other countries: Foreign Medical Program, 

PO Box 65021, Denver, CO 80206-9021; telephone: 303-331-7590; e-mail: www.va.gov/

hac/contact; Web site: www.va.gov/hac .

EXHIBIT 5-1

THINGS TO REMEMBER ABOUT 

VETERANS AFFAIRS HEALTHCARE

1. Veterans need to enroll to receive VA healthcare. 

2. Registration is not enrollment; it is an intention to enroll.

3. Priority group assignment is subject to 

change based on the law of supply and 

demand and eligibility.

4. Veterans must provide supporting documents to substantiate enrollment eligibility.

5. Financial status can determine eligibility for 

specific benefits.

6. Veterans should enroll as soon after discharge or release from active duty as possible.

7. Learn more about VA healthcare programs 

and eligibility from the nearest VA medical 

facility. VA facilities including telephone 

numbers are listed online, at www.va.gov/

directory, or in the local telephone directory 

under the US government listings. Veterans 

can also call the Health Benefit Service Center toll free at 1-877-222-VETS (8387), or visit 

the VA health eligibility Web site at www.

va.gov/healtheligibility.

VETERANS BENEFITS ADMINISTRATION

The VBA is the VA’s benefits delivery system. “The 

mission of the Veterans Benefits Administration (VBA), in 

partnership with the Veterans Health Administration and the 

National Cemetery Administration, is to provide benefits and 

services to veterans and their families in a responsive, timely 

and compassionate manner in recognition of their service to 

the Nation.”11 VBA has four area offices, 57 regional offices, and 153 benefits delivery-at-discharge sites.

The VA dispenses a broad spectrum of benefits 

programs and services to eligible active duty, reserve, 

and National Guard service members and veterans. 

These benefits are legislated in title 38 of the US Code. 

Every year the VA publishes a booklet in English and 

Spanish containing a summary of veteran benefits 

for the calendar year (available at: www.va.gov). 

VBA is responsible for initial veteran registration, 

eligibility determination, and five key lines of benefits 

and entitlements: (1) compensation and pension, (2) 

vocational rehabilitation and employment, (3) insurance, (4) education (GI Bill), and (5) loan guaranty. 

In 2006 the VBA paid out $38.9 billion in claims (approximately half going for disability compensation, 

pension, education assistance, and medical care), 

$25.0 billion in guaranteed loans coverage, and $1.4 

trillion in insurance coverage for service members 

and veterans.
79

Overview of the Department of Veterans Affairs

Compensation and Pension Programs 

These programs provide direct payments to veterans, dependents, and survivors as a result of the 

veteran’s service-connected disability or because of 

financial need.3

	 •	 Disability compensation. A monetary benefit 

paid to veterans with disabilities resulting 

from a disease or injury incurred or aggravated during active military service. The benefit 

amount is graduated according to the degree 

of the veteran’s disability on a scale from 0% 

to 100% (in 10% increments).

	 •	 Dependency and indemnity compensation. 

Benefits generally payable to the survivors 

of service members who died while on active 

duty or survivors of veterans who died from 

their service-connected disabilities.

	 •	 Pension programs. Provide income support 

to veterans with wartime service and their 

families for a nonservice-connected disability 

or death. These programs are for low-income 

veterans and survivors.

	 •	 Burial and interment allowances. Payable allowances for certain veterans. A higher rate of 

burial allowance applies if the veteran’s death 

is service-connected.

	 •	 Spina bifida monthly allowance. This allowance under 38 USC 1805 provides for 

individuals born with spina bifida who are 

children of personnel who served in the Republic of Vietnam during the Vietnam War era 

or served in or near the demilitarization zone 

in Korea during the period September 1, 1967, 

through August 31, 1971. Payment is made 

at one of three levels based on the degree of 

disability suffered by the child.

	 •	 Children of female Vietnam veterans born

with certain defects. This program provides 

a monetary allowance, healthcare, and vocational training benefits to eligible children 

born to women who served in the Republic 

of Vietnam during the period beginning 

February 28, 1961, and ending May 7, 1975, if 

they suffer from certain covered birth defects 

associated with the service of the mother in 

Vietnam that result in permanent physical or 

mental disability.

Vocational Rehabilitation and Employment Program

The vocational rehabilitation and employment 

program helps veterans with service-connected disabilities prepare for, find, and keep suitable jobs. For 

veterans with service-connected disabilities so severe 

that they cannot immediately consider work, the program offers services to improve their ability to live as 

independently as possible. Vocational rehabilitation 

services include a vocational evaluation (ie, assessment of interests, aptitudes, and abilities); vocational 

counseling and planning; employment services (ie, 

job-seeking skills and job placement assistance); training for suitable employment; supportive rehabilitation 

services; and independent living services. Generally, 

a veteran must complete a program of rehabilitation 

services within 12 years from the date of VA notification of entitlement to compensation. This period may 

be deferred or extended if a medical condition prevents 

the veteran from pursuing rehabilitation services for a 

period of time, or if the veteran has a serious employment handicap.

The vocational rehabilitation and employment program can also provide a wide range of vocational and 

educational counseling services to service members 

still on active duty, as well as veterans and dependents 

who are eligible for one of VA’s educational benefit 

programs. These services are designed to help an individual choose a vocational direction and determine 

the course needed to achieve the goal. Assistance may 

include interest and aptitude testing, occupational exploration, setting occupational goals, locating the right 

type of training program, and exploring appropriate 

educational or training facilities.

Insurance Programs 

VA insurance programs were created to provide life 

insurance at a “standard” premium rate to members of 

the armed forces who are exposed to the extra hazards 

of military service. Service members may maintain 

their VA life insurance following discharge, regardless 

of their health, and special programs were established 

for veterans with service-connected disabilities that 

may make them otherwise uninsurable. In general, 

a new program was created for each wartime period 

since World War I. Seven distinct VA life insurance 

programs have been created by legislation, and four 

of these programs, as well as a program of traumatic 

injury coverage, still issue coverage. 

Servicemembers’ Group Life Insurance 

Servicemembers Group Life Insurance (SGLI) provides up to $400,000 of life insurance coverage to active 

duty members of the uniformed services, National 

Guard, Commissioned Corps of the National Oceanic 

and Atmospheric Administration, Public Health Service, and reserves and Reserve Officer Training Corps, 

as well as cadets and midshipmen of the four service 
80

Care of the Combat Amputee

academies and volunteers in the Individual Ready 

Reserve. In addition, all dependent children are automatically insured for $10,000 at no charge. 

Family Service Members’ Group Life Insurance

SGLI also offers insurance for up to $100,000 in 

coverage for a service member’s spouse, if the service 

member is on active duty or a reserve member of a 

uniformed service. All dependent children are automatically insured for $10,000 at no charge.

Veterans’ Group Life Insurance 

Individuals who separate from service with SGLI 

coverage to Veterans’ Group Life Insurance, regardless 

of health, by submitting an application with the first 

month’s premium within 120 days of discharge. After 

120 days, the individual may still be granted coverage 

if evidence of insurability is submitted within 1 year 

of the end of the 120-day period.

Service-Disabled Veterans Insurance 

A veteran who has a VA service-connected disability 

rating but is otherwise in good health may apply for life 

insurance coverage of up to $10,000 within 2 years of 

the date of notification by VA of the service-connected 

status. This insurance is limited to veterans who left 

service after April 24, 1951. Totally disabled veterans 

may apply for an additional $20,000 of coverage under 

this program.

Veterans’ Mortgage Life Insurance 

Mortgage life insurance protection for up to $90,000 

is available to severely disabled veterans who receive 

a specially adapted housing grant.

Service Members’ Traumatic Injury Protection 

This coverage program is a rider to basic SGLI coverage policies and provides automatic traumatic injury 

protection coverage to all service members covered 

under SGLI effective December 1, 2005. It provides for 

payments between $25,000 and $100,000 (depending 

on the type of injury) to insured SGLI members who 

sustain traumatic injuries that result in certain severe 

losses. The benefit paid depends on the nature of the 

loss, as defined by VA regulations. Benefits are also 

retroactive to October 7, 2001, if the loss was suffered 

while deployed outside the United States on orders in 

support of OEF/OIF or while on orders in a combat 

zone tax exclusion area from October 7, 2001, through 

November 30, 2005. 

Education Programs 

VA education programs provide veterans; active 

duty, reserve, and National Guard service members; 

and certain veterans’ dependents with educational 

resources to supplement opportunities missed 

because of military service and to assist in the readjustment to civilian life. Currently there are six 

education programs (details may be found at: www.

gibill.va.gov).

Post-Vietnam Era Veterans’ Educational Assistance 

Program

This program is available for eligible veterans 

who entered active duty between January 1, 1977, 

and June 30, 1985. Benefits and entitlement are determined by the contributions paid while on active 

duty, and veterans have 10 years after separation to 

use the benefit.

Montgomery GI Bill—Active Duty

The Montgomery GI Bill for active duty personnel is a program of education benefits that may be 

used while on active duty or after separation. There 

are several distinct eligibility categories. Generally a 

veteran receives 36 months of entitlement and has 10 

years after separation to use the benefit.

Post-9/11 GI Bill

A new benefit provides educational assistance to 

individuals who served on active duty on or after 

September 11, 2001. Service members may elect to 

receive benefits under the post-9/11 GI bill if, on 

August 1, 2009, they have met qualifying requirements; are eligible for Chapter 30, 1606, or 1607 of 

the Montgomery GI Bill (see below); or are serving 

in the armed forces. Eligibility for benefits are for 15 

years from the last period of active duty of at least 

90 consecutive days. Built into this new benefit is 

the opportunity for the service members to transfer 

benefits to their spouse or dependent children. The 

most current information can be found at: www.

gibill.va.gov.12

Montgomery GI Bill—Selected Reserve

This version of the GI Bill is available to members 

of the Selected Reserve. VA administers this program, 

but DoD determines the member’s eligibility. Generally a qualified member of the Reserve receives 36 

months of entitlement and has 14 years in which to 

use the benefit. 
81

Overview of the Department of Veterans Affairs

Reservists Educational Assistance Program 

This program funded and managed by DoD is 

available to members of the Selected or Ready Reserve 

who are called to active duty to support contingency 

operations. VA administers this program but DoD and 

the Department of Homeland Security determine the 

member’s eligibility. Generally a qualified individual 

receives 36 months of entitlement and is able to use 

the benefit as long as he or she remains in the Selected 

or Ready Reserve.

National Call to Service

This educational benefit program may be used while 

on active duty or after separation. The person must 

have enlisted on or after October 1, 2003, under the 

National Call to Service program and selected one of the 

two education incentives provided. These are either (1) 

education benefits of up to 12 months of GI Bill benefits 

(the 3-year rate) or (2) education benefits of up to 36 

months of the GI Bill benefits (half the 2-year rate).

Dependents Educational Assistance Program

This program assists dependents of veterans who 

(a) have been determined to be 100% permanently 

disabled because of a service-connected condition, (b) 

died from a service-connected condition, or (c) died 

while on active duty. Dependents typically receive 45 

months of eligibility. The criteria for using this benefit 

as follows:

	 •	 Children have 8 years to use this benefit.

	 •	 A spouse of a living veteran has 10 years to 

use this benefit.

	 •	 A surviving spouse of a veteran who died 

with a 100% service-connected condition has 

10 years to use this benefit.

	 •	 A surviving spouse of a veteran who died on 

active duty has 20 years to use this benefit.

Education benefits are available to children of active 

duty personnel who have served for at least 2 years 

and have contributed $1,200 under the Montgomery 

GI Bill (Chapter 30) or Selected Reserve and National 

Guards members certified as eligible under the Montgomery GI Bill—Selected Reserves (Chapter 1606). The 

Chapter 30 program is limited to payment for tuition 

and fees, and the Chapter 1606 program provides a 

monthly stipend. 

Loan Guaranty Program

The VA home loan guaranty program helps eligible 

veterans and service members purchase and retain 

homes, in recognition of their service to the nation. Assistance is provided through VA’s partial guaranty of loans 

made by private lenders in lieu of the substantial down 

payment and other investment safeguards required in 

conventional mortgage transactions. This protection 

means that in most cases qualified veterans can obtain 

a loan without making a down payment. Additionally, 

the program offers the benefits listed below.

Servicing Assistance 

The loan guaranty program provides help for 

borrowers having difficulty in making their loan 

payments. The assistance ranges from financial 

counseling to direct intervention with the lender to 

obtain forbearance or arrange a reasonable repayment 

schedule. Whenever possible, the goal is to help the 

veteran retain ownership of his or her home and avoid 

foreclosure. In instances where homeownership retention is not possible, several alternatives to foreclosure 

are available that can somewhat mitigate the negative 

impact on the borrower.

Specially Adapted Housing Grants

Veterans who have specific service-connected 

disabilities can obtain specially adapted housing 

grants for constructing an adapted dwelling or 

modifying an existing dwelling. The program’s 

goal is to provide disabled veterans a barrierfree living environment that affords a level of 

independent living not otherwise possible. The 

grant can be used up to three times, as long as 

the combined grant totals do not exceed the allowable grant maximum. Additionally, eligible 

veterans who are temporarily residing in a home 

owned by a family member may also use a portion of 

the grant maximum to assist in adapting the family 

member’s home to meet his or her special needs.

Native American Direct Home Loans 

These loans, made directly by the VA, are available 

to eligible Native American veterans who wish to purchase or construct a home on federal trust lands. 

Benefits for Active Duty Personnel

The VA has a variety of associated or similar benefits 

available to active duty personnel.

Insurance Benefits 

Service members and reserve forces are eligible for 
82

Care of the Combat Amputee

up to a maximum of $400,000 in SGLI. Spousal coverage is available up to a maximum of $100,000, and 

children are automatically covered for $10,000 at no 

cost. Any member of the uniformed services covered 

by SGLI is automatically covered by a traumatic injury 

protection rider, which provides payments of between 

$25,000 and $100,000 to members who have a traumatic 

injury and suffer losses such as, but not limited to, 

amputations, blindness, and paraplegia.

Home Loan Guaranty Benefits 

Persons on active duty are eligible for a VA home 

loan guaranty after serving on continuous active duty 

for 90 days. Service members going through the benefits delivery-at-discharge program who are found to 

have service-connected conditions are exempt from 

the loan guaranty funding fee.

Specially Adapted Housing Grants 

Certain service members as well as veterans with 

service-connected disabilities may be entitled to a 

specially adapted housing grant from VA to help build 

a new specially adapted house or buy a house and 

modify it to meet their disability-related requirements. 

Eligible individuals may now receive up to three 

grants, with the total dollar amount of the grants not 

to exceed the maximum allowable amount. Previous 

grant recipients who had received assistance of less 

than the current maximum allowable amount may be 

eligible for an additional grant.

Financial Assistance for Purchasing a Vehicle

Veterans and service members may be eligible for a 

one-time payment of not more than $11,000 toward the 

purchase of an automobile or other conveyance if they 

have service-connected loss or permanent loss of use 

of one or both hands or feet, permanent impairment 

of vision of both eyes to a certain degree, or ankylosis 

(immobility) of one or both knees or one or both hips. 

They may also be eligible for adaptive equipment, and 

for repair, replacement, or reinstallation required because of disability or for the safe operation of a vehicle 

purchased with VA assistance.

Healthcare Benefits

VA healthcare facilities are available to active duty 

service members in emergency situations and upon 

referral by military treatment facilities or TRICARE. VA 

provides a comprehensive medical benefits package 

to veterans enrolled in its healthcare program and is 

fully capable of meeting the treatment needs of those 

who are referred for care or who require emergency 

healthcare services. Service members may receive a 

one-time dental treatment up to 90 days from separation if they were not provided treatment within 90 days 

before separation from active duty. 

Medal of Honor Pension Payments

Active duty personnel who have been awarded the 

Medal of Honor and determined to be eligible by one 

of the service departments are entitled to receive a 

special Medal of Honor pension from the VA. 

Benefits Delivery at Discharge 

Through this program, service members can file claims 

for disability compensation, pension, vocational rehabilitation, automobile allowance, and specially adapted 

housing prior to separation. VA employees will assist in 

the filing and preparation of the claim as well as adjudicate the claim within days following separation. Additionally, VA offers counseling and claims assistance to 

separating service members throughout the United States 

and around the world through the transition assistance 

program and disabled transition assistance program.

Vocational Rehabilitation and Employment

Service members pending medical separation from 

active duty may also apply if their disabilities are reasonably expected to be rated at least 20% following 

discharge. These service members must be referred to 

a VBA coordinator for application assistance.

NATIONAL CEMETERY ADMINISTRATION

On November 11, 1998, President Bill Clinton signed 

the Veterans Programs Enhancement Act, changing the 

name of the National Cemetery System to the National 

Cemetery Administration (NCA). The NCA operates 

125 national cemeteries in the United States and territories, together with management of 33 soldiers’ lots, 

Confederate cemeteries, and monument sites. The mission of NCA is to honor US veterans with a final resting 

place and commemorate their service. This mission is 

accomplished through four major program areas:

1. Providing for the interment of eligible service 

members, veterans, reserve and National 

Guard members, and certain family members 
83

Overview of the Department of Veterans Affairs

establishing, expanding, or improving state 

veterans’ cemeteries that complement NCA. 

There are currently 65 state veterans’ cemeteries in 35 states throughout the nation, Guam, 

and Saipan. In FY 2006, 22,434 veterans and 

dependents were buried in these cemeteries.

4. Providing presidential memorial certificates 

to veterans’ loved ones to honor the service 

of honorably discharged deceased service 

members or veterans. In FY 2006, NCA issued 

405,538 certificates on behalf of the president. 

Today, more than 24 million veterans, reservists, and National Guard members with 20 

years of qualifying service (who are entitled 

to retirement pay or would be entitled, if at 

least 60 years of age), have earned the honor 

of burial in a national cemetery. Veterans with 

discharges other than dishonorable, their 

spouses, and dependent children may be 

eligible for burial in a VA national cemetery. 

Those who die on active duty may also be 

buried in a national cemetery.

in national cemeteries. A total of 96,797 veterans and eligible family members were buried 

in national cemeteries in FY 2006. More than 

3.2 million veterans, spouses, and dependents 

are buried in over 7,200 acres of NCA’s developed land. NCA maintains these cemeteries 

and memorials as national shrines.

2. Furnishing headstones and markers for the 

335,172 graves of veterans across the United 

States and the world. In national cemeteries, 

a headstone or marker is provided, including the cost of placement. The government 

does not provide for the cost of setting the 

headstone or marker in private cemeteries. 

3. Administering the state cemetery grants 

program, which provides financial assistance 

to states for establishing, expanding, and improving state veterans’ cemeteries. Since the 

program was established in 1978, 151 grants 

have been made, totaling over $264 million 

through FY 2006. The program provides 

federal funding for up to 100% of the cost of 

BENEFITS PROVIDED BY OTHER AGENCIES

Department of Agriculture Loans for Farms and 

Homes

The US Department of Agriculture provides loans 

and guarantees to buy, improve, or operate farms. 

Loans and guarantees are available for housing in 

towns generally up to 20,000 in population. Applications from veterans have preference. For further 

information, contact Farm Service Agency or Rural 

Development, US Department of Agriculture, 1400 

Independence Avenue, SW, Washington, DC 20250, 

or apply at local Department of Agriculture offices, 

usually located in county seats.

Housing and Urban Development Veteran Resource Center

US Department of Housing and Urban Development sponsors the Veteran Resource Center (HUDVET), which works with national veterans’ service 

organizations to serve as a general information center 

on all of the department’s housing and community 

development programs and services. To contact HUDVET, call 1-800-998-9999, TDD 800-483-2209, or visit 

the Web site: www.hud.gov/hudvet.

Naturalization Preference

Honorable active duty service in the US armed 

forces during a designated period of hostility allows an 

individual to naturalize without any required periods 

of residence or physical presence in the United States. A 

service member who was in the United States, certain 

territories, or aboard an American public vessel at the 

time of enlistment, reenlistment, extension of enlistment, or induction may naturalize even if he or she is 

not a lawful permanent resident.

On July 3, 2002, president George W Bush issued 

Executive Order 13269, establishing a new period of 

hostility for naturalization purposes beginning September 11, 2001, and continuing until a date designated 

by a future executive order. Qualifying members of the 

armed forces who have served at any time during a 

specified period of hostility may immediately apply for 

naturalization using the current form N-400, Application for Naturalization. Additional information about 

filing and requirement fees and designated periods of 

hostility are available on the US Citizenship and Immigration Services Web site: www.uscis.gov.

Individuals who served honorably in the US armed 

forces but were no longer on active duty status as of 

September 11, 2001, may still be naturalized without 

the usual residence and physical presence requirements if they filed form N-400 while still serving or 

within 6 months of termination of their active duty 

service. An individual who files the application after 

the 6-month period following termination of service is 

not exempt from the residence and physical presence 
84

Care of the Combat Amputee

requirements, but may count any period of active duty 

service toward the requirements. Individuals seeking 

naturalization under this provision must establish 

that they are lawful permanent residents (such status 

having not been lost, rescinded, or abandoned) and 

that they served honorably in the US armed forces for 

at least 1 year. 

If a service member dies as a result of injury or 

disease incurred or aggravated by service during a 

time of combat, the service member’s survivors can 

apply for the deceased service member to receive 

posthumous citizenship at any time within 2 years 

of death. The issuance of a posthumous certificate of 

citizenship does not confer US citizenship on surviving 

relatives; however, non-US citizen spouses or qualifying family members may file for certain immigration 

benefits and services based upon their relationship to 

a citizen service member who died during hostilities 

or a noncitizen service member who died during hostilities and was later granted posthumous citizenship 

(see www.uscis.gov for more information).

Small Business Administration Outreach to Veterans

The US Small Business Administration (SBA) 

Office of Veterans Business Development conducts 

comprehensive outreach to veterans, service-disabled 

veterans, and reserve component members of the US 

military. The office formulates, executes, and promotes policies and programs that provide assistance 

to veteran-owned small businesses. The SBA is the 

primary federal agency responsible for assisting veterans who own or are considering starting small businesses. The SBA also conducts research in veterans’ 

entrepreneurship.

Among the services provided are business counseling and training through five veterans’ outreach 

centers, more than 1,000 small business development 

centers, nearly 400 SCORE (Service Corps of Retired 

Executives) chapters with 11,000 volunteer counselors, 100 women’s business centers, and various loan 

and loan guarantee programs ranging from micro 

loans to venture capital assistance. A special military 

reservist economic injury disaster loan is available for 

self-employed reservists whose small businesses may 

have been damaged through extended absences of the 

owner or essential employee as a result of activation 

to military duty. Veterans participate in all SBA federal 

procurement programs, and the SBA supports veterans 

and others in international trade. A veterans’ business 

development officer is stationed at every SBA district 

office. Information about SBA’s full range of services 

can be found at: www.sba.gov/vets or by calling 

202-205-6773 or 1-800-U-ASK-SBA (1-800-827-5722). 

Information on programs for reservists is available at: 

www.sba.gov/reservists.

Social Security Administration Benefits for Veterans and Dependents

Monthly retirement, disability, and survivor benefits under Social Security are payable to veterans and 

dependents if the veteran has earned enough work 

credits under the program. Upon the veteran’s death, 

a one-time payment of $255 also may be made to the 

veteran’s spouse or child. In addition, a veteran may 

qualify at age 65 for Medicare’s hospital insurance and 

medical insurance. Medicare protection is available to 

people who have received Social Security disability 

benefits for 24 months, and to insured people and their 

dependents who need dialysis or kidney transplants, 

or who have amyotrophic lateral sclerosis (more commonly known as Lou Gehrig’s disease). Since 1957 

military service earnings for active duty (including 

active duty for training) have counted toward Social 

Security, and those earnings are already on Social Security records. Since 1988 inactive duty service in the 

reserve component (such as weekend drills) has also 

been covered by Social Security. Service members and 

veterans are credited with $300 in additional earnings 

for each calendar quarter in which they received active 

duty basic pay after 1956 and before 1978.

Veterans who served in the military from 1978 

through 2001 are credited with an additional $100 in 

earnings for each $300 in active duty basic pay, up 

to a maximum of $1,200 a year. No additional Social 

Security taxes are withheld from pay for these extra 

credits. If veterans enlisted after September 7, 1980, 

and completed less than 24 months of active duty or 

their full tour of duty, they may not be able to receive 

the additional earnings. Check with Social Security for 

details. Additional earnings are no longer credited for 

military service periods after 2001. Also, noncontributory Social Security earnings of $160 a month may be 

credited to veterans who served after September 15, 

1940, and before 1957, including attendance at service 

academies. For information, call 1-800-772-1213 or 

visit: www.socialsecurity.gov. (Note: Social Security 

cannot add these extra earnings to the record until an 

application is filed for Social Security benefits.)

Individuals age 65 or older and those who are blind 

or otherwise disabled may be eligible for monthly 

Supplemental Security Income payments if they 

have little or no income or resources. States may 

supplement the federal payments to eligible persons 

and may disregard additional income. Although VA 

compensation and pension benefits are counted in 

determining income for Supplemental Security In-
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Overview of the Department of Veterans Affairs

come purposes, some other income is not counted. 

Also, not all resources count in determining eligibility. For example, a person’s home and the land it is 

on do not count. Personal effects, household goods, 

automobiles, and life insurance may not count, depending upon their value. Information and help is 

available at any Social Security office or by calling 

1-800-772-1213.

Military service members can receive expedited 

processing of disability claims from Social Security. 

These claims are separate from VA claims and require 

separate application for benefits. This program is for 

military service members who become disabled while 

on active duty on or after October 1, 2001, regardless 

of disability location. Active duty status and receipt of 

military pay does not, in itself, prevent payment of disability benefits and should never stop a service member from making an application. The service member’s 

actual work activity, not the amount of pay or military 

status, is the determining factor for benefits. Disability 

benefits are disbursed through two programs: (1) the 

Social Security disability insurance program, which 

pays benefits to those who worked long enough and 

paid Social Security taxes; and (2) the Supplemental 

Security Income program, which pays benefits based 

on financial need. For additional information see the 

Web site: www.socialsecurity.gov.13

Armed Forces Retirement Home

Veterans are eligible to live in the Armed Forces 

Retirement Home located in Washington, DC, if their 

active duty military service is at least 5% enlisted, warrant officer, or limited duty officer, and if they qualify 

under one of the following four categories:

1. At least 60 years of age and were discharged 

or released under honorable conditions after 

20 or more years of active service.

2. Determined to be incapable of earning a 

livelihood because of a service-connected 

disability incurred in the line of duty.

3. Served in a war theater during a time of war 

declared by Congress or were eligible for 

hostile fire special pay and were discharged 

or released under honorable conditions, and 

are determined to be incapable of earning 

a livelihood because of injuries, disease, or 

disability.

4. Served in a women’s component of the 

armed forces before June 12, 1948, and are 

determined to be eligible for admission due 

to compelling personal circumstances. 

Eligibility determinations are based on rules 

prescribed by the home’s chief operating officer. 

Veterans are not eligible if they have been convicted 

of a felony or have alcohol, drug, or psychiatric 

problems. Married couples are welcome, but both 

must be eligible in their own right. At the time of 

admission, applicants must be capable of living independently. The Armed Forces Retirement Home 

is an independent federal agency. For information, 

call 1-800-332-3527 or 1-800-422-9988, or visit the 

Web site: www.afrh.gov.

Commissary and Exchange Privileges

Unlimited exchange and commissary store privileges in the United States are available to honorably 

discharged veterans with a service-connected disability rated at 100%, un-remarried surviving spouses 

of members or retired members of the armed forces, 

recipients of the Medal of Honor, and the dependents 

and orphans of any of these individuals. Certification 

of total disability is done by VA. Reservists and their 

dependents also may be eligible. Privileges overseas 

are governed by international law and are available 

only if agreed upon by the local government. Though 

these benefits are provided by DoD, VA does provide 

assistance in completing DD form 1172, Application 

for Uniformed Services Identification and Privilege 

Card. For detailed information, contact the nearest 

military installation.

WHAT EVERY VETERANS AFFAIRS BENEFICIARY NEEDS TO KNOW

1. Benefits are always changing and are based 

on a number of variables—type of discharge, 

length of service, dates of service, number of 

family members, degree of disability, legislative actions, combat service, just to name 

a few. “May be eligible” does not mean “is 

eligible.” Benefits can vary widely among 

beneficiaries.

2. VA beneficiaries must apply for VA benefits 

to receive benefits.

3. VA beneficiaries should not apply for benefits 

alone. Applying is easier when the beneficiary is accompanied by a family member, 

power of attorney, veteran representative, or 

legal representation. 

4. The following documents are needed for 

benefits application processing:

	 •	 A copy of DD form 214, Certificate of 
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Care of the Combat Amputee

directories under “Veteran Affairs.” 

O Contacting the VA liaison or VBA counselor colocated with the warrior transition unit’s case managers.

O Contacting a Vet Center.

6. State, local, and national veterans’ service 

organization representatives are available to 

assist with benefits counseling and claims 

processing. A list of such representatives can 

be found in the attachment to this chapter and 

online at: www.va/gov/vso.

7. The VHA (Veterans Health Administration) 

and VBA (Veterans Benefits Administration) 

are distinct, separate branches of the VA. 

These two VA branches engage in limited 

collaboration, interaction, and information 

exchange. Every step in the application 

process requires beneficiary action or oversight. Beneficiaries need to keep records of 

every action taken throughout the claim 

process; they should provide only copies of 

original documents (do not provide original 

documents unless absolutely required) and 

make a record of telephone contacts and 

personal visits, including date, time, name of 

VA employee and contact information, what 

transpired during the conversation or visit, 

follow-up action required, etc. 

8. The Veterans Claims Act of 2000 and Duty to 

Assist, requires the VA to obtain any records 

in the VA’s possession or within any other 

federal agency. The law also mandates that 

the VA tell the claimant what evidence is 

needed to support his or her claim. The VA 

now must make several efforts to obtain any 

evidence identified by the claimant. 

9. By law, the burden of proof falls on the veteran or dependent. Even though the VA is now 

required to look for evidence, the process may 

take many months. Veterans can help their 

claim and speed up the process if they can obtain supporting evidence such as the following: 

	 •	 personal statements, especially those of 

combat veterans claiming a “combatrelated” injury or illness; 

	 •	 statements from friends, relatives, or anyone who has knowledge of the veteran’s 

disability and its relationship to service; 

and

	 •	 medical evidence. 

However, any lay statements must fit certain 

criteria and are not always helpful. Some 

can be harmful to the veteran’s claim. The 

veteran should discuss any statements with 

Release or Discharge from Active duty, if 

available.

	 •	 VA claim number or Social Security 

number if receiving benefits under prior 

service.

	 •	 A copy of all marriage certificates or divorce decrees (if any).

	 •	 A copy of each child’s birth certificate (or 

adoption order).

	 •	 A copy of the beneficiary’s certificate if he 

or she has dependent parents.

	 •	 A copy of any service medical records substantiating disabilities for compensation for 

military service-related injuries.

	 •	 A completed VA form 21-526, Veterans 

Application for Compensation or Pension 

(an online version is available, and paper 

versions are available from any VA regional 

office).

	 •	 If applicable, combat operations documentation:

O copy of leave and earnings statement 

showing receipt of hostile fire or imminent danger pay,

O receipt of the Armed Forces Expeditionary Medal,

O receipt of the Kosovo Campaign Medal,

O receipt of the Global War on Terrorism 

Expeditionary Medal,

O receipt of the Southwest Asia Campaign 

Medal,

O proof of exemption of federal tax status 

for hostile fire or imminent danger pay,

O orders to a theater of combat operations, 

and

O copy of other awarded medals associated with the combat operations or 

operations involving imminent danger.

5. Application for health and other benefits can 

be done many ways:

	 •	 Online by accessing the VA Web site: www.

va.gov/1010EZ.htm.

	 •	 Using a paper version of VA form 10-10EZ, 

Application for Health Benefits. The form 

can be obtained several different ways: 

O Calling VA’s health benefits service center, toll free at 1-877-222-VETS (8387), 

Monday through Friday between 8:00 

am and 8:00 pm (Eastern Standard Time).

O Contacting any VA regional office at 

1-800-827-1000 from any location in the 

United States or Puerto Rico. VA facilities also are listed in the federal government section blue pages of the telephone 
87

Overview of the Department of Veterans Affairs

a veterans’ benefits counselor.

10. Although the VA strives for standardization, 

not all VA medical facilities and regional 

offices are alike. VA and DoD medical facilities are similar in that they have a degree of 

autonomy, as do the VA regional offices—

interpretation of regulations, policies, and 

procedures can vary from facility to facility, 

impacting beneficiary benefits. 

WHAT MILITARY HEALTHCARE PROVIDERS 

NEED TO KNOW

1. DoD healthcare providers cannot underestimate the importance of proper medical 

record documentation for service members 

wounded, injured, or sickened in the line of 

duty. The more “who, what, when, where, 

and how” is documented in the medical 

record, the better the supporting documentation the service member or veteran will 

be able to present when filing a claim. For 

combat injuries, the medical record should 

contain as much information about the details 

of the injury as possible, including the service 

member’s duty assignment, unit, location, 

name of witnesses, and other identifying 

information about the injury or illness and 

circumstances.

2. The partnership between DoD and VA will 

continue to strengthen over time. Providers 

must stay educated about VA benefits and 

develop professional relationships with VA 

personnel on the installation or assigned duty 

at the MTF.

3. It is better to refer service members, veterans, 

and other beneficiaries to VA personnel than 

to give out erroneous information about benefits.

4. States also provide veteran benefits, and 

benefits can vary from state to state.

5. Providers should learn the VA language, 

obtain copies of VA regulations governing 

disability rating, and write medical notes and 

reports in a manner that provides the necessary information for VA rating specialists to 

make appropriate rating decisions.

6. Key VA programs and personnel14:

	 •	 VHA facilities provide appropriate health

and mental healthcare services to active 

duty service members who served in OEF 

or OIF. Coordination of those services is to 

be ensured by the following personnel:

O OEF/OIF program manager, a designated nurse or social worker serving at

each VA medical center to coordinate 

care provided to OEF or OIF service 

members and veterans; functions as 

the facility’s point of contact for the VA 

liaisons at military treatment facilities. 

O OEF/OIF case managers, nurses and 

social workers at each VHA facility who 

work with those who are severelyinjured, ill, and otherwise in need of case 

management services. 

	 •	 Between three and eight transition patient advocates for OEF and OIF service 

members and veterans serve at each VISN. 

Although the positions are distributed 

to the VISN offices, the duty stations are 

at designated medical centers within the 

VISN. These positions are funded by the 

VA central office.

	 •	 The VA liaison, stationed at major MTFs 

nationwide, is considered the VHA representative to the military installation 

and represents the VA in all aspects of 

patient care, transfer, and outreach. The 

primary role of the VA liaison is to ensure 

the effective transfer of healthcare, both 

inpatient and outpatient, from the MTF to 

the appropriate VHA facility. The liaisons 

work with on-site staff, service members, 

and families to ensure priority access to 

needed healthcare services and education 

about VHA benefits. Service members 

returning from Iraq and Afghanistan may 

have severe and complex injuries, minor 

injuries, and/or mental health needs. VA 

liaisons obtain clear referral information 

and authorization for VHA to treat those 

still on active duty, as well as coordinating 

with VHA facility enrollment coordinators 

to initially register active duty OEF/OIF 

service members or enroll veterans. Registering service members in the computer 

system eases transfer of care to the VHA 

treatment facility. Although the liaisons 

report administratively to the VHA facility 

closest to the MTF, they report programmatically to the VHA Office of Care Management and Social Work. The VA liaison 

is an experienced clinical social worker, 

recognized as an independent practitioner 

who can demonstrate the ability to manage 
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Care of the Combat Amputee

and evaluate programs and policies.15

	 •	 VA rehabilitation nurses may be assigned 

duty at major MTFs. Nursing care in a 

rehabilitation setting focuses on helping 

individuals with impairments resulting 

from injuries, illness, or chronic disease 

reach their optimal level of health and function. Rehabilitation nurses have additional 

expertise in the sequelae and rehabilitation 

care of conditions such as amputation, 

brain injury, neuromuscular conditions, 

orthopaedic conditions, stroke, and visual 

impairment. As integral members of the 

patient’s management team, rehabilitation nurses carry out the rehabilitation 

plan of care 24 hours a day, 7 days a week. 

Rehabilitation nurses are also involved in 

educating the patient and caregivers to facilitate optimal transition to the next level 

of care. 

	 •	 VBA military service coordinators at key 

MTFs or VA medical facilities must meet 

with every injured OIF/OEF service member, when medically appropriate, to make 

them aware of all potential VA benefits 

and services, as well as other benefits and 

services available through other sources, 

and assist them in completing claims and 

gathering supporting evidence. Counselors 

must provide all their clients with a business card containing contact information, 

and routinely inform hospitalized service 

members about the status of their pending 

claims.7

	 •	 VBA OIF/OEF coordinators ensure that a 

liaison is established with military and VA 

medical facility staff, particularly discharge 

planners. For VBA outreach efforts and coordination to be effective, VBA must have 

access to admission and discharge information as seriously disabled service members 

are admitted, transferred to another medical facility, and finally released. VBA OIF/

OEF coordinators are responsible for the 

duties of the case manager if one has not 

been assigned.7

	 •	 VBA case managers work out of the VBA’s 

regional office as the primary VBA point 

of contact for claims processing. However, VBA counselors at the MTF may stay 

involved if the service member is still a 

patient at the facility. In those cases, coordination between the VBA counselor and 

case manager is essential. 

	 •	 Transition assistance advisors work in 

each state or territory as the statewide 

point of contact to assist service members 

in accessing VA benefits and healthcare 

services. Advisors also provide assistance in obtaining entitlements through 

the TRICARE military health system and 

access to community resources. Staffed 

by 55 contract positions and two federal 

technicians, this program began in May 

2005 with a memorandum of agreement 

between the National Guard Bureau and 

the VA. 

	 •	 The Army Medical Department VA polytrauma liaison program facilitates the 

continuity of care between MTFs and VA 

treatment facilities. The Army polytrauma 

liaison serves as the interface between case 

management and administrative matters, 

while functioning as the primary point 

of contact in the transition process for injured soldiers and their family members. 

The presence of a uniformed liaison is 

required to ensure that all the soldier’s 

needs, both clinical and administrative, are 

seamlessly addressed, retaining a military 

link and precluding potential feelings of 

abandonment during this critical transition 

period. Army liaisons should reach out to 

all soldiers in the VA treatment facilities. 

Liaisons are currently active in the four VA 

polytrauma centers listed below16: 

O Minneapolis VA Medical Center, Minnesota (geographic responsibility for Great 

Plains Regional Medical Command).

O Hunter Holmes McGuire VA Medical 

Center, Richmond, Virginia (geographic 

responsibility for North Atlantic Regional Medical Command).

O Palo Alto VA Medical Center, California 

(geographic responsibility for Western 

Regional Medical Command).

O James A Haley VA Hospital, Tampa, 

Florida (geographic responsibility for 

South East Regional Medical Command).

An additional polytrauma center is scheduled to 

open at the Audie Murphy VA Medical Center in San 

Antonio, Texas.
89

Overview of the Department of Veterans Affairs

This overview of the VA veterans’ benefits is intended to educate military healthcare providers to 

better care for and assist wounded, injured, and ill 

service members and their family members. Every 

person entering the armed forces must understand VA 

SUMMARY

REFERENCES

1. Department fact sheet. Department of Veterans Affairs Web site. Available at: http://www1.va.gov/opa/fact/index.

asp#health. Accessed November 1, 2007.

2. Office of Construction and Facilities Management: Historic Preservation. A brief history of the VA. Department of Veterans Affairs Web site. Available at: http://www.va.gov/facmgt/historic/Brief_VA_History.asp. Accessed November 

1, 2007. 

3. Department of Veterans Affairs. Federal Benefits for Veterans and Dependents. 2007 ed. Washington, DC: US Government 

Printing Office; 2007.

4. Department of Veterans Affairs. 2007 Organizational Briefing Book. Washington, DC: VA Office of Human Resources 

and Administration; 2007.

5. Department of Veterans Affairs, Office of Policy and Planning, National Center for Veteran Analysis and Statistics, VA 

Benefits & Health Care Utilization. Washington, DC: VA; 2008.

6. Department of Veterans Affairs. VA Web site. Available at: http://www.va.gov/. Accessed November 1, 2007.

7. Department of Veterans Affairs. Analysis of VA Healthcare Utilization Among US Global War on Terrorism (GWOT) Veterans: Operation Enduring Freedom, Operation Iraqi Freedom (OEF/OIF). Washington, DC: VHA Office of Public Health 

and Environmental Hazards; 2008. 

8. Fact sheet: VA long term care, January 2005. Department of Veterans Affairs Web site. Available at: http://www.va.gov.

Accessed November 1, 2007.

9. Department of Veterans Affairs Web site. VA health care overview. March 2008. Available at: http://www.va.gov/

healtheligibility/library/pubs/healthcareoverview/. Accessed October 14, 2008.

10. Department of Veterans Affairs. Notice of Privacy Practices. Washington, DC: VA: 2003. IB 10-163.

11. Veterans Benefits Administration. Department of Veterans Affairs Web site. Available at: http://www.vba.va.gov/

org/vbaorg.htm. Accessed November 1, 2007.

12. Department of Veterans Affairs. The Post-9/11 Veterans Education Assistance Act of 2008. Washington, DC: VA; 2008. 

Factsheet 22-08-01.

13. Social Security Administration. Disability Benefits for Wounded Warriors. Washington, DC: SSA; 2007. SSA Publication 

No. 05-10030.

14. Department of Veterans Affairs. Transition Assistance and Case Management of Operation Iraqi Freedom (OIF) and Operation 

Enduring Freedom (OEF) Veterans. Washington, DC: VA; 2007. VHA Handbook 1010.01.

15. Department of Veterans Affairs. Polytrauma Rehabilitation Procedures. Washington, DC: VA; 2005. VHA Handbook 

1172.1.

organization and the benefits they may become eligible 

for before and after separation or discharge. Additional 

details for benefits and services are available on the VA 

Web site: www.va.gov. The one constant factor about 

VA benefits is that benefits are constantly changing.
90

Care of the Combat Amputee

16. Office of the Surgeon General. AMEDD Veterans Affairs (VA) Liaison Program. Washington, DC: OTSG; 2006. OTSG/

MEDOM Memorandum Policy 06-03.
91

Overview of the Department of Veterans Affairs

ATTACHMENT: RESOURCES FOR VETERANS

Important Telephone Numbers

Program	 Phone Number

VA Benefits 1-800-827-1000

Health Care 1-877-222-8387

Education 1-888-442-4551

Life Insurance 1-800-669-8477

Debt Management 1-800-827-0648

Mammography Hotline 1-888-492-7844

Telecommunication Device for the Deaf (TDD) 1-800-829-4833

Civilian Health and Medical Program of the Department of

Veterans Affairs 1-800-733-8387

Headstones and Markers 1-800-697-6947

Special Health Issues: Gulf War, Agent Orange, Project 112/Shad 1-800-749-8387

Important Web Addresses

Activity Internet Address

VA Home Page http://www.va.gov

VA Health Care http://www.va.gov/health/

Returning Veterans http://www.seamlesstransition.va.gov/

Survivor Benefits http://www.vba.va.gov/survivors/index.htm

VA Facilities http://www.va.gov/directory/guide/home.asp

VA Forms http://www.va.gov/vaforms/

VA Benefit Payment Rates http://www.vba.va.gov/bln/21/Rates/

Education Benefits http://www.gibill.va.gov/

Home Loan Guaranty http://www.homeloans.va.gov/

Life Insurance http://www.insurance.va.gov/

Vocational Rehabilitation http://www.vba.va.gov/bln/vre/index.htm

Burial and Memorial Benefits http://www.cem.va.gov/

Veterans Employment and Training http://www.dol.gov/vets/

Federal Jobs http://www.usajobs.opm.gov/

Veterans Preference http://www.opm.gov/veterans/index.asp

Military Records http://www.archives.gov/st-louis/military-personnel/

Department of Defense http://www.defenselink.mil/

Organizations Chartered by Congress or Recognized by Veterans Affairs for Claim Representation

Air Force Sergeants Association 

American Defenders of Bataan and Corregidor 

American Ex-Prisoners of War 

American GI Forum of the United States 

American Gold Star Mothers, Inc. 

American Legion 

American Red Cross 

American War Mothers 

AMVETS 

Armed Forces Services Corporation 

Army and Navy Union, USA, Inc 

Blinded Veterans Association 

Blue Star Mothers of America, Inc 

Catholic War Veterans, USA, Inc 

Congressional Medal of Honor Society of the United 

States of America 

Disabled American Veterans 

Fleet Reserve Association 

Gold Star Wives of America, Inc 

Italian American War Veterans of the USA 

Jewish War Veterans of the USA 

Legion of Valor of the USA, Inc 

Marine Corps League 

Military Chaplains Association of the United States of 

America 

Military Order of the Purple Heart of the USA, Inc 

Military Order of the World Wars 

National Amputation Foundation, Inc 
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Care of the Combat Amputee

National Association for Black Veterans, Inc 

National Association of County Veterans Service Officers, Inc 

National Association of State Directors of Veterans Affairs (NASDVA) 

National Veterans Legal Services Program 

Navy Club of the United States of America 

Navy Mutual Aid Association 

Non Commissioned Officers Association 

Paralyzed Veterans of America 

Pearl Harbor Survivors Association, Inc. 

Polish Legion of American Veterans, USA 

Swords to Plowshares: Veterans Rights Organization 

The Retired Enlisted Association 

United Spinal Association 

US Submarine Veterans of World War II 

Veterans Assistance Foundation, Inc 

Veterans of Foreign Wars of the United States 

Veterans of the Vietnam War, Inc/Vets Coalition 

Veterans of World War I of the USA, Inc 

Vietnam Veterans of America 

Women’s Army Corps Veterans Association

Nonchartered Veterans Service Organizations

African American Veterans and Families 

Air Force Association 

Air Force Women Officers Association 

Air Warrior Courage Foundation, Inc 

All Faith Consortium 

Alliance of Women Veterans 

Americal Division Veterans Association 

American Coalition for Filipino Veterans 

American Merchant Marine Veterans 

American Military Retirees Association 

American Military Society 

American Retiree Association 

American Veterans Alliance, Inc 

American Veterans for Equal Rights Inc 

American Volunteer Reserve 

American WWII Orphans Network (AWON) 

Arab American War Veterans, Inc 

Army Aviation Association of America 

Asian American Veterans Association 

Association for Service Disabled Veterans 

Association of Ex-POW of the Korean War, Inc 

Association of Military Surgeons (AMSUS) 

Association of the 199th Light Infantry Brigade 

Association of the US Army, USA 

Association of Veterans Education Certifying Office 

Blinded American Veterans Foundation 

Bureau of Maine Veterans Services 

BVL Fund—Bowlers Serving America’s Veterans 

China Burma India Veterans Association, Inc 

Cold War Veterans Association 

Combined National Veterans Association of America 

Congressional Black Caucus Veterans Braintrust 

Chief Warrant Officer & Warrant Officer (CWO&WO) 

Association US Coast Guard 

Daughters of Union Veterans of the Civil War 

Destroyer Escort Sailors Association 

Eighth Air Force Historical Society 

Enlisted Association of the National Guard of the US 

Florida Department of Veterans Affairs 

Help Hospitalized Veterans 

Hispanic War Veterans of America 

Homeless & Disabled Veterans 

Japanese American Veterans Association 

Japanese American Veterans Counsel 

Korea Veterans of America 

Korean Defense Veterans of America 

Korean Ex-Prisoners of War 

Korean War Veterans Association of the USA, Inc 

Marine Corps Reserve Association 

Military Justice Clinic, Inc 

Military Officers Association of America 

Vietnam Era Prisoners of War (NAM-POWS), Inc 

National 4th Infantry (IVY) Division Association 

National Academy for Veterans Service Officers 

National Alliance for the Mentally Ill 

National American Indian Veterans 

National Association for Society of Military Widow 

National Association for Uniformed Services 

National Association of American Veterans, Inc 

National Association of Atomic Veterans 

National Association of Black Military Women 

(NABMW) 

National Association of Concerned Veterans 

National Association of Fleet Tug Sailors, Inc 

National Association of Radiation Survivors 

National Association of State Veterans Homes 

National Association of State Women Veterans Coordinators 

National Association of Veterans Program Administrators 

National Coalition for Homeless Veterans 

National Congress of Puerto Rican Veterans, Inc 

National Guard Association of the United States 

National Gulf War Resource Center, Inc 

National League of Families of American Prisoners and 

Missing in Southeast Asia

National Military Family Association 

National Order of Battlefield Commissions 

National Society Daughters of the American Revolution 

National Society of New England Women 

National Veterans Business Development Corporation 

National Veterans Foundation 

National Vietnam Veterans Coalition 

Naval Enlisted Reserve Association 

Naval Reserve Association 

Navy League of the United States 

Navy Nurse Corps Association 

Navy Seabee Veterans of America 

New Era Veterans, Inc (registered in NY and PA) 
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Overview of the Department of Veterans Affairs

Office of Strategic Services (OSS)- 101 Veterans Association, (The American-Kachin Rangers”

P-38 (The Flying Bulls) National Association 

Reserve Officers Association of the United States 

Second Airborne Ranger Association, Inc 

Supreme Headquarters Allied Expeditionary Force 

(SHAEF)/European Theater of Operations, United 

States Army (Etousa) Veterans Association 

Society of Military Widows 

The 2nd Airborne Ranger Association, Inc 

The Center for Internee Rights, Inc 

The Chosen Few 

The Forty & Eight 

The National Veterans Organization of America 

The Red River Valley Fighter Pilot 

The Women Marines Association 

Thailand, Laos, Cambodia (TLC) Brotherhood, Inc 

Tragedy Assistance Program for Survivors, Inc 

US Merchant Marine Veterans of World War II 

US Navy Veterans Association 

United States Ship (USS) LSM-LSMR Association 

United Armed Forces Association 

United States Army Warrant Officers Association 

United States Federation of Korea Veterans Organization 

United States Merchant Marine Veterans of WWII 

United States Merchant Marine Veterans of WWII 

United States Navy Cruiser Sailors Association 

United States Navy Veterans Association 

United States Submarine Veterans, Inc 

United States Volunteers 

United States Coast Guard (USCG) Chief Petty Officers 

Association 

Veterans and Military Families for Progress 

Veterans Leadership Program of Western PA 

Veterans of America 

Veterans of the Battle of the Bulge 

Veterans United for a Strong America 

Veterans‘ Widows/ers International Network, Inc 

Vietnam Veterans Institute 

Vietnam Veterans Memorial Fund 

Vietnam Women’s Memorial Foundation, Inc 

Women Accepted for Volunteer Emergency Services 

(WAVES) National 

Women Airforce Service Pilots of World War II 

Women In Military Service for America Memorial 

Women’s Overseas Service League
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Care of the Combat Amputee