Denied for VA Community Care? Here’s what to do next.
If a recent request for community care was not approved by the VA, this can be frustrating and unclear. This page provides general information about what that decision may mean and a possible next step to consider.
1) Action is Needed
When a request for additional visits is not approved, the community care office/provider who submitted it has limited ability to change that decision.
The next step typically needs to come from you.
Contact your VA Primary Care Provider (PCP) or care team to discuss your situation.
When you speak with your VA provider, you can ask:
if a new authorization request can be submitted
whether your situation may qualify under Best Medical Interest (BMI)
What is Best Medical Interest (BMI)?
Some community care requests go through an additional (secondary) VA review - this if where MOST DENIALS occur.
Under 2025 updates, tied to The Dole Act, your VA provider may be able to request community care based on their clinical judgment.
When BMI applies, it may reduce the need for that additional (secondary) review
2) Ask About a New Authorization and Best Medical Interest
What to Share With Your Provider:
What care you are receiving
How it has helped - pain improvement, quality of life improvement, decreased pain medication use, etc.
Any setbacks or worsening symptoms without care
Why continuing care matters for you
Why other treatments aren’t effective for your specific case/symptoms.
