Source: http://whatwouldadogdo.blogspot.com/2012_09_01_archive.html
Timestamp: 2017-05-28 08:25:33
Document Index: 76444890

Matched Legal Cases: ['art 17', 'art 70', 'art 17', 'art 17', 'art 17', 'art 17', 'art 17', 'art 70', 'art 70']

What Would A Dog Do: September 2012 What Would A Dog Do skip to main |
Boots And Barkley American Beef Bully Sticks Recall
Kasel Associated Industries Recalls Boots & Barkley American BeefBully sticks Because of Possible Salmonella Health Risk
Kasel Associated Industries of Denver, CO is voluntarily recalling its BOOTS & BARKLEY 6 COUNT 5 INCH AMERICAN BEEF BULLY STICKS product because it may be contaminated with Salmonella. Salmonella can sicken animals that eat these products and humans are at risk for salmonella poisoning from handling contaminated pet products, especially if they have not thoroughly washed their hands after having contact with the pet products or any surfaces exposed to these products.Healthy people infected with Salmonella should monitor themselves for some or all of the following symptoms: nausea, vomiting, diarrhea or bloody diarrhea, abdominal cramping and fever. Rarely, Salmonella can result in more serious ailments, including arterial infections, endocarditis, arthritis, muscle pain, eye irritation, and urinary tract symptoms. Consumers exhibiting these symptoms after having contact with this product should contact their healthcare providers.Pets with Salmonella infections may be lethargic and have diarrhea or bloody diarrhea, fever, and vomiting. Some pets will have only decreased appetite, fever and abdominal pain. Infected but otherwise healthy pets can be carriers and infect other animals or humans. If your pet has consumed the recalled product and has any of these signs, please contact your veterinarian.The recalled American Beef Bully Sticks were distributed nationwide through Target retail stores from April through September 2012.The product comes in a clear plastic bag containing 6 bully sticks marked with bar code number 647263899189. Kasel Industries is recalling all lot numbers because the following lot codes tested positive through analysis by the State of Colorado Department of Agriculture: BESTBY20APR2014DEN, BESTBY01JUN2014DEN, BESTBY23JUN2014DEN, and BESTBY23SEP2014DEN.No illnesses have been reported to date in animals or humans in connection with this problem.The recall was the result of a routine sampling by the State of Colorado Department of Agriculture which revealed that the finished products contained the Salmonella bacteria. The company has ceased the production and distribution of the product while FDA and the company continue investigating as to the source of the contamination. No other products made by Kasel Associated Industries are included in the recall.Consumers who have purchased the 6 count 5 inch packages of Boots & Barkley American Beef Bully Sticks are urged to return it to the place of purchase for a full refund. Consumers with questions may contact Kasel Associated Industries at 1-800-218-4417 Monday thru Friday from 7am to 5pm MDT. Posted by
So Which Dog Are You Going To Vote For In The 2012 Hero Dog Awards
Kristin Chenoweth To Host 2012 Hero Dog Awards Airing On Hallmark Channel November 8, 2012 Emmy and Tony Award Winner to Lead Star-Studded Evening Honoring Courageous Canines
Hallmark Channel and American Humane Association announced today that popular television, film and Broadway star Kristin Chenoweth will host the 2012 American Humane Association Hero Dog Awards™, a star-studded evening honoring America's most courageous canines. The Hero Dog Awards, which are presented by the Lois Pope LIFE Foundation and produced by Emmy® award-winning MRB Productions, will air as a 90-minute special on Hallmark Channel November 8, 2012 at 8:00 pm ET/PT. The program will air as part of Hallmark Channel's Pet Project, the network's cross-platform campaign designed to celebrate the joy and enrichment animals bring to our lives.
"I am thrilled and honored to be a part of this unique program with American Humane Association," says Chenoweth, a passionate advocate for animals who founded her own charity, Maddie's Corner, to benefit shelter pets. "I was a judge at last year's Hero Dog Awards and am delighted to host the best and most heartwarming animal show on television."
"Kristin Chenoweth is one of my personal heroes," says American Humane Association President and CEO Dr. Robin Ganzert. "Not only is she a tremendous talent, beloved by millions of her stage, screen, and television fans, but she has a heart of gold when it comes to animal advocacy. As host for the top animal awards show in the country, she will help us capture the hearts of the nation and bring major support to the lifesaving programs that make a difference for millions of children and animals each year. She is a true heroine to them and America's noble hero dogs!"
"Kristin Chenoweth is an extremely talented and beloved stage and television personality, as well as a passionate advocate for the welfare of animals — making her the perfect choice for host of the 2012 'Hero Dog Awards,'" says Bill Abbott, President & CEO, Crown Media Family Networks. "Kristin will bring her signature warmth, compassion, and off-beat comedy to this year's show and I am positively delighted to welcome her to Hallmark Channel where she is sure to be a huge hit with our audience." Chenoweth joins a roster of celebrity supporters of the Hero Dog Awards, including special honoree Betty White, red carpet host Joey Lawrence and celebrity judges Whoopi Goldberg, Victoria Stilwell, Candy Spelling, Miranda Lambert, Kristin Bauer Van Straten, Michelle Forbes, J.R. Martinez, Tinsley Mortimer, and Megyn Price, among many others.
Two Million Ballots Cast for Nominees
Following nationwide voting in which more than two million ballots were cast by the American public, eight remarkable finalists were chosen, one winner in each of the following categories: "Jynx" for Law Enforcement/Arson Dogs; "Holly" for Service Dogs; "Stella" for Therapy Dogs; "Gabe" for Military Dogs; "Tabitha" for Guide Dogs; "Soot" for Search and Rescue Dogs; "Tatiana II" for Hearing Dogs, and "Daniel" for Emerging Hero Dogs (ordinary dogs who do extraordinary things). These eight finalists will be flown to Beverly Hills with their human handlers, where they will walk the red carpet and be presented with a special Hero Dog award, following moving video tributes that bring their stories to life. The evening will be capped off when one of the eight finalists will be announced as the winning American Hero Dog of the year.
Voting is currently underway at www.herodogawards.org, where a full list of the eight category winners, along with a summary of each dog's poignant story, can be found. Special thanks to MRB Productions for sponsoring the Hearing Dog category, Pfizer Animal Health for the Therapy Dog category, State Farm for the Law Enforcement/Arson Dog category and Trupanion for the Service Dog category. Flying the heroes and their human handlers is JetBlue, and the airline's JetPaws program, the official airline of the American Humane Association Hero Dog Awards.
Emmy and Tony Award winner Kristin Chenoweth is an accomplished singer and actress of stage, television and film. She recently completed a North American concert tour featuring music from her latest album, "Some Lessons Learned," as well as an array of her most memorable songs and Broadway show tunes. She is known for her Tony Award-nominated turn as the original "Glinda," the good witch, in Broadway's "Wicked" and her show-stealing, Tony-winning performance in "You're a Good Man, Charlie Brown." She has received two Emmy Award nominations for her role as "April Rhodes" on the hit series GLEE. She won an Emmy for her role as "Olive Snook" on "Pushing Daisies." She also starred in "GCB" and will next be seen on "The Good Wife."
Read The FDA Report On Jerky Pet Treats Made In China
FDA Investigates Animal Illnesses Linked to Jerky Pet Treats
What is the issue?Since 2007, the FDA has become aware of increasing numbers of illnesses in pets associated with the consumption of jerky pet treats. The majority of complaints involve chicken jerky (treats, tenders, and strips), but others include duck, sweet potato, and treats where chicken or duck jerky is wrapped around dried fruits, sweet potatoes, or yams.
The FDA has received approximately 2,200 reports of pet illnesses which may be related to consumption of the jerky treats. The majority of the complaints involve dogs, but cats also have been affected. Over the past 18 months the reports have contained information on 360 canine deaths and one feline death. There does not appear to be a geographic pattern to the case reports. Cases have been reported from all 50 states and 6 Canadian provinces in the past 18 months.
Although the FDA has been actively investigating the reports of illnesses, no definitive cause has been determined. The ongoing global investigation is complex, multifaceted and includes a wide variety of experts at the FDA including toxicologists, epidemiologists, veterinary researchers, forensic chemists, microbiologists, field investigators and senior agency officials. In the past 10 years, there has been a dramatic increase in importation of pet food from China. Human consumption of poultry in China largely consists of dark meat, leaving a large amount of light meat poultry products available for export. From 2003, when China first approached the USDA about poultry exports, to 2011, the volume of pet food exports (regulated by the FDA) to the United States from
China has grown 85-fold (see table). It is estimated that nearly 86 million pounds of pet food came from China in 2011. Pet treats, including jerky pet treats are currently considered the fastest growing segment in the pet food market. What are the signs of the illnesses?The majority of the cases in dogs report primarily gastrointestinal signs, including vomiting and diarrhea, sometimes with blood and/or mucus, and can involve severe signs such as pancreatitis or gastrointestinal bleeding. The next most common signs relate to kidney function, including frequent urination, increased urine, severe thirst, kidney failure and some cases resemble a rare kidney related illness called Fanconi’s syndrome. Typically Fanconi syndrome is found in certain breeds of dogs that are pre-disposed to hereditary Fanconi syndrome (e.g. Basenji).
Progression of the investigation: What is being done about the problem? Since 2007, the FDA has been actively investigating the cause of illnesses reported in pets which may be associated with the consumption of jerky pet treat products. Beginning in 2007, samples of products – collected at import, at retail stores, and submitted by consumers and veterinarians -- have been tested by FDA laboratories, by the Veterinary Laboratory Response Network (Vet-LRN), and by other animal health diagnostic laboratories in the United States for multiple chemical and microbiological contaminants. The Vet-LRN program is currently focused on testing products that have been submitted by pet owners whose pets have experienced adverse effects following ingestion of the treats. In addition, starting in 2007, the FDA reached out through the veterinary community to solicit tissue samples (blood, urine, feces, necropsy, etc.) that have been associated with active jerky pet treat cases, but to date; none of the testing results have revealed the cause of the illnesses.
To date, product samples have been tested for contaminants known to cause the symptoms and illnesses reported in pets including, Salmonella, metals, furans, pesticides, antibiotics, mycotoxins, rodenticides, nephrotoxins (such as aristolochic acid, maleic acid, paraquat, ethylene glycol, diethylene glycol, toxic hydrocarbons, melamine, and related triazines) and were screened for other chemicals and poisonous compounds. DNA verification was conducted on these samples to confirm the presence of poultry in the treats. The FDA’s testing of jerky treat product samples for toxic metals including tests for heavy metals have been negative.
In 2011, samples were also submitted for nutritional composition, including fatty acids, crude fiber, glycerol, protein, ash and moisture and other excess nutrients. The purpose of nutritional composition testing is to verify the presence of ingredients listed on the label. To date, none of the testing results have revealed an association between a causative agent and the reported illnesses.
The FDA is now expanding its testing to include irradiation byproducts and is consulting with the National Aeronautics and Space Administration (NASA) experts to discuss this possibility further. After increased complaints began in 2011, the FDA conducted five plant inspections in China during March and April 2012. These firms were selected for inspection because the jerky products they manufacture were identified with some of the highest numbers of pet illness reports. The FDA conducted the inspections to get a greater understanding of the manufacturing processes used to make the jerky pet treats and to see if this would help further the public health investigation. The FDA did identify that one firm falsified receiving documents for glycerin, which is an ingredient in most jerky pet treats. As a result of the inspection, the Chinese authority, the Administration of Quality Supervision, Inspection and Quarantine (AQSIQ), informed the FDA that it seized products at that firm and suspended exports of its products until corrective actions were taken by the firm.
The FDA has also reached out to U.S. pet food firms to enlist their help in this public health investigation and is seeking further collaboration on scientific issues and data sharing. No specific products have been recalled. However, if the FDA identifies the cause, or a recall is initiated, the Agency will notify the public.
What can pet owners do?The FDA is reminding pet owners that jerky pet treats are not necessary for pets to have a fully balanced diet, so eliminating them will not harm pets. Commercially produced pet food, which is very safe, contains all of the nutrients that pets need.
The FDA is advising pet owners who choose to feed their pets jerky pet treat products to watch their pets closely for any or all of the following signs that may occur within hours to days of feeding the products: decreased appetite; decreased activity; vomiting; diarrhea, sometimes with blood; increased water consumption and/or increased urination. If your pet shows any of these signs, stop feeding the jerky pet treat product. Owners should consult their veterinarian if signs are severe or persist for more than 24 hours, as it is important that your pet receive prompt medical attention. Blood tests may indicate kidney failure (increased urea nitrogen and creatinine). Urine tests may indicate Fanconi syndrome (increased glucose). Although most pets appear to recover, some reports to the FDA have involved pets that have died.
In addition, pet owners may want to continue to monitor information as it is posted by the FDA. The agency has continually updated the Questions & Answers document1 on its web site and will add information as it becomes available.
How can you help our investigation?
While your veterinarian will tend to your pet’s condition, you or your veterinarian can learn how to help the FDA’s Center for Veterinary Medicine (CVM) investigate your pet’s illness. Dr. Bernadette Dunham, director of CVM, shares how you can report a pet food illness on her blog2 from August 21, 2012. Cases of animal illness associated with pet foods can be reported electronically through the Safety Reporting Portal3, or by calling the FDA Consumer Complaint Coordinators in your state.
The information in this update reflects the FDA’s best efforts to communicate what it has learned from the manufacturer and the state and local public health agencies involved in the investigation. The agency will update the public as more information becomes available. I don't know abouut you, but I wouldn't by any type of pet food from China for any of my pets.
Breeder's Choice Pet Food Recall
Breeder's Choice Pet Food Recalls AvoDerm Natural Lamb Meal & Brown Rice Adult Dog Formula Because of Possible Salmonella Health Risk
Breeder’s Choice Pet Food is recalling a single manufacturing batch of Breeder's Choice AvoDerm Natural Lamb Meal & Brown Rice Adult Dog Formula due to possible contamination with Salmonella. The product affected by this recall is identified below and has the following "Best Before" dates:
Product Code/SKU/ Material #UPC CodeSizeProduct Name/DescriptionBest Before Code (day/month/yr)
10000650740 5290702043 826 lb.AvoDerm Natural Lamb Meal & Brown Rice Adult Dog Formula28 Aug 201329 Aug 201330 Aug 2013
Healthy people exposed to Salmonella should monitor themselves for some or all of the following symptoms: nausea, vomiting, diarrhea or bloody diarrhea, abdominal cramping and fever. Rarely, Salmonella can result in more serious ailments, including arterial infections, endocarditis, arthritis, muscle pain, eye irritation, and urinary tract symptoms. Consumers exhibiting these signs after having contact with this product should contact their healthcare providers.
No human or pet illnesses have been reported to-date. The recall notification is being issued based on a single manufacturing batch wherein a sample with the "Best Before" dates of August 28, 29 and 30, 2012 had a positive result for salmonella. The AvoDerm Natural Lamb Meal & Brown Rice Adult Dog Formula product was originally manufactured on August 29, 2012 and distributed on August 30 and 31, 2012. Salmonella testing was conducted by Silliker, Inc. (Southern California Laboratory). Breeder's Choice Pet Foods has taken immediate action to remove the product from all applicable distribution centers and retail customers, and is fully investigating the cause.
Recalled products were distributed to retailers and distributors in the states of California, Georgia, Illinois, Nevada, Virginia, and Washington.
Consumers who have purchased the AvoDerm Natural Lamb Meal & Brown Rice Adult Dog Formula product with the above-referenced "Best Before" dates are urged to contact Breeder's Choice Customer Service representatives.
A letter and instructions have been forwarded to all Breeder’s Choice Pet Food customers. Breeder’s Choice Customer Service representatives and company veterinarians are responding to inquires through the 1-866-500-6286 phone number and will answer any questions regarding pets that have been fed the product. Pet owners can also visit the Breeder’s Choice Pet Food website for more information http://www.avoderm.com/. Contact:
1-866-500-6286
So How Are The Special K-9 Elite Force Dogs Trained
Nat Geo WILD Greenlights 16-part Series "Alpha Dogs" From Executive Producers Jack Osbourne and Rob Worsoff Series Will Go Inside the Training of a Special K-9 Elite Force Dedicated to Serving Our Country
Nat Geo WILD Executive Vice President and General ManagerGeoff Daniels announced today that the network has greenlit the 16-part series Alpha Dogs, which follows the training behind a special elite force of K-9s dedicated to serving our country. Executive produced by Jack Osbourne and Rob Worsoff of Schweet Entertainment, LLC, each 30-minute episode gains exclusive access to the kennels and trainers at Indiana's Vohne Liche Kennels, one of the largest police-dog training facilities in the country.
The Alpha Dogs have jumped out of helicopters to capture Osama Bin Laden and have tracked Saddam Hussein. They're in police departments, the Secret Service and every branch of the military. Now Nat Geo WILD follows their stories — from first bite to finding the bomb.
"Alpha Dogs will focus on these highly trained dog heroes that have muscle and smarts," says Daniels. "Our viewers will love to see the incredible drills and exercises the dogs undergo, follow the instruction process with their dedicated trainers who carry top security clearances, see the application in the field for military and police units, and even watch the fun they have playing fetch on their days off."
Osbourne added, "We are excited to partner with Nat Geo WILD on this project and show everything from examining how the dogs are trained to detect drugs, weapons and improvised explosive devices to finding a hidden cell phone in a prison cell, to focusing on other real-world situations in everyday communities."
Alpha Dogs is produced for Nat Geo WILD by Schweet Entertainment, LLC. For Schweet Entertainment, LLC, executive producers are Jack Osbourne and Rob Worsoff. For Nat Geo WILD, executive producers are J-T Ladt and Ashley Hoppin, senior vice president of development and production is Janet Han Vissering, and executive vice president and general manager is Geoff Daniels.
About Nat Geo WILDFor more than 30 years, National Geographic has been the leader in wildlife programming. The networks Nat Geo WILD andNat Geo WILD HD, launched in 2010, offer intimate encounters with nature's ferocious fighters and gentle creatures of land, sea and air that draw upon the cutting-edge work of the many explorers, filmmakers and scientists of the National Geographic Society. Part of the National Geographic Channels US, based in Washington, D.C., the networks are a joint venture between National Geographic and Fox Cable Networks. In 2001, National Geographic Channel (NGC) debuted, and 10 years later, Spanish-language network Nat Geo Mundo was unveiled. The Channels have carriage with all of the nation's major cable, telco and satellite television providers, with Nat Geo WILD currently available in 56 million U.S. homes. Globally, Nat Geo WILD is available in more than 100 million homes in 90 countries and 28 languages. For more information, visit www.natgeowild.com.
Department of Veterans Affairs Final Rule On Service Dogs for Veterans
Register Volume 77, Number 172 (Wednesday, September 5, 2012)]
[Rules
and Regulations]
[Pages
54368-54382]
the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc
No: 2012-21784
2900-AN51
The Department of Veterans Affairs (VA) amends its regulations concerning
veterans in need of service dogs. Under this final rule, VA will
provide to veterans with visual, hearing, or mobility impairments benefits
to support the use of a service dog as part of the management of such
impairments. The benefits include assistance with veterinary care,
travel benefits associated with obtaining and training a dog, and the
provision, maintenance, and replacement of hardware required for the dog
to perform the tasks necessary to assist such veterans.
Effective Date: This rule is effective October 5, 2012.
FURTHER INFORMATION CONTACT: Lynnette Nilan, RN, MN, Patient Care Services,
(10P4), Veterans Health Administration, Department of Veterans
Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (406) 422-4476.
(This is not a toll free number.)
INFORMATION: On June 16, 2011, VA published in the Federal
Register (76 FR 35162) a proposed rule to amend VA regulations to
broaden and clarify current benefits to veterans with guide dogs, and to
establish new benefits related to service dogs. Pursuant to 38 U.S.C.
1714(b) and (c), VA may provide to veterans enrolled under 38 U.S.C.
1705 guide dogs trained for the aid of people who are blind and service
dogs trained for the aid of the hearing impaired or persons with a
spinal cord injury or dysfunction or other chronic impairment that
substantially limits mobility. Under section 1714(d), VA is also authorized
to provide certain travel expenses related to the provision of such
In 1961, VA promulgated 38 CFR 17.118(a)
(recodified as current 38 CFR
17.154(a) in 1996) restating the statutory language, which at that time
limited VA's authority to the provision of guide dogs for blind veterans.
In 2001, Congress amended section 1714 to authorize VA to provide
service dogs for veterans with other disabilities. See Department
of Veterans Affairs Health Care Programs Enhancement Act of 2001,
Public Law 107-135, title II, Sec. 201.
This rule implements that
authority and establishes a single regulation relating to the provision
of guide and service dog benefits by VA.
Interested persons were invited to submit
comments to the proposed rule on
or before August 15, 2011, and we received 98 comments. All of the
issues raised by the commenters that concerned at least one portion of the
54369]]
can be grouped together by similar topic, and we have organized our
discussion of the comments accordingly. For the reasons set forth in the
proposed rule and below, we are adopting the proposed rule as final,
with changes, explained below, to proposed Sec. 17.148(b)(2), (d),
(d)(1)(ii), and (d)(3) and Sec. 17.154.
of ``Service Dogs''
Section 17.148(a) defines ``service dogs''
as ``guide or service dogs
prescribed for a disabled veteran under [Sec. 17.148].'' Multiple commenters
argued that this definition is circular, and further contended
that the omission of mental health impairments in Sec. 17.148(b)(1)
violates basic protections set forth in regulations implementing
the Americans with Disabilities Act of 1990 (ADA). See 28 CFR
36.104 (specifically recognizing service dogs trained to assist individuals
with mental impairments and defining ``service animal'' to mean
``any dog that is individually trained to do work or perform tasks for the
benefit of an individual with a disability, including a physical,
sensory, psychiatric, intellectual, or other mental disability'').
These commenters advocated that VA should use the definition
of ``service animal'' set forth in the regulations implementing
the ADA. We make no changes based on these comments.
The requirements in the ADA and regulations
implementing the ADA are
applicable only to ``public entities,'' and Federal Government agencies
such as VA are not included in the ADA definition of a public entity.
See 42 U.S.C. 12131(1). Thus, the specific requirements set forth
in the ADA are not applicable to VA. Although this does not prevent
VA from adopting, through regulation, a definition of ``service animal''
consistent with 28 CFR 36.104, it would be inappropriate to do so for
the purposes of the programs regulated by this rule. The ADA and its
implementing regulations exclusively address the issue of access to public
facilities by individuals with disabilities, whereas the purpose of this
rule is to authorize benefits to a veteran with a service dog. Access
is not discussed in Sec. 17.148 or
Sec. 17.154. Conversely, the ADA
and its implementing regulations are neither controlling nor informative
with regard to the administration of benefits to veterans with
service dogs. The definition of ``service dogs'' in Sec. 17.148(a)
is reasonable because it is not overly broad for the purpose of the
rule, and is appropriate to effectuate Congressional intent. Cf. 38
U.S.C. 1714(c) (providing authority for 38 CFR 17.148 and authorizing
VA to ``provide service dogs trained for the aid of'' those veterans
with hearing impairments, mobility impairments, etc., but not addressing
access to VA facilities by persons accompanied by service dogs).
The concerns from commenters were that Sec. 17.148 ``reinvents the
wheel'' by establishing a new definition for a term that is already defined
in Federal regulation, and further that Sec. 17.148 was unlawful
under such regulation. However, as discussed above, the ADA definition
of ``service animal'' is not applicable, and also is not helpful
in determining the circumstances under which VA will provide the
benefits described in Sec. 17.148.
Commenters asserted that VA should use the
term ``assistance animal''
instead of ``service dog'' because, they assert, the term ``service
dog'' is understood more narrowly in the service dog industry to refer
only to those dogs that assist with mobility impairments, whereas
Sec. 17.148(a) defines ``service dogs''
to mean dogs that aid with
mobility impairments, visual impairments, and hearing impairments. By
contrast, commenters stated that ``assistance animal'' is an industry
term that encompasses dogs that assist with mobility, visual, and
hearing impairments, and in turn should be used by VA in Sec. 17.148(a).
We make no changes based on these comments.
We disagree that every person in the service
dog industry would understand
what an ``assistance animal'' is in the way described by the commenter.
Moreover, our regulations are written for a broader audience than
those who may own or train service dogs, to include VA employees who
administer benefits in accordance with our regulations. We believe that
``assistance animal'' in fact could be interpreted to have multiple
colloquial meanings, and specifically may be likely to suggest that VA
will provide benefits for animals other than dogs. We do not believe,
as suggested by commenters, that our use of the term ``service dogs''
to encompass guide dogs for visual impairments and service dogs for
hearing and mobility impairments would confuse veterans seeking benefits
under the rule. Most importantly, Sec. 17.148(a) clearly defines
the term and states that the definition therein applies ``[f]or the
purposes of'' Sec. 17.148. In applying
for this benefit, veterans would
be expected to understand that the regulatory definition applies, and not
any other definition that may be set forth elsewhere or understood
in common parlance.
Rule Does Not Deny Access of Any Service Dog to VA Health Care Facilities
Multiple commenters contended that the
certificate requirement in Sec. 17.148(c)(1) as proposed would violate their
access rights under the
regulations implementing the ADA. See 28 CFR 36.302 (stating that ``[a]
public accommodation shall not require documentation, such as proof
that the animal has been certified, trained, or licensed as a service
animal''). We reiterate that this rulemaking does not address the
issue of access to VA health care facilities by individuals accompanied
by service dogs, and will not be used to determine whether a
particular service dog will be allowed to enter a VA facility. Comments
that allege unlawful violations of access rights or raise other
issues relating to access to VA facilities, therefore, are beyond the
scope of this rule. Therefore, we make no changes based on these comments.
A certificate is required under Sec. 17.148(c)(1) only to enable
the veteran to receive service dog benefits, but is not required to gain
entry to VA facilities. This rulemaking does not permit or prohibit
the access of service dogs to VA health care facilities.
Access to VA facilities by service dogs
accompanying individuals with
disabilities is controlled by 40 U.S.C. 3103, which states: ``Guide
dogs or other service animals accompanying individuals with disabilities
and especially trained and educated for that purpose shall be
admitted to any building or other property owned or controlled by the
Federal Government on the same terms and conditions, and subject to the
same regulations, as generally govern the admission of the public to the
property.'' 40 U.S.C. 3103(a). The VA regulation that currently controls
the access of animals to VA facilities is found at 38 CFR 1.218(a)(11),
and we are in the process of amending Sec. 1.218(a)(11) to be
fully compliant with 40 U.S.C. 3103(a).
Exclusion of Benefits for Mental Health Service Dogs Is Not Unlawful
Multiple commenters asserted that the
exclusion of benefits to mental
health service dogs is unlawfully discriminatory because it creates
a different standard for treatment options between those veterans
with mental health impairments and those veterans without mental
health impairments. One commenter specifically alleged that not providing
benefits for service dogs that mitigate the effects of mental health
illnesses, while providing benefits for service dogs that mitigate
54370]]
impairments, may be a violation of Section 504 of the Rehabilitation
Act (Section 504). Section 504 provides:
No otherwise qualified individual with a
disability in the United
States, as defined in section 705(20) of this title, shall, solely
by reason of her or his disability, be excluded from the participation
in, be denied the benefits of, or be subjected to discrimination
under any program or activity receiving Federal financial
assistance or under any program or activity conducted by any
Executive agency or by the United States Postal Service.
U.S.C. 794(a).
We agree that the benefits administered
under this rule are subject to
Section 504, but disagree that not providing benefits for mental health
service dogs violates Section 504. VA is not restricting service dog
benefits based on disability. VA is providing benefits to both physically
and mentally disabled veterans for the same purpose, which is to
provide assistance for the use of a particular device (a service dog) when
a service dog is clinically determined to be the optimal device
to help a veteran manage a visual impairment, a hearing impairment,
or a chronic impairment that substantially limits mobility. All
veterans will receive equal consideration for benefits administered for
these service dogs, provided all other criteria in Sec. 17.148 are met,
regardless of accompanying mental health diagnosis. Veterans diagnosed
with a hearing or visual impairment will certainly not be deemed
ineligible for service dog benefits because they also have a mental
health impairment. We also note that mobility impairments under Sec. 17.148 are not specifically limited to
traumatic brain injuries or
seizure disorders in Sec. 17.148(b)(3).
Some commenters misinterpreted
the rule to contain such a limitation and argued that other
mental impairment may produce mobility impairment. To clarify, if a
veteran's mental impairment manifests in symptoms that meet the definition
of ``chronic impairment that substantially limits mobility'' in
Sec. 17.148(b)(3) and a service dog is
clinically determined to be the
optimal device to manage that mobility impairment, then such a veteran
will be awarded service dog benefits. The rule does not prevent such
individualized assessments of veterans with mental health impairments,
as long as the service dog would be evaluated as a device to
mitigate the effects of a visual, hearing, or mobility impairment. If this
requirement is met, VA would not deny service dog benefits simply
because the service dog may also assist with mental impairment that
does not cause a limitation identified in Sec. 17.148(b).
The rule prevents the administration of
benefits for a dog to mitigate
the effects of a mental illness that are not related to visual,
hearing, or mobility impairments, but this restriction is not discriminating
based on the fact that a veteran has a mental disability.
This restriction is based on a lack of evidence to support a
finding of mental health service dog efficacy. In contrast, VA's shared
national experience has been to directly observe positive clinical
outcomes related to the use of service dogs and increased mobility
and independent completion of activities for veterans with visual,
hearing, and mobility impairments. Our observations are bolstered
by the existence of nationally established, widely accepted training
protocols for such dogs that enable the dogs to perform a variety
of tasks directly related to mitigating sensory and mobility impairments
(such as alerting to noise, opening doors, turning on light switches,
retrieving the telephone, picking up objects, etc.). We are unaware
of similarly vetted and accepted training protocols for mental health
service dogs, or how assistance from such dogs could be consistently
helpful for veterans to mitigate mental health impairments.
Although we do not disagree with some
commenters' subjective accounts
that mental health service dogs have improved the quality of their
lives, VA has not yet been able to determine that these dogs provide
a medical benefit to veterans with mental illness. Until such a determination
can be made, VA cannot justify providing benefits for mental
health service dogs.
Several commenters asserted that limiting
Sec. 17.148 to veterans diagnosed
as having visual, hearing, or substantial mobility impairments
violates 38 U.S.C. 1714, which was amended in 2009 to authorize
VA to provide ``service dogs trained for the aid of persons with
mental illnesses, including post-traumatic stress disorder, to veterans
with such illnesses who are enrolled under section 1705 of this
title.'' 38 U.S.C. 1714(c)(3). Though multiple commenters stressed that
this rule's exclusion of mental health service dogs violates 38 U.S.C.
1714(c)(3), we reiterate as stated in the proposed rule that under
the statutory language VA may provide or furnish a guide dog to a veteran
but we are not required to do so. See 38 U.S.C. 1714 (c)(1)-(3) (noting
that ``[t]he Secretary may, in accordance with the priority specified
in section 1705 of this title, provide'' [service dogs]). As we
explained in the proposed rule, this rulemaking expands part 17 of 38 CFR,
which already addressed guide dogs for the blind, to now authorize
benefits for hearing disabled and substantially mobility impaired
veterans, because we have an adequate basis of clinical experience
and evidence to suggest service dog efficacy for veterans with
these impairments. Therefore, we make no changes based on the above
Exclusion of Benefits for Mental Health Service Dogs Is Not Unreasonable
Commenters contended that VA is acting
against its own practices in administering
benefits by requiring completion of a congressionally mandated
service dog study prior to determining whether to administer mental
health service dog benefits. Commenters asserted that while most VA
regulations only rely on medical judgment or medical need to justify the
provision of medical benefits, in this instance VA is without reason
requiring a higher standard of clinical evidence. As stated by one
VA's position that it can only act here in
accord with a solid scientific
evidence base is not in accord with its own practice. In most
instances involving medical benefits, VA regulations rely simply
on medical judgment, ``medical need,'' or a determination that
providing the service is ``necessary.''
This is not an accurate statement. Current
VA regulations do not discuss
whether there is evidence to support the provision of a particular
therapy or treatment method, but this does not support the inference
that our regulations discount the need for evidence to support
the provision of such therapy or treatment. Indeed, if we ultimately
determine that mental health dogs are appropriate treatment tools
for mental health impairments, we will amend our regulations to authorize
benefits for such dogs. VA is currently evaluating the efficacy
of mental health service dogs, pursuant to the National Defense
Authorization Act for Fiscal Year 2010, Public Law 111-84, Sec. 1077(a) (2009) (the NDAA), which states that
``the Secretary of Veterans
Affairs shall commence a three-year study to assess the benefits,
feasibility, and advisability of using service dogs for the treatment
or rehabilitation of veterans with physical or mental injuries
or disabilities, including post-traumatic stress disorder.'' All
participants in this study are veterans with mental health disabilities
who are receiving service dog benefits similar to those described
in this rulemaking, but the service dogs for these veterans assist
specifically with the effects of mental illness.
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the NDAA provided that effectiveness of dogs for physical disabilities
could additionally be evaluated in the study, we have chosen
to limit this study's focus to mental health disabilities. However,
we do not believe this limitation supports commenters' assertions
that VA is creating an unreasonable double standard with regard
to the need for clinical evidence, prior to administering benefits
for mental health service dogs. The NDAA study is limited to veterans
with mental health illness because VA has already determined from a
clinical standpoint that service dogs are effective for assisting
veterans with physical disabilities and mobility impairments. Moreover,
we believe that the use of the word ``or'' in the NDAA makes the
focus of the service dog study discretionary, and further that Congress
clearly intended that VA must specifically evaluate the efficacy
of mental health service dogs: ``The Secretary shall ensure that at
least half of the participants in the study are veterans who suffer
primarily from a mental health injury or disability.'' Public Law
111-84, Sec. 1077(c)(4). There is no
similar criterion in the law to
compel that any portion of the participants must be veterans who suffer
primarily from a physical injury or disability.
Though many commenters asserted that there
is sufficient clinical evidence
that VA could presently use to support administering mental health
service dog benefits, the only evidence submitted in support of this
assertion were anecdotal accounts of subjective benefits, including:
Decreased dependence on medications; increased sense of safety
or decreased sense of hyper-vigilance; increased sense of calm; and the
use of the dog as a physical buffer to keep others at a comfortable
distance. Again, we do not discount commenters' personal experiences,
but we cannot reasonably use these subjective accounts as a basis
for the administration of VA benefits. This is the precise reason
VA is currently gathering evidence in the NDAA study--to determine
how, exactly, service dogs may perform specific tasks or work that
mitigates the effects of mental health disabilities.
Finally, we respond to multiple commenters'
concerns with the manner
in which VA is currently conducting the mandatory NDAA study. Essentially,
these commenters stated that VA's conducting of the study is
unreasonable because either the methodology is flawed, or VA's service
dog organization partners in the study are inappropriate. Particularly,
commenters alleged that VA has partnered exclusively with Assistance
Dogs International (ADI) and ADI-accredited organizations in conducting
the study, and further that ADI is not a proponent of psychiatric
service dogs; such commenters accused VA of making adverse determinations
regarding the efficacy of mental health service dogs before
the study is complete. Generally, we find these comments to be beyond
the scope of this rule, because VA is not basing any decisions in this
rulemaking on any outcomes of the mandatory study, as the study has not
yet been completed. However, we will note that VA has not partnered
exclusively with ADI or ADI-accredited organizations to conduct
the mandatory study. All relevant Federal requirements concerning
research studies were followed by VA as relates to this study;
an abstract of the study to include listed eligibility and exclusion
parameters is available for public viewing at http://clinicaltrials.gov/ct2/show/study/NCT01329341.
Therefore, we make no changes
based on the above comments.
Dogs Must Be Certified by ADI or International Guide Dog Federation
(IGDF) for Veterans With Visual, Hearing, or Substantial Mobility
Impairments To Receive Benefits
Multiple commenters argued that VA should
remove the requirement in Sec. 17.148(c) as proposed that a service dog
complete ADI training and be
ADI certified before a veteran with a substantial mobility impairment
can begin receiving benefits under Sec. 17.148(d). These commenters
put forth many reasons in support of removing this requirement,
which we will specifically address in the following discussion.
We make no changes to the rule based on these comments. In administering
service dog benefits, VA must ensure that tested and proven
criteria regarding service dog training and behavior are in place
to ensure the integrity of the service dog benefits administered, and the
safety of veterans and others who might come in contact with the
veteran or the dog. There are no Federal standards for service dog training
that we can apply, and VA does not have the expertise to design
its own accreditation program or standards. ADI and IGDF are national,
industry-recognized organizations with established and proven training
criteria. Commenters offered many anecdotal observations concerning
the quality and reliability of non-ADI organizations to train
service dogs, but no commenters offered concrete, supportive evidence
to persuade us that there are any organizations other than ADI or IGDF
that have an established history and national credibility such that
they should be recognized in Sec. 17.148(c).
The reliance on ADI and IGDF accreditation
is no different than our reliance
on other nationally standardized criteria to ensure safe, high quality
health care across all settings. For instance, VA relies on the Centers
for Medicare and Medicaid Services (CMS) Resident Assessment Instrument/Minimum
Data Set as the comprehensive assessment for all veterans
in VA Community Living Centers (long term care facilities). See
Veterans Health Administration (VHA) Directive 2008-007. In addition,
VA requires States to rely on this tool for veterans in State homes receiving
per diem payments from VA for the provision of nursing home
care. See 38 CFR 51.110(b)(1)(i). Similarly, VA relies on and enforces
by regulation National Fire Protection Association (NFPA) safety
standards in all VA community residential care facilities, contract
facilities for outpatient and residential treatment services for
veterans with alcohol or drug dependence or abuse disabilities, and State
homes. See 38 CFR 17.63, 17.81(a)(1), 17.82(a)(1), and 59.130(d)(1).
We rely on various private, State, and local certifications
concerning professional expertise. See, e.g., 38 CFR 3.352(b)
(predicating aid and attendance allowance on need for care from
health-care professional licensed to practice by a State or political
subdivision thereof), Sec. 17.81(a)(3)
(conditioning VA authority
to contract with residential treatment facilities that are ``licensed
under State or local authority''), Sec. 17.900 (recognizing certification
of health care providers issued by, inter alia, The Joint Commission
as well as specified government organizations including CMS).
Thus, VA reliance on the recognized expertise of a public or private
organization is not uncommon, nor is it illegal or questionable,
so long as the basis for the reliance is well-reasoned and
Despite the negative comments that asserted
that ADI is an inefficient
organization or is inadequate in some respects, other commenters
recognized that there are no other national organizations that
perform a similar function, and that there are very few individuals
who can accurately assess the quality of a service dog's training.
Some commenters praised ADI, stating that ADI certification is
``the best route to go'' and that the requirement will ensure that VA is
not paying for dogs of ``questionable value to our vet[eran]s.'' If at
some point in the future we discover an efficient way to assess the
quality of training provided by non-ADI
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non-IGDF dog providers, we will of course amend the rule; however, at this
time, ADI and IGDF accreditation is the best guarantee we have that
our veterans will be provided with safe, high quality service dogs.
We now specifically address comments that
requiring certification from an
ADI-accredited organization effectively creates a sole source contract,
in violation of the general requirement for open and fair competition
in Federal Acquisition Regulations. See 48 CFR 6.101. Multiple
commenters further alleged that Sec. 17.148(c) as proposed would
violate a ``performance-based'' assessment requirement under Federal
Acquisition Regulations for service contracts, because it emphasizes
the source of service dog training rather than the result of that
training. See 48 CFR 37.600 et seq. Without discussing under what circumstances
VA may be permitted to enter into sole source contracts, we
clarify for commenters that VA is not contracting with ADI or IGDF generally
or with any ADI-accredited or IGDF-accredited organization to purchase
service dogs for veterans under this rule. There is no fiscal conflict
of interest or violation of Federal Acquisition Regulations because
the rule does not authorize any financial arrangement whatsoever
with ADI or IGDF.
Multiple commenters stated that the ADI
limitation in Sec. 17.148(c)
is inefficient and ineffective for veterans by asserting that,
compared to non-ADI organizations: There are not enough ADI-
organizations around the United States to meet veteran demand
for service dogs; the cost to purchase ADI-certified service dogs is
prohibitive; and the wait to receive a service dog from an ADI-
organization is too long. We make no changes based on these comments.
We acknowledge that not all States have
registered ADI-accredited or
IGDF-accredited organizations; however, Sec. 17.148(d)(3) does provide
for the reimbursement of travel expenses associated with the training
a veteran must complete as offered by an ADI-accredited or IGDF-accredited
organization. Therefore, there will be no out of pocket travel
costs for veterans who must travel out of state to obtain a dog after a
service dog is prescribed. Thus, we do not believe the absence of
ADI-accredited or IGDF-accredited organizations in a particular State
will serve as a barrier to obtaining a service dog.
Regarding the cost to obtain a service dog,
we did not receive any concrete
evidence from commenters that non-ADI accredited or non-IGDF accredited
organizations are on average less expensive. Rather, commenters
offered anecdotal claims that non accredited organizations are
less expensive in some cases. A few commenters asserted that non-
accredited and non-IGDF accredited providers have less overhead costs
because those organizations do not have to spend money to acquire or
maintain accreditation. The ADI accreditation fee is $1000.00 paid every 5
years, with annual fees of approximately $50.00. The cost of IGDF
accreditation is a one-time fee of $795, with an annual fee of $318
and a per unit fee of $39.45. We do not believe that these costs would
necessitate an increased cost being passed to veterans specifically.
ADI accreditation and IGDF accreditation are the only reasonable
means we have of ensuring that an organization is using tested,
standardized training and behavior criteria prior to a service dog
being placed with a veteran. We view the cost of ADI and IGDF accreditation,
therefore, as necessary and reasonable in order to ensure
that we administer benefits in a safe and consistent manner. We clarify
for one commenter that VA only intends to recognize those service
dog organizations that have full membership in ADI or IGDF, or that
are fully ADI or IGDF accredited, versus those organizations in the
process of becoming ADI or IGDF accredited. This is consistent with our
goal of ensuring VA only administers benefits for use of high quality
service dogs that were subject to standardized training protocols.
Regarding the wait time to obtain a dog,
commenters did not provide evidence
to support that on average ADI-accredited organizations take longer
than non-ADI accredited organizations to place service dogs with veterans.
Many commenters instead provided anecdotal accounts of non-
organizations not utilizing ADI-specific training, and in turn training
dogs faster than ADI organizations. Non-ADI organizations that facilitate
``owner training'' were especially noted by commenters as being
faster and more effective for veterans, whereby the veteran would directly
train the service dog. Again, we do not believe that we should administer
benefits under the rule unless we can ensure that the service
dogs for which we pay benefits are all subject to the same set of
tested standards, to ensure safety and consistent quality. We do not believe
this level of safety and quality can be met without accreditation
based on nationally applicable criteria. This practice follows
the same process VA uses with every other product, device, or treatment
modality provided to our veterans.
Some commenters argued that VA could use
other nationally recognized,
performance based tests instead of requiring ADI certification
to demonstrate that service dogs are safe and appropriately
trained to mitigate effects of substantial mobility impairments.
These commenters stated that submission to VA of a service dog's
performance on a Public Access Test (PAT) or the American Kennel Club's
Canine Good Citizen (CGC) test, in combination with statements indicating
the level of the service dog's training and confirming the dog's
good health, would provide sufficient objective evidence that service
dogs are suitable for provision of benefits under the rule. Nationally
recognized temperament tests such as a PAT or the CGC may indicate
whether a service dog is stable and unobtrusive to the public to
justify access (and, again, Sec. 17.148
does not concern access), but
these tests do not communicate the level of a service dog's specific
training, or whether the service dog should be prescribed for a
veteran as an assistive device. An accompanying statement submitted to VA
that subjectively attests to a service dog's training is similarly
inadequate, as VA seeks to administer benefits uniformly under
the rule and therefore must ensure that all service dogs are subject
to the same performance based standards. We make no changes based
on these comments.
One commenter expressed support of VA's
decision to specifically include
seizure disorder as a covered impairment, and requested that VA more
clearly indicate in the final rule which tasks a service dog may complete
for such an eligible veteran. We reiterate that we require ADI and
IGDF certification specifically because VA does not have the expertise,
experience, or resources to develop independent criteria. For
this reason, we make no changes to the rule to provide specific examples
of tasks which any service dog may perform for a veteran. ADI has
developed training protocols for service dogs to complete work and tasks
for impairments as described in the rule, to include seizure disorders.
Finally, multiple commenters contended that
VA could adopt independent
training programs to internally produce service dogs for veterans,
versus relying on certificates from external ADI-accredited service
dog organizations. One commenter stated that VA should initiate an
independent training program whereby veterans with post traumatic stress
54373]]
(PTSD) participate in training service dogs for the intended beneficiaries
of this rule, i.e., veterans with visual, hearing, or substantial
mobility impairments. This commenter compared such an internal
training program to a program developed by the Denver VA Medical
Center and Denver VA Regional Office in 2009, called ``Operation
Freedom,'' in which veterans assisted in advancing dogs through
CGC test training for 6 weeks as a component of the veterans' mental
health treatment plans. After completion of this 6 week basic obedience
training program, the dogs were trained by an external ADI-
organization in a rigorous 7 month regimen to become service dogs,
and were placed with other veterans with disabilities. The initial
pairing of the dogs with veterans during basic obedience training,
as a treatment modality for mental health illnesses, provided those
veterans with opportunities in skills development and community reintegration.
Particularly, the program provided a bridge to community involvement
through a meaningful volunteer opportunity that served other
Though VA is not opposed to such training
opportunities as a component
of a treatment plan for a particular veteran, Operation Freedom
is not an example of an independent and internal training program
to train or produce service dogs for veterans. As the commenter correctly
stated, the dogs involved in Operation Freedom were actually trained
to become service dogs by an external ADI-accredited organization,
over an extended period of time and subject to ADI standards
as adopted and applied by that organization. We additionally clarify
that even the initial basic obedience training that veterans assisted
in providing to dogs was not provided on VA property, but rather
on the property of the ADI-accredited organization, because the goal of
Operation Freedom was to provide community reintegration opportunities
for participating veterans as part of those veterans' treatment
plans. The goal of Operation Freedom was ultimately not to produce
service dogs for veterans, and we therefore do not find this example
as provided by the commenter to be illustrative as to what VA should
enact with regards to independent and internal service dog training
programs. As stated previously, because VA does not have the expertise,
experience, or resources to develop independent training criteria
or otherwise train or produce service dogs for veterans, we require
that service dogs be trained and placed with veterans by ADI-
and IGDF-accredited organizations. However, this in no way limits
any veteran's personal choice to undertake any training experiences
with any service dog organization, nor does it prevent VA from
conducting programs similar to Operation Freedom. The commenter also
noted potential cost savings for VA to conduct internal service dog
training programs that employ PTSD veterans, but as explained earlier
VA is not purchasing service dogs from ADI-accredited or IGDF-
organizations, and such cost comparisons are therefore not relevant.
We make no changes based on the above comments.
One additional commenter suggested that
instead of requiring ADI certification,
that VA should hire professional service dog trainers to join
rehabilitation therapy departments (e.g., to join Occupational and Physical
Therapy departments) as VA staff, and that this would enable VA to
professionally train service dogs at a higher output and with less
cost than paying for ADI-certified service dogs. We make no changes
based on this comment, as such cost considerations are not relevant
because VA is not purchasing service dogs. VA does not have the
expertise, experience, or resources to develop independent training criteria,
and VA will not adopt or initiate internal training programs, as this
would effectively make VA act as a professional service dog certifying
body. VA's lack of expertise in this area is exactly why we have
mandated ADI or IGDF certification.
Qualify for Benefits, a Service Dog Must Be ``Optimal'' for the Veteran
Under Sec. 17.148(b)(2), we require that the service dog must be the
``optimal'' device for the veteran to manage his or her impairment and
live independently, and service dog benefits will not be provided if
other assistive means or devices would provide the same level of independence
as a service dog. Several commenters asserted that the use of one
assistive device does not necessarily obviate the need for other assistive
devices, and therefore that Sec. 17.148(c) as proposed should
not be used to exclude the prescription of a service dog if other
devices may assist the veteran. We agree in part with the comments,
but make no change to the regulation because the regulation does
not prevent veterans from using multiple assistive devices.
For purposes of Sec. 17.148(b)(2), an eligible veteran may be prescribed
both a service dog and another assistive device, as long as each
provides a distinct type of assistance, or if, without each of the devices,
the veteran would be unable to complete tasks independently. For
instance, for a veteran with a mobility impairment that is characterized
by loss of balance and subsequent falls, both a balance cane
and a service dog might assist a veteran with balance and walking; the
cane might be optimal for assistance with walking, but the service dog may
be the optimal means for that veteran to regain a standing position
and stabilize after a fall. In such a case, the service dog may be
prescribed to the veteran, as well as the balance cane. Similarly,
a veteran with multiple impairments may be prescribed assistive
devices to assist with one impairment and a service dog to assist
with another. The ``optimal'' limitation in Sec. 17.148(b)(2) will
not limit the prescription of a service dog when necessary for the veteran
to manage the impairment and live independently, but it will prevent
the provision by VA of multiple assistive devices that serve the
same purpose. By avoiding duplication of benefits in this manner, we
maximize the amount of resources available to veterans and ensure that
benefits are provided in a responsible manner.
Commenters stated that the ``optimal''
criterion in Sec. 17.148(b)(2)
as proposed would be used to ensure that service dogs are prescribed
as assistive devices only as a ``last resort.'' A service dog is
not a ``last resort'' in the sense inferred by the commenters. VA will
not use the ``optimal'' requirement in such a way as to deprive any
veteran of an assistive device that would best mitigate the effects of a
veteran's impairment and provide the veteran the highest level of independence.
The rule is designed, however, to promote the use of service
dogs only when it is clinically determined that other devices will
not adequately enable the veteran to live independently. This rationale
of promoting service dogs secondary to other assistive devices
is not without reason. A service dog is a long term commitment that
requires tremendous dedication and effort on the part of the veteran,
as well as significant costs--only part of which would be paid for by
VA under Sec. 17.148. A service dog must
be fed, exercised, groomed,
nursed when ill, and integrated into the veteran's family as a necessary
partner in the veteran's daily life. If the extent of the veteran's
mobility impairment is such that the only tasks requiring assistance
are picking up or reaching items, then a device that is not a
service dog that fully accomplishes these tasks is not only sufficient,
but also is not unduly burdensome for the veteran. We
54374]]
changes based on these comments.
Commenters argued that the rule should
contain additional criteria that
would objectively measure a veteran's level of independence between
different devices, instead of the single ``optimal'' criterion. We
believe, however, that because these are clinical determinations based
on ``medical judgment'' under Sec. 17.148(b)(2), additional criteria
are unnecessary and unhelpful. Therefore, we make no changes based
on these comments. It is clear in Sec. 17.148(b)(2) that devices,
including a service dog, will be clinically evaluated to determine
which are necessary and most beneficial for the veteran to manage
an impairment and live independently. We stressed the importance of this
clinical determination in the proposed rule:
VA does not intend to allow cost or any
other factors to discourage
the use of new technologies and equipment to maximize the independence
of veterans. We believe that providing VA with discretion
to choose between a service dog or assistive technology based
on medical judgment rather than cost-effectiveness would ensure
that VA's patients receive the highest quality of care that the
VA-system can provide.
76 FR
One commenter additionally noted that the
above rationale from the proposed
rule presumed that higher cost technologies offer a higher standard
of care. We clarify that the intent of this rationale was to support
VA's use of clinical judgment to determine what device allows the
veteran to function most independently, and not have such a determination
influenced by factors such as cost.
Some commenters asserted that while another
device may provide the exact
same functions in mitigating the effects of mobility impairments as a
service dog, service dogs nonetheless should be considered optimal and be
prescribed because they uniquely provide certain ancillary benefits,
including: Subjective feelings of increased personal comfort and
understanding; an increased sense of purpose for the veteran in having
to care for a living thing; an increased sense of self-esteem and
overall psychological well-being; and improved social and community reintegration
skills. We do not dispute these subjective accounts from commenters;
however, we believe Congress authorized VA to provide service
dogs to veterans with disabilities as a means of mitigating the effects
of a disability--and not for the purpose of companionship or emotional
support. Therefore, we make no changes based on these comments.
The authorizing statute links the provision of service dogs to
their having been trained ``for the aid of'' veterans with hearing impairments,
mobility impairments, etc.; the statute does not suggest that
ancillary benefits are to be considered. 38 U.S.C. 1714(c). Therefore,
Sec. 17.148 does not authorize benefits
based on ancillary benefits
that service dogs may provide but that are not specific to mitigating
the effects of a veteran's disability, and which are not the product
of specific training. Though dogs may generally tend to engender
in their owners subjective feelings of improved well being, this is
not the intended effect of service dog assistance under 38 U.S.C.
1714(c) or Sec. 17.148.
As proposed, the determination that the
service dog is ``optimal'' for the
veteran under Sec. 17.148(b)(2) was to
be made by a VA clinician
using medical judgment. Multiple commenters objected to this standard,
for various reasons. Chiefly, commenters claimed that a VA clinician
would not have the requisite expertise related to service dogs to
properly compare their unique characteristics and benefits to other
assistive devices. Instead, these commenters asserted that the decision-making
process should involve either a local evaluation board or
interdisciplinary team, in which prosthetic staff and other rehabilitative
therapy staff is represented. We agree, and have amended the
first sentence of Sec. 17.148(b)(2) from
the proposed rule to require
``[t]he VA clinical team that is treating the veteran for such impairment''
to assess whether it is appropriate to prescribe a service dog for
that veteran. The ``VA clinical team'' will include, by virtue of
being the clinical staff that is treating the veteran for the qualifying
visual, hearing, or mobility impairment, the veteran's primary
healthcare provider, and any other relevant specialty care providers
and professional staff, to include prosthetic and rehabilitative
therapy staff. Thus, the first sentence of Sec. 17.148(b)(2)
now reads: ``The VA clinical team that is treating the veteran
for such impairment determines based upon medical judgment that it is
optimal for the veteran to manage the impairment and live independently
through the assistance of a trained service dog.''
We also recognize that ensuring that VA
clinical staff is knowledgeable
regarding service dog utilization is critical to the successful
partnering of veterans with service dogs. VA is developing and
will disseminate educational tools and training opportunities that will assist
VA clinical staff to obtain this knowledge. In preparation for the
effective date of this rulemaking, we have drafted clinical practice
recommendations and have produced a video presentation for dissemination
to every VA health facility in the country. Both the clinical
recommendations and the video communicate to clinical staff the
traits, capabilities, tasks, and utility of service dogs for mobility,
hearing, and vision impairments. These and other training materials
will include professional education credits, so clinical staff
will have incentive to participate, and some training opportunities
will be required training for a veteran's clinical team when it
is necessary to determine if an assistive device is needed. The training
provided at local facilities will ensure the veteran's treatment
team will be qualified to evaluate between various assistive means,
to include understanding the abilities of service dogs, and then be able
to prescribe the most appropriate assistive device.
Multiple commenters criticized the rule for
disregarding the expertise
of service dog organizations. It is true that for a veteran to
receive benefits under the rule, a service dog must be prescribed by the
veteran's clinical team, and that decision is made without consulting
the service dog organization from which a veteran ultimately obtains
a service dog. However, the prescription of a service dog is a treatment
decision made by the VA clinical team that is treating the veteran
for the qualifying impairment, and we believe that consultation with a
private organization that has no clinical expertise as to the medical
treatment for a specific veteran is inappropriate. Therefore, we make
no changes based on these comments. At the same time, service dog
organizational expertise and experience are essential to the process
whereby a service dog is placed with a veteran. After a clinical
decision is made to prescribe a service dog, a service dog organization
will use its professional judgment to make independent decisions
concerning whether a service dog will actually be placed with the
veteran. The ADI-accredited or IGDF-accredited organization conducts
its own assessments based on national criteria and its specialized
experience in the field, and the veteran must complete the service
dog organization's evaluation and training before that organization
will match the veteran with a service dog and place that dog in
the veteran's home.
VA's role in the service dog organization's
is purely supportive. For instance, VA will assist the veteran
with obtaining medical and psychological
54375]]
and other documentation that the service dog organization may request
from VA (if approved for release by the veteran). VA will additionally
provide assistance to veterans in locating a service dog organization,
if requested. In response to one commenter, however, VA will
not formally refer veterans to specific ADI-accredited or IGDF-
organizations, or initiate a process whereby a veteran may consent
to have VA act as an intermediary between the veteran and the service
dog organization. We believe such a referral system would blur the
distinct line that should exist between VA's responsibility to determine
whether a service dog may be clinically necessary for a veteran,
and the service dog actually being placed with the veteran. The
clinical practice recommendations and other guidance VA has developed
will alert VA staff to commonly available resources that would
aid the veteran in locating service dog organizations, and this information
could be provided to the veteran (e.g., the Web site to find
the nearest ADI-accredited or IGDF-accredited organization). VA will
additionally assist the veteran in obtaining medical information the
service dog organization may require.
In response to the same commenter, VA will
not develop a standard form to
be certified or otherwise completed by the service dog organization,
for the veteran to submit to VA under Sec. 17.148(c)(1)-
receive benefits. Instead, VA will accept a certificate as required
under Sec. 17.148(c)(1)-(2) in all forms
as issued to the veteran
from the individual service dog organizations. Such certificates
must indicate that an adequate training program has been completed
to warrant receipt of benefits under the rule. VA's lack of expertise
in certifying whether appropriate training has been completed is the
precise reason VA has required ADI or IGDF certification for all service
dogs acquired on or after the effective date of the final rule.
Some commenters stated that only the
service dog organizations themselves
should be the designated decision makers under Sec. 17.148, arguing
that only these organizations could properly compare service dogs to
other assistive devices and determine what is the most ``optimal''
means to assist a veteran. We do not believe a service dog organization
would be so qualified, as they do not have the expertise of
licensed VA clinicians to clinically assess or treat a specific veteran,
nor do they have the clinical responsibility of VA clinicians to
evaluate assistive device options other than service dogs. Additionally,
as the benefits under the rule are to be administered incident
to a veteran's medical treatment, only the veteran's clinical team
may be designated decision makers regarding the initial clinical assessment.
Therefore, we make no changes based on these comments.
Commenters asserted that having VA
clinicians make the determination
whether a service dog is optimal discounts the veteran's input
into their own treatment options, and instead advocated that the decision
should be solely between the veteran and the service dog organization.
In keeping with VA's policy of providing patient centered care,
VA clinicians do not discount the input of veterans regarding treatment
options. As with any other medical care VA provides, the prescription
of a service dog for a veteran would be the recommended course
of treatment only after the veteran's clinical team considers all
relevant factors, to include veteran preference in treatment options.
A veteran's preference for a service dog, therefore, would certainly
be a factor in a determination to prescribe a service dog. We make no
VA Is
Not Purchasing or Otherwise Obtaining Service Dogs for Veterans Under
Several commenters objected to a basic
premise in this rule, which is that
VA will assist veterans in determining whether a service dog is an
appropriate treatment option and will maintain service dogs through the
provision of veterinary and other benefits, but VA will not actually
purchase or obtain service dogs for veterans. We make no changes
based on these comments. As explained in the proposed rulemaking,
we reiterate that we interpret the ``may * * * provide'' language
in 38 U.S.C. 1714(c) to mean that VA need not actually purchase
or acquire dogs for eligible veterans. 76 FR 35162. This is consistent
with VA policy, extant prior to the promulgation of this rule,
concerning guide dogs for the visually impaired; VA does not purchase
or obtain such dogs on behalf of veterans under the similar authority
(``may provide'') in 38 U.S.C. 1714(b). As stated previously, we
simply lack the facilities and expertise to purchase or obtain, or to
train service dogs for placement with veterans, and we will continue to rely
on independent organizations that have been recognized as having
such expertise. VA has opted instead to offer other benefits to facilitate
the provision of service dogs to veterans.
One commenter asserted that VA purchases other
``devices'' for veterans,
and further that VA categorizes service dogs as ``devices,'' and
therefore that this rulemaking must address how VA plans to purchase
service dogs for veterans from service dog organizations. We make no
changes based on this comment. The commenter did not specify what
type of ``devices'' VA purchases for veterans as a comparison to service
dogs, but we assume the intended reference was to prosthetic devices
or appliances that may be provided to certain veterans under 38 CFR
17.38 and 17.150. Although we have stated in this rulemaking that we view
a service dog as a surrogate for another assistive device, we clarify
that with regards to VA procurement policy, we do not treat service
dogs in the same manner as prosthetic devices that are purchased
for veterans. Unlike prosthetic devices that are provided by VA to
veterans at VA expense, the actual placement of a service dog with a
veteran is not VA's decision, and ultimately is not a clinical decision--the
actual placement is the decision of a service dog organization,
subject to that organization's own non-clinical assessment
and training standards. VA is unable to provide training and fitting
of a service dog for a veteran, as we provide for prosthetic devices
that are purchased for veterans, again because VA at this time lacks
this expertise.
Notwithstanding VA's lack of expertise in
purchasing or obtaining service
dogs to provide directly to veterans, several commenters asserted
that VA should cover a veteran's out of pocket costs to independently
purchase a service dog. We reiterate that the rule is designed
to support service dogs only when it is clinically determined that
other assistive devices will not adequately enable the veteran to live
independently, because a service dog is a long term commitment that
as well as potentially significant continuing costs for veterans
that will not be paid by VA (e.g., non-prescription food, over-the-counter
medications). VA will therefore not directly purchase service
dogs for veterans. VA will not potentially incentivize the independent
purchase of service dogs by veterans by creating an expectation
that the purchase costs will be covered.
Another commenter asserted that VA should
establish a ``fee for service''
program to purchase service dogs for veterans, because such remuneration
would increase availability of service
54376]]
well as decrease potential wait times for veterans to obtain service
dogs. We do not agree that the availability of service dogs specifically
for veterans is impeded by veterans' inability to cover purchasing
costs, because we understand that a majority of service dogs are
acquired by veterans with little or no out of pocket cost. Therefore,
we make no changes based on this comment. Additionally, we do not
believe that a veteran's inability to purchase a service dog would
contribute to any potential wait time for that veteran to obtain a
service dog. Rather, we believe that the only factors that would contribute
to potential wait times for veterans to obtain service dogs would
be the supply of trained and available service dogs, which is unaffected
by whether such dogs can be purchased or by whom.
VA Will
Not Pay for Certain Expenses Under Sec. 17.148(d)(4)
Commenters asserted that VA should pay for
certain expenses associated
with a service dog that would be excluded under Sec. 17.148(d)(4)
as proposed. Specifically, commenters argued that VA should
pay for grooming, nail trimming, non-sedated teeth cleaning, nonprescription
medications, and nonprescription food and dietary supplements,
because commenters asserted that these services are directly
related to the dog's ability to provide assistive services, and
therefore should be considered covered by VA. See 76 FR 35164 (explaining
that the restrictions expressed in Sec. 17.148(d)(4) are present
to ``ensure that the financial assistance provided by VA would not be
used to provide services that are not directly related to the dogs'
ability to provide assistive service.''). Commenters stated that these
excluded services are directly related to the dog's ability to provide
assistive services because they are either necessary to ensure a
service dog's longevity and reliable working service to the veteran, or are
necessary to maintain the higher standards of cleanliness service
dogs must maintain. We make no changes to the rule based on these
comments, but reiterate our general policy as stated in the proposed
rule that we regard the service dog as a surrogate for another assistive
device, and require that the veteran therefore utilize the service
dog responsibly and provide general care and maintenance. As with
prosthetic devices prescribed by VA, the veteran is expected to maintain
equipment by ensuring it is cared for, cleaned, serviced, and protected
from damage. In the case of prosthetic devices, VA repairs broken
equipment, and provides annual servicing and replacement parts such as
hearing aid batteries or oxygen tank refills, when needed. In the
case of a service dog, VA believes this equates to repairing and or replacing
harnesses or other hardware, providing annual and emergent veterinary
care, providing prescription medications, or paying for other
services when prescribed by a veterinarian. In the same way VA would
expect a veteran to protect and utilize his or her wheelchair in order
to keep it in good working condition, or keep his or her prosthetic
limb clean and functioning, VA expects that a veteran will generally
maintain the service dog with daily feeding, regular grooming,
and by covering any other expenses which are not clinically prescribed
by a veterinarian.
Grooming and other excluded services in
Sec. 17.148(d)(4) are important
for the general health of a service dog as an animal, and may affect
a service dog's ability to provide services. However, services excluded
in Sec. 17.148(d)(4) are not uniquely
required by a service dog to
perform the work and specific tasks for which they were trained. Services
excluded in Sec. 17.148(d)(4) are
services that all dogs require for general good health and well
being, and we therefore do not believe they are directly related to the
specific assistance provided by a service dog. For instance, service
dogs surely must have their nails maintained at an appropriate length
to prevent certain maladies and discomfort associated with overgrowth
or damage. However, the exact same need exists for nonservice
dogs as well, such that all dogs' general ability to walk and
maneuver is affected by maintenance of their nails. Unlike a specialized
harness provided by VA, nail grooming is not uniquely required
by a service dog to perform the work and specific tasks for which
they were trained, and hence is not covered under the rule. We apply
this same rationale for other items, such that VA will not pay for
standard, nonspecialized leashes and collars, or nonprescription food or
medications, or any other basic requirements mandated by State governments
for dog ownership generally, such as dog licenses. Again, such
standard needs are not unique to service dogs--it is for the overall
health and well being of all dogs as domestic animals that they be
adequately controlled by their owners, are routinely fed and kept free of
pests such as fleas and ticks, etc.
Commenters stated that service dogs are
subject to heightened standards
of cleanliness by virtue of being permitted access to public areas,
which in turn creates a greater need for grooming services. Commenters
asserted further that individuals with substantial mobility impairments
may not be able to complete necessary grooming to ensure service
dogs may gain access to public areas, and specifically stated the
inability of these individuals to complete grooming tasks would be exacerbated
by the fact that most ADI-certified dogs are large dog breeds
with long hair. However, we are not aware of any rules regarding service
dog access to public places that hold service dogs to heightened
standards of cleanliness that would not otherwise be appropriate
for a dog living in a home and assisting a disabled veteran,
nor did the commenters offer any specific examples of such heightened
standards. Nonetheless, we do not believe that an ADI-
or IGDF-accredited service dog organization would place a service
dog with an individual who could not demonstrate an ability to provide
for the basic maintenance and care of the service dog, to include
required grooming sufficient to allow the dog access to a public
area. We make no changes based on these comments.
A few commenters noted specifically that
many of the services excluded
in Sec. 17.148(d)(4) as proposed are
discounted for members of the
International Association of Assistance Dog Partners (IAADP), and
that VA should in turn pay for IAADP memberships for veterans with approved
service dogs. We make no changes to the rule based on these comments.
The sole cost savings associated with IAADP membership as described
by commenters was related to prescription medications, which are
covered under Sec. 17.148(d)(1)(ii).
Additionally, because the veteran
must be generally responsible for expenses related to the nonmedical
daily care and maintenance of a service dog, the veteran would
also be responsible for membership in any organization that may assist
in covering such expenses. One commenter additionally advocated for VA
to initiate a service dog support group, and likened the benefits
of such a support group to the benefits individuals may receive
as IAADP members. For instance, the commenter suggested that such a
VA support group should have a membership requirement, and would be a
more cost effective way to use VA funds for service dogs as well as
promoting socialization and education. Although we do not disagree with
the commenter on the potential value of such a support group, we make no
changes to this rule based on the same rationale related to IAADP
membership as expressed above.
54377]]
Will Not Be Provided for More Than One Service Dog at a Time
Commenters asserted that a requirement in
Sec. 17.148(d) as proposed,
that benefits would only be provided for ``one service dog at any
given time'' is too restrictive. Commenters stated that many service
dogs continue to live with veteran owners after being replaced by a
new service dog, and opined that the veteran should continue to receive
benefits to relieve the financial burden of continuing to care for the
retired service animal. We make no changes based on these comments.
A retired service dog would no longer be providing specific assistance
to the veteran to mitigate the effects of a disability, and VA
would therefore lack authority to continue to provide benefits to the
veteran based on his or her medical need for the service dog. To the
extent that keeping a retired service dog could be a financial strain
on a veteran, all ADI-accredited and IGDF-accredited organizations
offer the option for owners to place retired service dogs in the
homes of volunteers.
Commenters also stated that the restriction
of benefits to only one service
dog at a time does not properly consider the extended training periods
often required to obtain replacement service dogs, and will create
an undue lapse in service dog benefits for those veterans whose current
service dogs will soon be retired. Essentially, commenters asserted
that the restriction creates a costly choice for a veteran to either
apply benefits under the rule towards obtaining a replacement service
dog, or continue to have benefits apply to a current service dog
until it is officially retired. We agree that it is important that veterans
do not experience a lapse in service dog benefits when obtaining
a replacement service dog, and did not intend for the limitation
in paragraph (d) to cause such a lapse. Therefore, we have added
to paragraph (d)(3) the following note: ``VA will provide payment for
travel expenses related to obtaining a replacement service dog, even if
the veteran is receiving other benefits under this section for the
service dog that the veteran needs to replace.'' To emphasize this clarification,
we have added to the introductory text of paragraph (d) a
sentence to explain that there is an exception in paragraph (d)(3) to the
``one service dog at any given time'' provision in the rule. This exception
will only apply to travel benefits under paragraph (d)(3), because
the organization that is training the replacement service dog would
be responsible for other benefits under Sec. 17.148(d) as needed by the
replacement dog, until the veteran actually acquires the replacement
dog from the organization. At the time the veteran acquires the
replacement service dog, the veteran would in effect be retiring the
former service dog, and would apply all service dog benefits under this
section to the replacement dog.
Dogs Obtained Before the Effective Date of the Final Rule
Multiple commenters interpreted Sec. 17.148(c)(2) as proposed to compel
veterans who obtained non-ADI or non-IGDF certified service dogs before
the effective date of the final rule to undergo the certification
process with an ADI-accredited or IGDF-accredited organization
prior to being eligible for benefits. This is not the intent
or function of Sec. 17.148(c)(2), in all
cases. The rule clearly
states that for veterans to receive benefits for service dogs obtained
before the effective date of the rule, veterans may submit proof
from a non-ADI or non-IGDF organization that the service dog completed
a training program offered by that organization. See Sec. 17.148(c)(2)
(explaining that it is only when a veteran may not be able to
attain such proof from a non-ADI or non-IGDF organization that ``[a]lternatively,
the veteran and dog [could obtain the certification from
ADI or IGDF]''). We make no changes based on these comments.
Commenters asserted that for previously
obtained dogs, the final rule
must establish criteria in Sec. 17.148(c)(2) to allow VA to determine
whether the training courses certified by non-ADI or non-IGDF organizations
were adequate to produce a well trained dog capable of assisting
the veteran. We make no changes based on these comments. As stated
in the proposed rule, we do not have the expertise, experience, or
resources to develop independent criteria to assess the efficacy of service
dog training programs. Additionally, we do not want those veterans
with existing service dogs to be subjected to new requirements which
could prevent their receipt of benefits. Therefore, we accept a certificate
from a non-ADI or non-IGDF organization that existed before the
effective date of the final rule as proof that the veteran's service
dog has successfully completed an adequate training program, and
that a veteran who otherwise meets the criteria in the rule may receive
applicable benefits. Essentially, we are ``grandfathering in'' service
dogs acquired before the effective date of the final rule by not
requiring such dogs to have ADI or IGDF certification.
We further clarify for one commenter that
the 1 year limitation in Sec. 17.148(c)(2) to obtain a certificate that the
veteran's service dog has
successfully completed an adequate training program only applies
if the certificate comes from the original non-ADI or non-IGDF organization.
The 1 year limitation is not applicable for a veteran who must,
because they cannot obtain a certificate from the original non-
ADI or
non-IGDF organization, undergo new training with an ADI-
or IGDF-accredited organization. See Sec. 17.148(c)(2) (explaining
that the 1 year limitation applies when a certificate is obtained
from a non-ADI organization, or ``[a]lternatively, the veteran and dog
[could obtain the certification from ADI or IGDF]''). We make no
changes to the rule text based on this comment because the language is
clear. In response to commenters' concerns that ADI-accredited organizations
will not certify service dogs that were not also initially
trained there, VA will ensure through continued workings with ADI-accredited
and IGDF-accredited organizations that there exists a mechanism
to provide for such certification.
Lastly, one commenter advocated
specifically that veterans who currently
receive VA benefits for guide dogs should not be required to undergo
the clinical determination process in Sec. 17.148(b)(2) to now receive
benefits under Sec. 17.148(d). We make
no changes based on this
comment, as all veterans who would seek to receive benefits under Sec. 17.148(d) must be subject to the same requirements,
to ensure equitable
administration of benefits. However, we note that for any veteran
who is currently receiving guide dog benefits from VA, that veteran
has already undergone the same type of clinical evaluation to determine
efficacy of the dog, and would have a history of medical documentation
supporting the use of the dog as indeed the most optimal device
to manage the veteran's impairment. Effectively then, the veterans
already receiving guide dog benefits from VA would not be subject
to a new clinical evaluation process under Sec. 17.148(b)(2), as this
would be duplicative and unnecessary.
Related to Insurance Coverage and Payments
Section 17.148(d)(1) as proposed would
provide an insurance policy to
veterans with prescribed service dogs that guarantees coverage of all
veterinary treatment considered medically necessary. Commenters urged
that Sec. 17.148(d)(1) as proposed
54378]]
revised for multiple reasons, with a majority of commenters stating that
certain processes involved in payment for veterinary care should be
clarified. Under Sec. 17.148(d)(1)(i),
VA ``will be billed for any premiums,
copayments, or deductibles associated with the policy'' negotiated
and offered by VA to veterans with prescribed service dogs. VA will
only pay premiums and other costs as specified in Sec. 17.148(d)(1)(i)
for the commercially available policy that VA provides to the
veteran, and not for any other policy that a veteran may obtain independently.
The insurance company that holds the VA-provided policy will
attain appropriate contractor status under Federal acquisition standards
by registering with the Central Contractor Registration (CCR) to bill
VA for costs specified in Sec. 17.148(d)(1)(i),
and will be subject
to the same quality standards as other VA contractors.
Multiple commenters stated that the type of
insurance coverage that VA
would provide in Sec. 17.148(d)(1) as
proposed was inadequate, as all
commercially available insurance policies for service dogs rely on a
reimbursement model whereby veterans would pay the out of pocket cost for
veterinary treatment, prior to filing a claim with and being reimbursed
by the insurance company. Commenters stated that VA should, instead,
establish a system where VA pays for treatment costs, such as providing
veterans with prescribed service dogs some type of debit card to be
used for veterinary care. The rule clearly states that VA, ``and not the
veteran,'' will be billed directly for all costs for which VA is
responsible under Sec. 17.148(d)(1)(i).
The rule also states that the
policy will guarantee coverage for the types of treatment determined
by a veterinarian to be medically necessary in Sec. 17.148(d)(1)(ii),
but, as proposed, paragraph (d)(1)(ii) did not bar billing
a veteran for treatment costs. Our intent has always been to negotiate
and procure a contract, to the extent that is commercially feasible,
for an insurance policy that will not require the veteran to pay any
out of pocket costs for covered veterinary care and treatment costs.
VA has researched the commercial market and anticipates that VA will be
able to contract for this requirement on VA's terms. In response
to these comments and to further ensure that the regulation effectuates
our intent, we have revised the language of Sec. 17.148(d)(1)(ii)
from the proposed rule so that it bars the billing of veterans
for covered costs.
Based on the foregoing, we do not believe
that there is a need to clarify
any of the payment processes that are authorized by the regulation
or to provide in regulation any specific procedures that will be
established in accordance with the insurance policy for service dogs,
so long as the basic requirements in Sec. 17.148(d)(1) are met concerning
not billing veterans. For instance, this rule will not specify
that the insurance provider must be registered in the CCR, because
it is a requirement under separate Federal Acquisition Regulations
that all Federal contractors must be registered in CCR. See 48 CFR
4.1102.
Commenters also criticized that typical
insurance policies that would
be commercially available would not provide the scope of coverage required
to adequately care for a service dog, as the medical needs of a
service dog are higher due to the level of physical work a service dog
completes on a regular basis. We clarify that the rule intends that VA will
select a policy with broad coverage, to ensure that all services
which are likely to be considered medically necessary by a veterinarian
who meets the requirements of the insurer are in fact covered.
VA will consult with ADI, IGDF, and the American Veterinary Medical
Association to ensure that the most comprehensive policy, specific
to the needs of service dogs, is chosen. Additionally, in response
to commenter concerns that such a policy is not likely to be accepted
widely across the nation, VA will consider geographic availability
when choosing the policy.
Related to the Reimbursement of Veteran Travel Expenses
Commenters argued that Sec. 17.148(d)(3) as proposed was vague regarding
reimbursement and eligibility for travel expenses, and should more
specifically indicate the type of travel expenses covered, to include
lodging and expenses related to training and retraining/
of service dogs. We make no changes to the rule based on
these comments. The rule is clear in Sec. 17.148(d)(3) that any veteran
who is prescribed a service dog under Sec. 17.148(b) will be eligible
to receive payments for travel expenses. We reiterate from the proposed
rule that Sec. 17.148(d)(3) is intended
to implement 38 U.S.C.
1714(d), ``which allows VA to pay travel expenses `under the terms
and conditions set forth in [38 U.S.C. 111]' for a veteran who is provided
a service dog.'' See 76 FR 35164. We believe that the language of
section 1714(d) can be read to interpret obtaining a dog as ``examination,
treatment, or care'' under section 111, but we would not make
payment of section 1714(d) benefits contingent upon the separate eligibility
criteria in section 111. This interpretation facilitates administration
of section 1714(d) benefits by allowing VA to avoid additional
expenses associated with establishing a new means of administering
travel benefits outside of section 111 mechanisms.
We clarify that all travel costs associated
with obtaining the service
dog, to include all necessary initial and follow up training, are
covered. Additionally, all types of travel costs which are considered
reimbursable in 38 U.S.C. 111 and 38 CFR part 70 are considered
reimbursable in this rule, to include approved lodging.
Commenters also indicated that VA should
not require a prescription for a
service dog before authorizing travel reimbursement related to procurement.
We disagree and make no changes based on these comments. We will
pay travel benefits only if it is determined by the veteran's clinical
team that a service dog is appropriate under Sec. 17.148; otherwise,
we would be paying costs related to procuring an assistive device
that may not ultimately be approved for the veteran.
Only VA
Staff May Provide, Repair, or Replace Hardware Under Sec. 17.148(d)(2)
Commenters asserted that the benefit to
provide service dog hardware
under Sec. 17.148(d)(2) as proposed
would be too restrictive. Commenters
stated that veterans should be reimbursed for payments made to
non-VA third party vendors to provide, repair, and replace such hardware,
instead of the current requirement that the hardware be obtained
from a Prosthetic and Sensory Aids Service at the veteran's local
VA medical facility. We make no changes to the rule based on these
comments. We believe that hardware should only be provided, repaired,
and replaced through VA, to ensure that our clinical and safety
standards are met. Merely reimbursing third-party providers does not
permit VA to oversee hardware provision to ensure that it is ``clinically
determined to be required by the dog to perform the tasks necessary
to assist the veteran with his or her impairment,'' as required
in Sec. 17.148(d)(2). A clinical
determination that covered hardware
must be task-specific for the type of assistance a service dog provides
is essential, or VA would be employing its professional clinical
staff to provide and repair common items related to dog ownership
generally, such as collars or leashes. The purpose of Sec. 17.148(d)(2)
is not to cover all equipment that a dog generally may require,
but rather to ensure that the veteran is not burdened in finding,
obtaining, or having to repair
54379]]
replace certain special hardware that a trained service dog requires to
provide specific assistance. We believe that allowing third party vendors
would also increase administrative burden for veterans, as this would
require the vendor to undergo a separate, extensive, and highly regulated
Federal process to identify, select, and utilize third party vendors,
which would cause an undue delay for veterans in obtaining necessary
Must Maintain Its Ability To Function as a Service Dog
Section 17.148(e) provides that for
veterans to continue to receive benefits
under the rule, the service dog must continue to function as a service
dog, and that VA may terminate benefits if it learns from any source
that the dog is medically unable to maintain that role, or a clinical
determination is made that the veteran no longer requires the service
dog. A few commenters objected to the ``any source'' criterion in
Sec. 17.148(e), stating that VA should restrict
to a veteran's medical provider with regards to a veteran's continued
clinical need for the service dog, and to the service dog's veterinarian
with regards to the service dog's fitness to continue providing
assistance. We make no changes to the rule based on these comments.
We first clarify that VA will only consider the veteran's clinical
team as a source of information to determine whether the veteran
continues to require the service dog; this is contemplated in paragraph
(e), which states that ``VA makes a clinical determination that
the veteran no longer requires the dog.'' With regards to the medical
fitness of a service dog, VA must be permitted to receive information
from a broad number of sources in a continuous manner while benefits
are administered, for the safety of veterans and to ensure that
benefits are administered equitably. The ``any source'' criterion as well
reduces administrative burden for veterans, in that VA would otherwise
need to prescribe a specific and regular means of evaluating whether
a service dog has maintained its ability to function as a service
The broad ``any source'' criterion in
paragraph (e) does not mean that VA
will rely upon information from any source to terminate service dog
benefits without considering the source of the information, and first
allowing veterans to submit contrary information. The 30 days notice
prior to termination of benefits provided for in paragraph (e) allows
the veteran ample time to present contrary information, if VA should
receive information that a service dog is not able to maintain its
function as a service dog.
Commenters additionally stated that VA
should exclude any insurance company
with which VA contracts to cover veterinary care costs as a source
of information concerning the medical fitness of a service dog. The
commenters, however, did not provide a rationale for such an exclusion.
To the extent that the commenters may be concerned that an insurance
company would seek to have service dogs deemed medically unfit
to avoid excess expenditures, we do not believe any incentive exists
to do so. As we stated in the proposed rule, our understanding is that
annual caps on expenditures are a common limitation in insurance
policies that cover service dog care, and Sec. 17.148(d)(1)(ii)
specifically provides for such caps to be considered in the
administration of veterinary care benefits. We reiterate that VA must be
permitted to consider information from a broad number of sources,
and do not see any inherent reasons that this specific limitation
should be implemented. Therefore, we make no changes based on
In response to commenter concerns that the
rule does not detail an appeals
process for a veteran whose service dog benefits are to be terminated,
or for a veteran who is not prescribed a service dog and cannot
obtain service dog benefits, we do not believe VA must prescribe a new
appellate mechanism in this rulemaking. All decisions under this rule,
whether decisions to prescribe a service dog and initiate service dog
benefits, or decisions to terminate such benefits, are clinical determinations
and therefore subject to the clinical appeals procedures in VHA
Directive 2006-057. It is VHA policy under this appeals process that
patients and their representatives have access to a fair and impartial
review of disputes regarding clinical determinations or the provision
of clinical services that are not resolved at a VHA facility level.
This clinical appeals process will be sufficient to resolve conflicts
related to the provision or termination of service dog benefits,
without prescribing a new appellate mechanism in this rulemaking.
of Proposed Sec. 17.154 To Include Term
``Veterans''
One commenter requested that we further
revise Sec. 17.154 as proposed
to delete the reference to ``ex-members of the Armed Services''
and replace it with a reference to ``veterans.'' We agree and
have revised the language of Sec. 17.154
from the proposed rule to read:
``VA may furnish mechanical and/or electronic equipment considered
necessary as aids to overcoming the handicap of blindness to blind
veterans entitled to disability compensation for a service-
disability.'' The term ``veteran'' has always been used in 38 U.S.C.
1714, and the regulatory term should follow the statute. In other
contexts, there may be a difference between an ``ex-member of the Armed
Forces'' and a ``veteran'' because the definition of ``veteran'' in
title 38 of the United States Code requires discharge or release from
service ``under conditions other than dishonorable,'' 38 U.S.C. 101,
whereas no such limitation would appear to apply to an ``ex-member of the
Armed Forces.'' In the context of 38 CFR 17.154, however, the change
does not alter the meaning of the regulation because Sec. 17.154
refers to an ``ex-member'' who is entitled to service-connected disability
compensation and who, therefore, must be a veteran (because such
compensation is offered only to veterans discharged or released under
conditions other than dishonorable).
Estimated Number of Respondents per Year
The proposed rule estimated that 100 new
service dogs would be provided
to veterans each year. Multiple commenters objected to this statement,
asserting that this number was far too low of an estimate, and
further was not a reflection of veteran need for service dogs but rather
a reporting of the number of service dogs that ADI could feasibly
provide to veterans each year. The estimated burden of 100 is not an
estimate of the number of veterans who may need a service dog. Rather,
this number is an estimate of the number of new veterans each year
that VA expects to present a certificate showing successful completion
of training in order to establish a right to obtain benefits under
Sec. 17.148(d). This number was based on
the number of veterans who
sought to receive new guide dog benefits in fiscal year 2010 under Sec. 17.154 (2010), which was 66, plus an
additional number of veterans
we estimated who would seek to receive new Sec. 17.148 service
dog benefits for hearing and mobility impairments. We estimated the
number of veterans who would seek new Sec. 17.148 benefits as a one
third increase over confirmed guide dogs for which VA provided benefits
the previous fiscal year, and based upon a projection for multiple
fiscal years, we arrived at 100 new veterans each year seeking benefits
under Sec. 17.148. The estimated number
of respondents is not, as
theorized by commenters, based on
54380]]
anticipated supply of service dogs that could be provided annually by
ADI-accredited organizations.
Other commenters asserted that the number
of estimated respondents at 100
was underreported in the proposed rule for financial reasons, or that VA
could only afford to purchase 100 dogs per year for veterans. We reiterate
that under the rule, VA is not actually purchasing the service
dogs from any ADI-accredited or IGDF-accredited service dog organization,
and we have no financial motive to underreport the estimated
number of respondents.
Estimated Total Annual Reporting and Recordkeeping Burden
proposed rule underreported the
expected burden time on veterans to complete necessary administrative
requirements to receive benefits under the rule. We clarify
that the burden time of less than 5 minutes as stated in the proposed
rule only contemplates the submission by the veteran of the certification
from the service dog organization that indicates certain training
requirements have been met, as required by Sec. 17.148(c). The
burden time does not reflect any of the time required for VA to conduct
its clinical evaluation to determine whether a service dog would
optimally benefit a veteran, nor the independent assessments that a
service dog organization conducts thereafter to place a service dog with a
veteran. Such time is not part of the veteran's burden to respond
to our collection by submitting a certificate. We have intentionally
kept paperwork to a minimum in obtaining this benefit because
veterans in need of service dogs are generally seriously disabled
and because veterans applying for these benefits will already be
enrolled in the VA health care system.
Regulatory Action Is Not Significant Under Executive Order 12866, and
Would Not Have a Significant Economic Impact on a Substantial Number
One commenter alleged that the rule should
be considered significant
under Executive Order 12866, because by limiting the source of
service animals to ADI-accredited or IGDF-accredited organizations, VA
effectively creates a sole-source contract with those agencies that will
have a major impact on the service animal industry. We interpret this
commenter's statement to mean that because they believe VA will be purchasing
guide and service dogs, that such purchasing will adversely affect
in a material way the nature of competition with non-ADI and non-IGDF
organizations. We reiterate that VA will not be contracting with
any ADI or IGDF organization to actually purchase guide or service dogs,
and make no changes to the rule based on this comment.
Multiple commenters argued that the rule
would have a significant economic
impact on a substantial number of small service dog organizations
that are either ineligible for membership in the identified
accreditation groups because they do not qualify for tax-
status (in the case of ADI accreditation), or because they cannot
afford the costs and effort that accreditation entails. We assume
that commenters believe that VA will be purchasing the service dogs,
and therefore that these nonaccredited organizations would be economically
disadvantaged unless they comply with the rule's accreditation
requirements. As VA will not be actually purchasing service
dogs, we do not believe any non-ADI or non-IGDF organization, as
small entities, would experience a significant economic impact. This rule
does not prevent individuals from acquiring service dogs from any organization,
but only establishes criteria that must be met if VA is then
going to provide certain benefits related to those service dogs.
We acknowledge that we require all service
dogs obtained after the effective
date of the rule to be ADI or IGDF certified, and as such veterans
may opt to seek the assistance of ADI or IGDF organizations over
other nonaccredited organizations in obtaining such dogs. However, there
is no indication that nonaccredited organizations rely on veterans
as an essential part of their business. In fact, multiple commenters
who themselves were nonaccredited organizations, and who objected
to the ADI accreditation standard in the rule, reported providing
service dogs to veterans free of charge. There is no evidence to
suggest that a substantial number of nonaccredited service dog organizations
will be detrimentally affected by a financial incentive for
veterans to seek to obtain service dogs from accredited service dog organizations.
Even if a substantial number of nonaccredited service dog
organizations significantly rely on veterans to buy their service dogs,
there is also no evidence to suggest that the cost of obtaining ADI or
IGDF certification is beyond the reach of a substantial number of
non-accredited organizations.
Commenters questioned the reasoning in the
proposed rule for our belief
that most service dog providers that provide dogs to veterans are
already accredited by ADI or IGDF. See 76 FR 35166. Based on multiple
commenters who themselves were non-ADI service dog organizations
and who did provide service dogs to veterans, we retract the
rationale that ``[w]e believe that most service-dog providers that provide
dogs to veterans are already accredited in accordance with the final
rule'' and also retract the accompanying statement that ``[t]he vast
majority of accredited programs do not provide dogs to veterans.'' However,
in view of our conclusion that gaining accreditation should not
result in a significant financial burden as explained in the proposed
rule notice, 76 FR 35166, this does not change our analysis that
the rule does not have a significant economic impact on a substantial
Not Newly Initiate Proposed or Formal Rulemaking Procedures
Multiple commenters stated that VA should
abandon this rulemaking, and
that it should begin again with a new proposed rule. One commenter further
stated that VA should initiate a public hearing, or should initiate
formal rulemaking procedures related to the administration of service
dog benefits. We decline to pursue either of these actions, as all
affected parties were put on proper notice of the intended provisions
in the proposed rule, and there were no significant reasons that
commenters put forward to require a new regulatory action that were
not addressed in this final rule. We believe we have addressed all significant
comments and made changes where appropriate, or have reasonably
supported why changes were not made.
For all the reasons noted above, VA is
adopting the proposed rule as
final with changes as noted to Sec. 17.148(b)(2), (d), (d)(1)(ii), and
(d)(3) and Sec. 17.154.
of Rulemaking
Title 38 of the Code of Federal
Regulations, as revised by this rulemaking,
represents VA's implementation of its legal authority on this
subject. Other than future amendments to this regulation or governing
statutes, no contrary guidance or procedures are authorized. All
existing or subsequent VA guidance must be read to conform with this rulemaking
if possible or, if not possible, such guidance is superseded
by this rulemaking.
This final rule at Sec. 17.148 contains new collections of information
under the Paperwork Reduction Act of 1995 (44 U.S.C. 3501-
On June 16, 2011, in a proposed rule published in
54381]]
Federal Register, we requested public comments on the new collections
of information. We received multiple comments in response to this
notice. A majority of the commenters alleged the collection was an
illegal restriction of the access rights of individuals with disabilities.
The response, as also stated in the preamble to this final
rule, is that a certificate showing adequate service dog training is not
necessary to gain access to VA facilities, but rather is only necessary
to receive benefits under this rule. Some commenters stated that
the number of respondents for this collection was underreported, because
more than 100 veterans need service dogs each year. The response,
as also stated in the preamble to this final rule, is that the
estimated burden of 100 is not an estimate of the number of veterans
who may need a service dog, but rather is an estimate of the number
of new veterans each year that VA expects to present a certificate
showing successful completion of training to obtain benefits.
Finally, some commenters asserted that the expected burden time
for this collection was underreported. The response, as also stated
in the preamble to this final rule, is that the burden time of less
than 5 minutes only contemplates the submission of the required certificate,
and does not reflect any of the time required for VA to conduct
its clinical evaluation to determine if a service dog would optimally
benefit a veteran, nor the independent assessments that a service
dog organization conducts thereafter to place the service dog with
the veteran. Therefore, we make no changes to this collection.
has approved the additional
collections in part 17 under OMB Control Number 2900-0785. We are
adding a parenthetical statement after the authority citations to the
section in part 17 for which new collections have been approved so that
the control number is displayed for each new collection.
Flexibility Act
The Secretary hereby certifies that this
final rule will not have a significant
economic impact on a substantial number of small entities as they
are defined in the Regulatory Flexibility Act, 5 U.S.C. 601-
612. We
do not believe that gaining accreditation should result in a significant
financial burden, as the standards for approval by ADI and IGDF
are reasonable thresholds that are generally expected and accepted within
the industry. The approximate cost to be an accredited organization
by IGDF is a one-time fee of $795, with an annual fee of $318
and a per unit fee of $39.45. The approximate cost to be an accredited
organization by ADI is $1000 every 5 years with annual fees of
approximately $50. Therefore, pursuant to 5 U.S.C. 605(b), this final
rule is exempt from the initial and final regulatory flexibility analysis
requirements of sections 603 and 604.
Orders 12866 and 13563
Executive Orders 12866 and 13563 direct
agencies to assess the costs
and benefits of available regulatory alternatives and, when regulation
is necessary, to select regulatory approaches that maximize net
benefits (including potential economic, environmental, public health
and safety effects, and other advantages; distributive impacts; and
equity). Executive Order 13563 (Improving Regulation and Regulatory Review)
emphasizes the importance of quantifying both costs and benefits,
reducing costs, harmonizing rules, and promoting flexibility. Executive
Order 12866 (Regulatory Planning and Review) defines a ``significant
regulatory action,'' which requires review by the OMB, as ``any
regulatory action that is likely to result in a rule that may: (1)
Have an annual effect on the economy of $100 million or more or adversely
affect in a material way the economy, a sector of the economy,
productivity, competition, jobs, the environment, public health
or safety, or State, local, or tribal governments or communities;
(2) Create a serious inconsistency or otherwise interfere with an
action taken or planned by another agency; (3) Materially alter the
budgetary impact of entitlements, grants, user fees, or loan programs
or the rights and obligations of recipients thereof; or (4) Raise
novel legal or policy issues arising out of legal mandates, the President's
priorities, or the principles set forth in this Executive Order.''
The economic, interagency, budgetary,
legal, and policy implications
of this final rule have been examined and it has been determined
to not be a significant regulatory action under Executive Order
requires, at 2 U.S.C. 1532,
that agencies prepare an assessment of anticipated costs and benefits
before issuing any rule that may result in an expenditure by state,
local, and tribal governments, in the aggregate, or by the private
sector, of $100 million or more (adjusted annually for inflation)
in any given year. This final rule will have no such effect on
of Federal Domestic Assistance Numbers
numbers and titles are 64.009
Veterans Medical Care Benefits, 64.010 Veterans Nursing Home Care,
and 64.011 Veterans Dental Care.
The Secretary of Veterans Affairs, or
designee, approved this document
and authorized the undersigned to sign and submit the document to the
Office of the Federal Register for publication electronically as an
official document of the Department of Veterans Affairs. John R. Gingrich,
Chief of Staff, Department of Veterans Affairs, approved this document
on July 30, 2012, for publication.
Subjects in 38 CFR Part 17
Administrative practice and procedure,
Alcohol abuse, Alcoholism, Claims,
Day care, Dental health, Drug abuse, Foreign relations, Government
contracts, Grant programs--health, Government programs--
Health care, Health facilities, Health professions, Health records,
Homeless, Medical and dental schools, Medical devices, Medical research,
Mental health programs, Nursing homes, Philippines, Reporting and
recordkeeping requirements, Scholarships and fellowships, Travel and
transportation expenses, Veterans.
C. McFetridge,
of Regulation Policy and Management, Office of the General Counsel,
For the reasons stated in the preamble, VA
amends 38 CFR part 17 as follows:
17--MEDICAL
authority citation for part 17 continues to read as follows:
Authority: 38 U.S.C. 501, and as noted in
specific sections.
Sec. 17.148 after the undesignated
center heading ``PROSTHETIC, SENSORY,
AND REHABILITATIVE AIDS'', to read as follows:
Sec. 17.148 Service dogs.
(a) Definitions. For the purposes of this
Service dogs are guide or service dogs
prescribed for a disabled veteran
(b) Clinical requirements. VA will provide
benefits under this section
to a veteran with a service dog only if:
54382]]
(1) The veteran is diagnosed as having a
visual, hearing, or substantial
mobility impairment; and
(2) The VA clinical team that is treating
the veteran for such impairment
determines based upon medical judgment that it is optimal for the
veteran to manage the impairment and live independently through the
assistance of a trained service dog. Note: If other means (such as technological
devices or rehabilitative therapy) will provide the same level
of independence, then VA will not authorize benefits under this section.
substantial mobility impairment
means a spinal cord injury or dysfunction or other chronic impairment
that substantially limits mobility. A chronic impairment that
substantially limits mobility includes but is not limited to a traumatic
brain injury that compromises a veteran's ability to make appropriate
decisions based on environmental cues (i.e., traffic lights or
dangerous obstacles) or a seizure disorder that causes a veteran to become
immobile during and after a seizure event.
(c) Recognized service dogs. VA will
recognize, for the purpose of paying
benefits under this section, the following service dogs:
(1) The dog and veteran must have
successfully completed a training program
offered by an organization accredited by Assistance Dogs International
or the International Guide Dog Federation, or both (for dogs
that perform both service- and guide-dog assistance). The veteran must
provide to VA a certificate showing successful completion issued by the
accredited organization that provided such program.
(2) Dogs obtained before September 5, 2012
will be recognized if a guide
or service dog training organization in existence before September
5, 2012 certifies that the veteran and dog, as a team, successfully
completed, no later than September 5, 2013, a training program
offered by that training organization. The veteran must provide to VA a
certificate showing successful completion issued by the organization
that provided such program. Alternatively, the veteran and dog
will be recognized if they comply with paragraph (c)(1) of this section.
(d) Authorized benefits. Except as noted in
paragraph (d)(3) of this
section, VA will provide to a veteran enrolled under 38 U.S.C. 1705
only the following benefits for one service dog at any given time in
accordance with this section:
(1) A commercially available insurance
policy, to the extent commercially
practicable, that meets the following minimum requirements:
(i) VA, and not the veteran, will be billed
for any premiums, copayments,
or deductibles associated with the policy; however, the veteran
will be responsible for any cost of care that exceeds the maximum
amount authorized by the policy for a particular procedure, course
of treatment, or policy year. If a dog requires care that may exceed
the policy's limit, the insurer will, whenever reasonably possible
under the circumstances, provide advance notice to the veteran.
(ii) The policy will guarantee coverage for
all treatment (and associated
prescription medications), subject to premiums, copayments, deductibles
or annual caps, determined to be medically necessary, including
euthanasia, by any veterinarian who meets the requirements of the
insurer. The veteran will not be billed for these covered costs, and the
insurer will directly reimburse the provider.
(iii) The policy will not exclude dogs with
preexisting conditions that do
not prevent the dog from being a service dog.
(2) Hardware, or repairs or replacements
for hardware, that are clinically
to assist the veteran with his or her impairment. To obtain such
devices, the veteran must contact the Prosthetic and Sensory Aids Service
at his or her local VA medical facility and request the items needed.
(3) Payments for travel expenses associated
with obtaining a dog under
paragraph (c)(1) of this section. Travel costs will be provided only to
a veteran who has been prescribed a service dog by a VA clinical
team under paragraph (b) of this section. Payments will be made as
if the veteran is an eligible beneficiary under 38 U.S.C. 111 and 38
CFR part 70, without regard to whether the veteran meets the eligibility
criteria as set forth in 38 CFR part 70. Note: VA will provide
payment for travel expenses related to obtaining a replacement service
dog, even if the veteran is receiving other benefits under this section
for the service dog that the veteran needs to replace.
(4) The veteran is responsible for
procuring and paying for any items
or expenses not authorized by this section. This means that VA will
not pay for items such as license tags, nonprescription food, grooming,
insurance for personal injury, non-sedated dental cleanings, nail
trimming, boarding, pet-sitting or dog-walking services, over-the-
medications, or other goods and services not covered by the policy.
The dog is not the property of VA; VA will never assume responsibility
for, or take possession of, any service dog.
(e) Dog must maintain ability to function
as a service dog. To continue
to receive benefits under this section, the service dog must maintain
its ability to function as a service dog. If at any time VA learns
from any source that the dog is medically unable to maintain that
role, or VA makes a clinical determination that the veteran no longer
requires the dog, VA will provide at least 30 days notice to the veteran
before benefits will no longer be authorized.
(Authority:
38 U.S.C. 501, 1714)
Office of Management and Budget has approved the information collection
requirements in this section under control number 2900-
0785.)
Revise Sec. 17.154 to read as follows:
Sec. 17.154 Equipment for blind veterans.
VA may furnish mechanical and/or electronic
equipment considered necessary
as aids to overcoming the handicap of blindness to blind veterans
entitled to disability compensation for a service-connected disability.
38 U.S.C. 1714)
Doc. 2012-21784 Filed 9-4-12; 8:45 am]
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