Veterans with Spinal Cord Injury/Disorders

VA’s Spinal Cord Injuries and Disorders System of Care provides a coordinated life-long continuum of services for Veterans with a spinal cord injury or disorder. VA serves Veterans in a convenient and connected network that delivers care for each phase of life.

The VA has the largest system of care for spinal cord injuries and disorders in the United States.

There are 24 VA medical centers in the United States with specialized centers (called Spinal Cord Injury Centers) for Veterans with spinal cord injuries and disorders (SCI/D). Comprehensive rehabilitation, SCI/D specialty care, medical, surgical, primary, preventive, psychological, respite, and home care are provided at these centers by interdisciplinary teams which include physicians, nurses, therapists (physical, occupational, kinesiotherapists, therapeutic recreation), psychologists, social workers, vocational counselors, dieticians, respiratory therapy, and other specialists as needed.

There are five Spinal Cord Injury (SCI) Centers that provide long term care for Veterans with SCI/D. In VA facilities that do not have SCI Centers, there is a designated team that consists of a physician, nurse, and social worker to address primary care needs for Veterans with SCI/D and to make referrals to SCI Centers. These SCI Centers and the teams in facilities that do not have centers, comprise the VA SCI System of Care. Some of the services provided in this system of care include rehabilitation, prosthetics and durable medical equipment, orthotics, sensory aids, assistive technology, environmental modifications, telehealth, ventilator weaning and care, chronic pain management, mental health treatment, drivers training, peer counseling, substance abuse treatment, vocational counseling, and caregiver training and support.

There is a long-standing Memorandum of Agreement between VA and the Department of Defense (DoD) to provide specialized care at VA medical facilities for Active Duty Servicemembers who have sustained a spinal cord injury. Ongoing collaboration and education between VA and DoD ensures continuity of care and services.

What Is SCI?

The spinal cord is the main pathway for transmitting information between the brain and the nerves that lead to muscles, skin, internal organs and glands. Injury to the spinal cord disrupts movement, sensation and function. Paraplegia results from injury to the lower part of the spinal cord, causing paralysis of the lower part of the body, including the bowel and bladder. Tetraplegia (sometimes called quadriplegia) results from injury to the spinal cord in the neck area, causing paralysis to the lower body, upper body and arms. SCI requires ongoing management of impairments and prevention of related problems.

Compensation

Veterans with SCI may receive up to 100% monthly disability compensation. They may receive additional compensation if the injury resulted in loss of use of hands or feet or in other disabilities. The rating may include other service-connected disabilities not related to their spinal injury. Many veterans with service-connected disabilities are also entitled to vocational counseling, grants for adapted housing and automobiles, a clothing allowance and payment for home and attendant care.

Health Care for Veterans with SCI

VA has the largest single network of SCI care in the nation. It provided a full range of care to nearly 26,000 veterans with spinal cord injuries and disorders in 2008 and SCI specialty care to about 13,000 of these veterans. A study conducted by a major consulting firm in 2000 comparing VA's SCI services to those funded by several private and public health insurers showed that VA's coverage was more comprehensive. VA integrates vocational, psychological and social services within a continuum of care and addresses changing needs throughout the veteran's life. VA provides supplies, preventive health care and education for veterans with SCI. VA also maintains medical equipment.

The average age of a person at the time of injury is increasing, as the general age of the population of the United States has increased. VA's system of care provides a coordinated lifelong continuum of services for eligible veterans with SCI of all ages, including emergency care, medical and surgical stabilization, rehabilitation, primary care, preventive care, specialty sustaining care, surgical care, outpatient care, home care and long-term care. VA's SCI specialty care focuses on the prevention or early detection of complications of SCI, with multidisciplinary teams providing annual comprehensive evaluations.

VA services are delivered through a "hub and spoke" system of care, extending from 24 regional SCI centers offering primary and specialty care by multidisciplinary teams to the 134 SCI primary care teams or support clinics at local VA medical centers. Each primary care team has a physician, nurse and social worker, and those with support clinics may have additional team members. Newly injured veterans and active-duty members are referred to a VA SCI center for rehabilitation after being stabilized at a trauma center. Each year, approximately 450 newly injured veterans and active-duty members receive rehabilitation at VA's SCI centers.

The 24 VA SCI centers are at the following locations: Long Beach, Palo Alto and San Diego, Calif.; Miami and Tampa, Fla.; Augusta, Ga.; Hines, Ill.; West Roxbury, Mass.; Minneapolis; St. Louis; East Orange, N.J.; Albuquerque, N.M.; Bronx and Castle Point, N.Y.; Cleveland; San Juan, P.R.; Memphis, Tenn.; Dallas, Houston and San Antonio, Texas; Hampton and Richmond, Va; Seattle; and Milwaukee.

The SCI center nearest to a veteran can provide the name of the SCI coordinator in the SCI primary care team at the nearest VA facility.

VA Regional SCI Centers

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