Foot health and VA prosthetics

VA therapeutic footwear

VA can prescribe and provide special shoes and inserts when your feet medically need them. Here is who qualifies, who orders them, and how to ask.

← Back to vsgsolutions.org VHA Directive 1173.9(1)
Veterans Crisis Line — dial 988, then press 1. Text 838255. Chat at veteranscrisisline.net. TTY 711 then 988, or 1-800-799-4889. 24 hours a day, 7 days a week. You do not have to be enrolled in VA benefits or health care to connect.
This is a medical-need benefit, and I could not verify that it is “free.” A popular flyer says “VA free shoes.” VA's directive says the footwear must be provided when it is medically necessary and part of your care. It does not say a veteran owes nothing, and it does not talk about copays at all. Here is what VA's own rules do say. VA's copay rules charge for outpatient visits (38 CFR 17.108) and medications (17.110), and 17.110 says “medication” does not include medical supplies or medical devices. The prosthetics rules (17.3200 to 17.3250) say nothing about a copay for the items. VA's supplies page says some items are free and that other medical supplies “may” carry copays. Reading those together, the shoes themselves are not a charge under the copay rules I found, but VA has not published a statement that says so, and a clinic visit can carry a copay for veterans who are not exempt. Under 17.108(d), veterans with a compensable service-connected disability, former prisoners of war, Purple Heart recipients and several other groups are exempt from the visit copay. Ask your VA Prosthetics clinic before you are fitted, and get the answer in writing.
Start here

What this benefit is

Medical footwear and in-shoe inserts, ordered by a VA clinician.

  • It comes from VHA Directive 1173.9(1), VA's policy on therapeutic footwear and in-shoe orthoses (issued Oct. 22, 2021, amended July 12, 2024).
  • The veteran and the prescribing clinician decide together which footwear and inserts fit your needs.
  • VA must provide it when it is medically necessary and an active part of your care.
  • It is not a general shoe allowance. You do not pick out any shoe you like.
Medical need first. Shoes second.
Who qualifies

The medical reasons the directive lists

Standard shoes cannot handle your foot.

  • ListedA foot or ankle deformity, with or without disease
  • ListedSensory neuropathy from a disease
  • ListedPeripheral arterial disease
  • ListedA neurologic injury
  • ExamplesA high foot-risk score, inpatient status, amputation, or one foot a different size from the other
  • AlsoUse of a prescribed orthotic or prosthetic device
The detailed criteria are in VA internal procedures that are not published in the directive. Your clinician applies them.
The doctor decides. You describe the problem.
Service connection

Do you need a VA rating?

The directive does not mention one.

  • The directive bases eligibility on medical need. In the text I read, it does not mention service connection or a disability rating.
  • VA's Prosthetics page says general eligibility is for veterans enrolled in VA health care with a medical need for the item.
  • That page limits hearing aids and eyeglasses to certain groups. It does not put therapeutic footwear on that list.
Enrollment is required. If you are not enrolled in VA health care, start there. See the steps panel below.
Enrolled and medically needing it.
How to get it

The steps

Your clinician starts it. Prosthetics fills it.

  1. Be enrolled in VA health care. Apply online, by phone, by mail, or in person at a VA medical center or clinic.
  2. Tell your VA provider about the foot problem. Primary care, podiatry or wound care. Say what hurts, what you have lost feeling in, and what shoes do not work.
  3. Get a foot exam. VA's Prosthetics page says a foot exam by primary care, podiatry or wound care comes before the referral to Prosthetics.
  4. Your clinician enters the prescription order and records your foot-risk score or deformity in your VA record. VA's Prosthetic and Sensory Aids directive says the prescribing provider submits the request through a PSAS administrative consult. You do not request it from PSAS yourself.
  5. The Prosthetics (orthotics) clinic reviews the order and fills it. Some orders are filled by an outside commercial provider that VA supervises.
  6. Go to your fitting. At the VA sites I checked, a current consult is required to schedule. Call the clinic if you do not have one.
The order starts with your VA clinician.
Who orders it

Who can prescribe

Privileged VA clinicians. The directive names these.

  • Podiatrists (DPM)
  • Physicians (MD and DO)
  • Physician assistants (PA)
  • Nurse practitioners (CNP)

The clinic that provides the footwear is staffed by orthotics/prosthetics clinicians. Purchasing is handled by VA Prosthetic and Sensory Aids Service (PSAS).

Local rules differ. One VA medical center's page says primary-care shoe consults are not accepted and a podiatry evaluation is needed. Another says a PM&R referral and a current consult are required, with no walk-ins. Ask your clinic.
Same national policy. Local front door.
What you get

Pairs, types and follow-up

From the directive.

  • Two serviceable pairs. An extra pair can be authorized for environmental conditions tied to your job or a regular activity.
  • Types named: custom-made shoes, depth-inlay shoes, healing (post-surgery) shoes, high-top shoes or boots, reinforced-toe shoes, and shoe modifications.
  • Inserts: accommodative, functional (custom) and non-custom.
  • Brands: the directive names none. Items must carry an assigned HCPCS billing code.
  • Follow-up: at least yearly, or sooner if you ask. It includes checking whether your footwear is still serviceable.
Ask for the yearly check.
Repairs

Repairs and replacement

The footwear directive is silent. VA's general rule is not.

  • VA's prosthetics rule, 38 CFR 17.3230, covers repairs to items it provides, even if VA did not first prescribe the item.
  • It covers replacement when an item is damaged, destroyed, lost or stolen, or when replacement is clinically indicated.
  • It says serviceable items that still meet your need are not replaced just to get a newer model.
  • Items must be a direct part of your treatment, not just for comfort or convenience.
Limit of what I verified: that rule lists “orthotic devices” and does not name footwear. The footwear directive has no repair steps and no replacement schedule. Its wear-and-tear criteria are in internal procedures I could not read. Ask your clinic how they handle repairs.
If they stop working, request a visit.
Related money

Clothing allowance

A different benefit. Do not mix them up.

  • VA pays an annual clothing allowance when a prosthetic or orthopedic device damages your clothing. It repays clothing damage. It does not supply the footwear.
  • See the Binder page on the 100% P&T benefits for the current amount and the August 1 date.
Shoes are care. Clothing allowance is repayment.
Ask your clinic

What I could not verify

I searched for these. VA did not publish them.

  • A VA statement on the cost of footwear. The copay rules cover visits and medications, not these items, but VA does not say “no charge” for footwear anywhere I looked.
  • How long it takes. VA's Prosthetic and Sensory Aids directive calls for “timely” provision and sets no time frame for devices.
  • Footwear repair steps and replacement schedule. Only the general rule above.
  • Walk-in hours and which clinic sees you first. Local. It differs by VA site.
Get the answers in writing.
Before you act. VA policy changes. Read the directive, and confirm with your own VA Prosthetics clinic. I read VHA Directive 1173.9(1), VHA Directive 1173, 38 CFR 17.3230 and VA's Prosthetics pages on October 19, 2026. Some of what I summarize comes from the directive's paraphrased text, so use the directive link for exact wording.

Sources