H.R. 1058 includes podiatrists within the Department of Veterans Affairs (VA) definition of a physician, increases their pay grade to match other VA physician compensation, and expands the opportunity to compete for leadership positions. In addition, the bill extends, through September 20, 2026, the current $90 per month limit on a VA pension paid to veterans residing in nursing homes when their nursing costs are paid through Medicaid.
Veterans face increasing numbers of foot and ankle ailments, including diabetic-related complications, peripheral neuropathy often linked to Agent Orange exposure, orthopedic maladies, and vascular compromise, with 1.8 million veterans at risk of amputation. As of 2015, 93% of new podiatry patients wait more than 15 days for an appointment, and podiatry is the 4th most referred-out surgical service to community care.
This problem is self-imposed. VA lags behind the private sector in pay and leadership opportunities for podiatrists. VA's qualifications for podiatrists were developed in 1976 and have not been updated in the 39 years since. In that time, the practice of podiatry has evolved significantly. Today, podiatrists receive education and training comparable to that of other medical doctors. Yet, VA podiatrists are paid on the special Title 38 scale for podiatrists, optometrists, and chiropractors, while a VA M.D. or D.O. is paid on a separate physician pay scale, which has significantly higher salaries. Further, many podiatrists join the VA with less than 10 years’ experience and without board certification; they stay long enough to earn board certification and then leave the VA for more pay or for a leadership position elsewhere. This means the VA is attracting less experienced podiatrists when they have a patient population that is more complex.