Dept of Veterans Affairs, 38 CFR Part 17 -- Benefits

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[Federal Register Volume 76, Number 116 (Thursday, June 16, 2011)]
[Proposed Rules]
[Pages 35162-35167]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-14933]

DEPARTMENT OF VETERANS AFFAIRS
38 CFR Part 17
RIN 2900-AN51

Service Dogs
AGENCY: Department of Veterans Affairs.
ACTION: Proposed rule.

SUMMARY: The Department of Veterans Affairs (VA) proposes to amend its
regulations concerning veterans in need of service dogs. Under current
regulations, VA provides benefits to veterans with guide dogs, and this
rulemaking would broaden and clarify those benefits. This rulemaking
would also implement new benefits related to service dogs.

DATES: Comments must be received by VA on or before August 15, 2011.

SUPPLEMENTARY INFORMATION: 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 dogs.
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. Under both the statutory and regulatory language VA may
provide or furnish a guide dog to a veteran but is not required to do
so. VA interpreted ``provide'' in section 1714 and ``furnished'' in
Sec. 17.154(a) to mean that VA need not actually purchase or acquire
dogs for eligible veterans if there is an appropriate alternative. (We
also note that nothing in 38 U.S.C. 1714 requires VA to provide a dog
to a disabled veteran--the statutory authority is that we ``may'' do
so). Accordingly, it has long been VA's policy to apply current Sec.
17.154(a) by recognizing guide dogs that are obtained by the veteran
from private (usually non-profit) organizations dedicated to training
guide dogs. In this manner, we can rely on the professional expertise
of these organizations without having to house the animals and hire
trainers. Currently, VA regulations recognize only guide dogs and not
service dogs. To assist the veteran, VA provides financial assistance
for veterinary care, and provides hardware required by the dog at no
cost to the veteran. The provision of travel benefits is authorized by
current Sec. 17.154(a), and the provision of hardware is authorized by
current Sec. 17.154(b). This proposed rule would authorize VA to
provide benefits for

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eligible veterans in need of service dogs, and clearly define the
benefit.

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In 2001, Congress amended section 1714 to provide that VA may also
provide service dogs for veterans with other disabilities. See
Department of Veterans Affairs Health Care Programs Enhancement Act of
2001, Public Law 107-135 (2001). This rulemaking would implement that
statutory amendment and would establish a single regulation relating to
the provision of assistive dogs by VA. In so doing, we would remove
current Sec. 17.154(a) and establish the criteria proposed in Sec.
17.148 so that the proposed rule would be the only regulatory authority
for benefits related to service dogs. As explained below, the proposed
rule would offer the same travel benefit offered under current Sec.
17.154(a). The proposed rule would also clarify that VA interprets
section 1714 as authorizing the provision of veterinary-care benefits
and would establish a clear procedure for awarding such benefits.
Proposed paragraph (a) would define service dogs as ``guide or
service dogs prescribed for a disabled veteran under this section.''
This rule would provide the same benefit to all eligible veterans, so
it is unnecessary to distinguish dogs by the services that they
provide. For example, we do not use the term ``guide dogs'', which
appears under current 38 CFR 17.154, because for the purposes of this
rulemaking, veterans who are eligible due to blindness would receive
the same benefit.
Proposed paragraph (b) would establish the clinical requirements to
obtain service-dog benefits. First, we would authorize benefits only if
the veteran is diagnosed as having a visual, hearing, or substantial
mobility impairment. These requirements incorporate the eligibility
criteria in section 1714. Second, we would require a clinical
determination by a VA clinician, which would be based upon the
clinician's medical judgment that ``it is optimal for the veteran to
manage such impairment and live independently through the assistance of
a trained service dog.'' By this, we intend to exclude situations in
which a VA clinician's medical judgment indicates that there are means
other than a dog, such as technological devices or rehabilitative
techniques, which would enable and encourage the veteran to live
independently. To emphasize this point, we would note that ``[i]f 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.'' 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.

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Third, for the purposes of this section, we would define
substantial mobility impairment as a spinal cord injury or dysfunction
or other chronic impairment that substantially limits mobility. In
providing guide-dog benefits, Congress intended to assist a group of
veterans whose visual impairment prevents them from physically moving
about in society. In providing service-dog benefits for veterans with
hearing or spinal cord injuries or other chronic impairment that
substantially limits mobility, Congress intended to help veterans with
physical limitations. Both of these benefits increase a veteran's
overall ability to move independently and safely in his or her home,
community, or both. However, the statute is silent as to a veteran who
can see and who does not have an injury that prevents full range of
motion but who nevertheless cannot move independently and safely in his
or her home, community, or both. Therefore, we would interpret chronic
impairment that substantially limits mobility to include, but not be
limited to, disabilities such as a traumatic brain injury that
compromises the ability to make appropriate decisions based on
environmental cues such as traffic lights or a seizure disorder that
renders a veteran immobile during and after a seizure event.

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In 2009, Congress authorized VA to provide service dogs for the aid
of persons with mental illnesses by amending section 1714. Although VA
welcomes the possibility that trained dogs may provide valuable
services to veterans diagnosed with certain mental illness, at this
time we do not have any scientific data to determine, from a purely
clinical standpoint, whether or when service dogs are most
appropriately provided to veterans with mental illness, including post-
traumatic stress disorder. In the National Defense Authorization Act
for Fiscal Year 2010, Pub. L. 111-84 (2009), Congress mandated a 3-year
study on the effectiveness of dogs for mental health purposes. The
results of this study will help us learn more about the services that
trained dogs can provide for veterans diagnosed with mental health
conditions. Upon the completion of the study and analysis of its
results, VA may revise its regulations in order to provide this service
to our veterans.

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Proposed paragraph (c) would establish criteria for obtaining a
service dog recognized under this section for purposes of obtaining
benefits. Under paragraphs (c)(1) and (2), we would recognize service
dogs obtained through an organization that is accredited by Assistance
Dogs International (ADI) or the International Guide Dog Federation
(IGDF). Proof of completion would be established by a certificate from
the organization. ADI is an international coalition of nonprofit
organizations that train and place service dogs. ADI has established an
accreditation procedure for service dog organizations, setting minimum
standards for safety and cleanliness of the training facility, fair and
ethical treatment of clients, proper health care for the dogs, humane
training methods, screening the suitability of dogs and clients,
matching dogs and clients, and compliance with all relevant laws. ADI
does not accredit organizations that provide guide dogs--ADI only does
so for service-dog organizations that train dogs to perform services
for individuals with conditions other than blindness. Accreditation of
guide-dog programs is done by IGDF, with whom ADI has a joint protocol.
ADI will only accredit guide-dog programs if they are also involved in
training service dogs, and even then ADI accredits only that portion of
the training related to service dogs--IGDF accredits the guide-dog
portion. IGDF does not accredit any non-guide dog programs. IGDF is an
international coalition of member organizations. IGDF is committed to
improving the guide dog industry throughout the world and has published
standards that cover a wide range of activities conducted by guide dog
organizations, such as organizational structure, fundraising,
recordkeeping, technical matters relating to dog health and welfare,
dog and client training, and school facilities.
VA has reviewed ADI's and IGDF's standards thoroughly, and we
believe that they represent appropriate criteria for training and
placing guide and service dogs. We are also unaware of any other
organizations that similarly scrutinize the process of training and
placing guide or service dogs. We note that there are no Federal
regulations governing the training of guide or service dogs, and VA
does not have the expertise, experience, or resources to develop
independent criteria. Therefore, we would rely on ADI and IGDF
accreditation to conclude that a dog is qualified and capable of
performing the tasks that are clinically required by the medical
determination prescribed under

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proposed paragraph (b)(2), i.e., that the dog will benefit the veteran
in a way that other assistive means cannot.

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For dogs acquired before the effective date of this rule, we would
require the veteran to provide a certificate showing that the veteran
and dog have completed a training course offered by a guide or service
dog organization in existence before such date. We would limit this
authority to organizations that existed before the effective date of
the regulation. The purpose of this paragraph is to ensure that
veterans who obtained dogs prior to the publication of this regulation,
but not through ADI or IGDF accredited organizations, would be eligible
for the benefits prescribed by this regulation. We would allow veterans
who obtained dogs through such non-accredited organizations up to 1
year after the effective date of this rule to obtain the required
certification. Alternatively, the veteran and dog could obtain the
certification from ADI or IGDF described under proposed paragraph
(c)(1).

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Federal Register
A Rule by the Veterans Affairs Department on 09/05/2012

ACTION Final Rule

SUMMARY 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.

UNIFIED AGENDA Guide and Service Dogs

https://www.federalregister.gov/arti...vice-dogs#h-16