What are other benefits of enrolling into VA SCI/D Care?

• The VA provides coordinated life-long care for veterans with a spinal cord injury, through a healthcare system called the Spinal Cord Injuries and Disorders (SCI/D) System of Care.
• There are 25 Spinal Cord Injuries and Disorders (SCI/D) Centers of Excellence across the country, referred to as “hubs”. Hubs provide SCI/D inpatient and outpatient care. Most other VA medical centers without an SCI/D Center serve as “spoke” sites.
  • Spoke sites have smaller teams with expertise in spinal cord injuries and disorders which can manage your day to day health care needs through outpatient care

To learn more: Veterans Affairs Spinal Cord Injuries and Disorders Brochure (va.gov)

Who is eligible for VA Health Care?

• A military veteran, plus National Guard and Reservists, who have served as active duty by federal order can apply for VA Health Care.
• Eligibility for health care is not related to injury during military services.
• Spinal cord injured, brain injured, blinded, and polytrauma active-duty military persons, including National Guard and Reservists, who were injured during training.

What are the specific criteria for eligibility?

You may be eligible to enroll in VA health care if all of these statements are true:

• You served in the active military, naval, or air service (including being called up from the National Guard or Reserve by a federal order), and
• You didn’t receive a dishonorable discharge, and
• You meet at least one of the service requirements for enrollment

You must meet at least one of these service requirements:

• You served at least 24 months in a row without a break (called continuous), or for your full active-duty period, or
• You were discharged for a service-connected disability, or
• You were discharged for a hardship or “early out,” or
• You served before September 7, 1980

Want to learn more? Visit: Eligibility For VA Health Care | Veterans Affairs

Where can a veteran apply for VA Healthcare?

• Online: Apply For Health Care | Veterans Affairs (va.gov)
• By Phone: 877-222-8387
• At any of the Department of Veterans Affairs 170 medical centers, or 1,063 community-based outpatient clinics.
  • Link for interactive map: Find VA Locations | Veterans Affairs
• Mail: Submit Form 1010Ez
  • About VA Form 10-10EZ | Veterans Affairs

 Once you apply…what happens?

• When you apply for VA health care, you will be assigned to 1 of 8 priority groups. This system helps to make sure that Veterans who need care right away can get signed up quickly.
• Assignments are based on military service history, income, medical history, and receipt of other VA benefits. Priority group 1 is highest priority and care will be established sooner. Group 8 is the lowest priority group.
• Learn more: VA Priority Groups | Veterans Affairs

How does a military veteran find a designated SCI Center (hub)?

• Interactive Map: VA's Spinal Cord Injuries and Disorders System of Care - Spinal Cord Injuries and Disorders System of Care
• These centers are a good source of information regarding all available services mentioned above including enrollment and establishing care

I am a military veteran, and have a spinal cord injury- I have enrolled in VA Healthcare. What should I do next?

• Immediately ask for a Catastrophic Disability Evaluation by contacting the enrollment coordinator at their local VA health care facility. (Evaluation is free)
  • Catastrophically disabled definition: To be considered catastrophically disabled, a Veteran must be determined by a designated VA medical person to have a severely disabling injury, disorder or disease that compromises their ability to carry out the activities of daily living to such a degree that personal or mechanical assistance is required to leave home or bed, or constant supervision is required to avoid physical harm to themselves or others.
• If found to be catastrophically disabled, the Veteran will be enrolled and receive cost-free VA medical care and medications; however, Veterans in this category may be subject to copayments for extended care (long-term care).  Additionally, enrolled Veterans in a lower priority group, such as Priority group 7 or 8, will be moved to Priority group 4.
• It is very important for veterans with SCI to request submission of necessary documentation for catastrophically disabled designation in order to be placed in a no-copay status. It be can requested at time of referral for acute SCI rehabilitation or at any time.

I am a veteran. Prior to my spinal cord injury, I was assigned a low priority group and was not yet enrolled for VA healthcare. Now that I have a spinal cord injury- should I try to enroll for VA Healthcare again?

• Yes! Veterans who were previously assigned a low priority group are reassigned when they are deemed catastrophically disabled by VA.

Summary

References: Eligibility for VA health care. Veterans Affairs. (2022, November 14). Retrieved April 1, 2023, from https://www.va.gov/health-care/eligibility/