The answer to Veteran's Choice in Orthotics
Kevin Matthews
Description
Collection
Title:
The answer to Veteran's Choice in Orthotics
Creator:
Kevin Matthews
Date:
6/5/2012
Text:
I have searched the VA website on several occasions and
Hello all,
I have searched the VA website on several occasions and was never able to find anything in writing that addressed orthotic care, until today.
I was searching again and found the VetsFirst website. In their contents bar the was a page to ask a question. I asked:
As a service connected veteran with a disability that requires a custom made leg brace, or orthosis, does the Veteran have the right to select a vendor other that the VA prosthetics department, as long as they are a contracted and accredited provider. There is information stating that choice is allowed for prostheses, or artificial limbs, but there is no information on orthoses. Can you direct me to a statute or policy regarding this?
I asked the question at 2:16 and received the following reply at 2:21. Amazing! I was never able to find this information, and I consider myself an apt googler.
The veteran cannot go to a contract agency without approval. A contract agency is used when the VA cannot provide the service or cannot provide prompt service then contract services can be provided. Here is a link to the VHA Handbook:
<URL Redacted>
The veteran has no choice.
VHA HANDBOOK 1173.10 January 29, 2008 2 3. PROCEDURES a. Medically prescribed orthotic devices and repairs must be provided in a timely and efficient manner to beneficiaries who are eligible for prosthetic services.
b. Upon receipt of a prescription, an evaluation of the patient by the Orthotist determines the appropriate orthotic device and/or service.
c. The VA Orthotic and Prosthetic Laboratory must provide orthotic devices and repairs to beneficiaries to the fullest extent possible. At facilities not having access to the VA Orthotic and Prosthetic Laboratory or where the laboratory's workload is such that the Orthotic and Prosthetic Laboratory cannot provide prompt service, local contracts are to be awarded to private contractors for procurement. Contract devices must be of high quality and are to be inspected by the Chief, Orthotic and Prosthetic Laboratory, Orthotist designee, or Orthotic Clinic within 30 days of delivery.
If I interpret this correctly, the VA clinic is required to do the work and can only refer out if they cannot provide the service in a timely manner. It sounds like even the VA clinics don't have a choice if they are able to provide the service. My guess would be if they are referring out, they'd better be able to answer why when asked by higher ups.
We all know that skills and talent sets differ between orthotists. Difficult cases require a level of experience, knowledge and talent. A young orthotist may be in over his head and want to refer to a more experienced orthotist, in the interest of the veteran. I'm not sure he could do that. The only stipulation I found that allows outside referrals is if they cannot provide it in a timely manner.
I feel this policy is flawed and should be changed, but for now it is policy, as far as I can tell. I don't believe it is enforced in many cases, or perhaps it is simply not known. Several respondents worked at a VA O&P Lab and still allow choice. Some even stated that was what they understood to be policy. This policy is up for recertification on or before the last working day of January, 2013.
My local VA could have saved me a lot of grief if they had directed me to the policy. I know this post may upset some people. I felt it my obligation to post this since I asked the question and subsequently found the answer, unless it has been suspended or something and I don't know about.
AOPA and NAAOP need our support for this and other upcoming legislation. Stay informed and get involved!
Kevin C. Matthews, CO/LO
Advanced Orthopedic Designs
12315 Judson Rd. #206
San Antonio, Texas 78233
210-657-8100
210-657-8105 fax
www.AdvancedOrthopedicDesigns.com
<Email Address Redacted>
Hello all,
I have searched the VA website on several occasions and was never able to find anything in writing that addressed orthotic care, until today.
I was searching again and found the VetsFirst website. In their contents bar the was a page to ask a question. I asked:
As a service connected veteran with a disability that requires a custom made leg brace, or orthosis, does the Veteran have the right to select a vendor other that the VA prosthetics department, as long as they are a contracted and accredited provider. There is information stating that choice is allowed for prostheses, or artificial limbs, but there is no information on orthoses. Can you direct me to a statute or policy regarding this?
I asked the question at 2:16 and received the following reply at 2:21. Amazing! I was never able to find this information, and I consider myself an apt googler.
The veteran cannot go to a contract agency without approval. A contract agency is used when the VA cannot provide the service or cannot provide prompt service then contract services can be provided. Here is a link to the VHA Handbook:
<URL Redacted>
The veteran has no choice.
VHA HANDBOOK 1173.10 January 29, 2008 2 3. PROCEDURES a. Medically prescribed orthotic devices and repairs must be provided in a timely and efficient manner to beneficiaries who are eligible for prosthetic services.
b. Upon receipt of a prescription, an evaluation of the patient by the Orthotist determines the appropriate orthotic device and/or service.
c. The VA Orthotic and Prosthetic Laboratory must provide orthotic devices and repairs to beneficiaries to the fullest extent possible. At facilities not having access to the VA Orthotic and Prosthetic Laboratory or where the laboratory's workload is such that the Orthotic and Prosthetic Laboratory cannot provide prompt service, local contracts are to be awarded to private contractors for procurement. Contract devices must be of high quality and are to be inspected by the Chief, Orthotic and Prosthetic Laboratory, Orthotist designee, or Orthotic Clinic within 30 days of delivery.
If I interpret this correctly, the VA clinic is required to do the work and can only refer out if they cannot provide the service in a timely manner. It sounds like even the VA clinics don't have a choice if they are able to provide the service. My guess would be if they are referring out, they'd better be able to answer why when asked by higher ups.
We all know that skills and talent sets differ between orthotists. Difficult cases require a level of experience, knowledge and talent. A young orthotist may be in over his head and want to refer to a more experienced orthotist, in the interest of the veteran. I'm not sure he could do that. The only stipulation I found that allows outside referrals is if they cannot provide it in a timely manner.
I feel this policy is flawed and should be changed, but for now it is policy, as far as I can tell. I don't believe it is enforced in many cases, or perhaps it is simply not known. Several respondents worked at a VA O&P Lab and still allow choice. Some even stated that was what they understood to be policy. This policy is up for recertification on or before the last working day of January, 2013.
My local VA could have saved me a lot of grief if they had directed me to the policy. I know this post may upset some people. I felt it my obligation to post this since I asked the question and subsequently found the answer, unless it has been suspended or something and I don't know about.
AOPA and NAAOP need our support for this and other upcoming legislation. Stay informed and get involved!
Kevin C. Matthews, CO/LO
Advanced Orthopedic Designs
12315 Judson Rd. #206
San Antonio, Texas 78233
210-657-8100
210-657-8105 fax
www.AdvancedOrthopedicDesigns.com
<Email Address Redacted>
Citation
Kevin Matthews, “The answer to Veteran's Choice in Orthotics,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/233782.
