What Is the MISSION Act
The MISSION Act (Maintain Internal Systems and Strengthen Integrated Outside Networks) is the 2018 Veterans Community Care and Access Reform Act that fundamentally changed how VA distributes healthcare between its own facilities and private community providers. Under this law, the VA must refer you to community care if your local VA facility cannot schedule your appointment within 20 days for primary care or specialty care, or if you live more than 40 miles from the nearest VA facility (30 miles for certain rural areas).
This matters directly to your disability claim process. If you need a Compensation and Pension (C&P) exam to support your claim, the VA may route you to a community provider rather than a VA medical center. Understanding how the MISSION Act works helps you know what to expect, which exam facilities might contact you, and how to coordinate your medical records across providers.
How It Affects Your Disability Claims
The MISSION Act introduces three practical considerations for veterans pursuing VA disability benefits:
- C&P exam routing: The VA contracts with community healthcare networks (QTC Management Services, LHI, and others) to conduct examinations. When your disability claim requires medical evaluation, you may be scheduled at a private clinic rather than a VA hospital. The quality and thoroughness of these exams vary significantly, which is why some veterans request VA exams instead.
- Nexus letter complications: If your C&P exam occurs at a community provider unfamiliar with VA disability standards, the examiner may not fully understand the nexus requirement (the connection between your service and current condition). You may need to provide additional documentation or request clarification from your Veterans Service Officer (VSO) if the exam report lacks adequate nexus statements.
- Medical record continuity: Community providers don't automatically access your VA medical records during the MISSION Act referral. You should request copies of all examination reports and submit them to your claim file immediately. Delays in receiving these documents can slow your disability rating decision.
When MISSION Act Applies
You qualify for MISSION Act community care if any of these conditions exist:
- Your VA facility cannot schedule an appointment within 20 days from the date you request it
- You live more than 40 miles from the nearest VA facility (or 30 miles in rural areas with provider shortages)
- You need specialty care that the VA facility refers out even when scheduling is available
- Your local VA facility lacks the specific service you need (like rare specialty exams for unusual service-connected conditions)
MISSION Act and the Appeals Process
If you disagree with findings in a community-provider C&P exam during the appeals process, you have specific options. You can request a new VA exam instead of relying on the community provider's report. Many veterans work with VSOs to request these corrections before the case moves to the Board of Veterans' Appeals, which can speed resolution. The VA Regional Office must consider your request seriously if the original exam contained medical errors or lacked nexus clarity.
Common Questions
- Can I refuse a community care C&P exam and insist on a VA exam? You cannot refuse outright, but you can request a VA exam through your VSO if you believe the community provider's credentials or findings are inadequate. Document your concerns specifically and submit them in writing to your Regional Office. This works best before the exam occurs.
- Will my community care C&P results delay my disability claim? Community exams typically take 2 to 3 weeks longer than VA exams to be completed and submitted. Request your examination report directly from the provider and submit it to the VA yourself if delays occur beyond 30 days from your exam date.
- Do I need to pay for community care exams under MISSION Act? No. The VA covers all costs for MISSION Act-authorized exams. However, verify the provider is VA-authorized before your appointment. If you receive a bill, contact your Regional Office immediately.