Veterans Affairs

**  BREAKING NEWS: Senate Passes Bill to Expand Chiropractic Services at Major VA Medical Centers ** 

The U.S. Senate has approved legislation that will improve the delivery of benefits to America’s veterans, bringing them one step closer to gaining access to chiropractic care at Department of Veterans Affairs (VA) major medical centers.  S. 1203, the 21st Century Veterans Benefits Delivery Act, passed under unanimous consent and has been referred to the U.S. House of Representatives where it awaits action.

Section 102 of the Act, titled “Expansion of Provision of Chiropractic Care and Services to Veterans,” calls for the chiropractic benefit to be carried out at a minimum of two additional medical centers or clinics per Veterans Integrated Service Network (VISN) no later than two years after enactment of the bill, with the program being implemented at no less than 50 percent of all medical centers in each VISN within three years of enactment. There are nearly 160 VA treatment facilities nationwide. Currently, the VA provides chiropractic services at 32 treatment facilities across the country.

Especially important to note in the bill is the expansion of chiropractic services available to veterans, which was broadened to include services provided by doctors of chiropractic (DCs) under the Preventative Health Services category, in addition to the existing coverage areas of Medical and Rehabilitative Services, placing DCs in a service category from which they were previously excluded.  

The bill comes after a 2010 VA report, “Analysis of VA Health Care Utilization Among Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) Veterans,” which cites “diseases of musculoskeletal system/connective system,” such as back pain, as the number one ailment of Iraq and Afghanistan veterans accessing VA treatment.

Sen. Jerry Moran (R-Kansas), a senior member of the Senate VA Committee and Ranking Member Sen. Richard Blumenthal (D-Conn.) championed the provision after introducing S. 398, the “Chiropractic Care Available to all Veterans Act of 2015,” from which the pro-chiropractic provisions of the recently passed legislation were derived. Sens. Moran and Blumenthal have been strong supporters of extending chiropractic care benefits to military retirees and active-duty personnel and worked closely with ACA in securing support for pro-chiropractic measures in Congress.

ACA believes that the inclusion of chiropractic services in the VA health care system will speed the recovery of many veterans returning from current operations in Iraq and Afghanistan. Chiropractic care has been proven to be a cost-effective and beneficial treatment option. In fact, a 2010 study published in Clinical Rehabilitation found that spinal manipulation provided better short- and long-term functional improvement and more pain relief in follow-up assessments than other physiotherapy interventions. Furthermore, a 2003 study published in the medical journal Spine found that manual manipulation provides better short-term relief of chronic spinal pain than a variety of medications.

Prior to congressional intervention over the past decade, no DCs served on the staff of any VA treatment facility. The availability of chiropractic services for eligible veterans was limited to VA “referrals” to DCs serving in private practice outside the VA system. Such referrals were so rare that chiropractic care was essentially non-existent within the VA system.



Watch this video to see how veterans in the VA health care system receive essential services from doctors of chiropractic.

In recent years, the Department of Veterans Affairs (VA) has started the long-overdue process of providing veterans with access to chiropractic care by placing doctors of chiropractic on staff at VA hospitals. The process of integrating chiropractic care in the VA system was initiated after Congress enacted a series of statues—Public Law 108-170 and Public Law 107-135—that reinforced a permanent chiropractic benefit within the VA health care system and specifically directed the VA to hire doctors of chiropractic to provide care for veterans.

As a result of the above-referenced congressional directives, the VA now provides chiropractic care (via hired or contracted staff) at 47 major VA treatment facilities within the United States. Unfortunately, an overwhelming majority of America’s veterans still do not have access to chiropractic care because the VA has taken no action to provide chiropractic care at more than 100 of its major medical facilities.

Despite important data demonstrating a critical need for chiropractic services within the VA, the disparity in access has been allowed to persist. Recent VA data (Analysis of VA Health Care Utilization among Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) Veterans, February 2010) cite “diseases of musculoskeletal system/connective system,” such as back pain, as the number one ailment of Iraq and Afghanistan veterans accessing VA treatment.

Resources for doctors of chiropractic seeing VA patients

The American Chiropractic Association has posted information for providers working with, or who would like to see patients through the VA Non-VA Care program.

Non-VA Care

Medical care provided to eligible Veterans outside of VA when VA facilities are not available. Non-VA Care is used when VA medical facilities are not "feasibly available." The local VA medical facility has criteria to determine whether Non-VA Care may be used. If a Veteran is eligible for certain medical care, the VA hospital or clinic should provide it as the first option. If they can't - due to a lack of available specialists, long wait times, or extraordinary distances from the Veteran's home - the VA may consider Non-VA Care in the Veteran's community.

Non-VA Care Provider Information

Once Purchased Care (non-VA Care) is authorized, Veterans may seek treatment from a provider in their community. This guide details what non-VA providers should expect in terms of authorizations and referrals, claims payment, and the return of medical documentation back to the authorizing VA Medical Center (VAMC).

Becoming a Non-VA Care Provider Information

Veterans Affairs fact sheet on chiropractic

Read this fact sheet to learn more about chiropractic in the VA

Veterans Affairs facilities offering chiropractic services

For a list of the 47 major VA medical facilities offering chiropractic services, click here

Veterans: How to receive the services provided by a Doctor of Chiropractic

For veterans seeking chiropractic care, please read this advisory to learn how to access this important service provided to you as part of your medical benefits.

Doctors of Chiropractic: To Treat Our Veterans Through the U.S. Department of Veterans Affairs