Confusion around Department of Veterans Affairs footwear benefits is common, and understandably so, since there isn’t just one program. Two separate benefits actually get lumped together in conversation, plus a broader clinical service coordinates both. Here’s how the system works.
Any VA-enrolled veteran whose VA clinician determines therapeutic footwear is medically necessary can be referred for it. Diabetes is the most common qualifying condition, but it isn’t the only one. Neuropathy, peripheral arterial disease, foot deformities, pressure points, chronic swelling or edema, and prosthetic needs can all lead to a referral for specialized footwear. The process typically starts with a primary care or podiatry appointment. If footwear is clinically indicated, that provider writes a prescription and refers the veteran to VA’s Orthotic, Prosthetic and Pedorthic Clinical Services team, commonly called OPPCS, for measurement, fitting and issuance.
OPPCS clinicians include prosthetists, orthotists, pedorthists and certified therapeutic shoe fitters. When clinically appropriate, VA policy allows for two serviceable pairs of therapeutic footwear. Veterans typically select from a catalog of approved styles rather than a single standard shoe, and some VA facilities have expanded orthotics access to satellite clinics specifically to reduce travel burden and wait times for veterans who previously had to be referred outside the system entirely.
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A related program, Prevention of Amputation in Veterans Everywhere, known as PAVE, proactively identifies veterans at elevated risk of foot complications, including those with diabetes, peripheral arterial disease, or neuropathy, and routes them toward foot care and protective footwear before a serious problem develops rather than after.
The Annual Clothing Allowance — A Different Benefit Entirely
Separately, VA offers an annual clothing allowance, authorized under 38 CFR 3.810, for veterans whose service-connected prosthetic or orthotic device causes unusual wear or tear on their clothing. This is a cash payment, not a shoe voucher, and it’s frequently confused with the footwear program itself. Eligible veterans typically need to apply annually, and payments are commonly issued in the early fall. Veterans who believe they may qualify should check with their prosthetic representative for current deadlines and submission requirements, including VA Form 10-8678.
How to Start the Process
There’s no direct application for therapeutic footwear the way there is for the clothing allowance. Every legitimate path into VA’s footwear benefit begins with a clinician, not a form. Veterans interested in whether they qualify should raise it directly with their primary care provider or request a podiatry referral. If therapeutic footwear is appropriate, that provider handles the referral into OPPCS, where fitting and ordering happen.
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Veterans who are unsure whether their VA facility offers on-site orthotics services, or who’ve previously been referred outside the VA for this care, can ask their care team whether that’s changed, since several VA health systems have been actively expanding in-house orthotics access in recent years.
Veterans with questions about eligibility for either benefit can contact their VA prosthetics representative directly, or reach VA at 800-698-2411.
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