Veterans and Caregivers: Osteopathic Cannabis Care

How VA Community Care Fits—Step-by-Step

Short version: Your very first visit with a qualified, state-authorized osteopathic physician (DO) will almost always be out-of-pocket. That’s because VA cannot certify patients for state medical cannabis programs or pay for cannabis itself. After that initial certification, though, many veterans continue follow-up care with a DO for conditions like chronic pain, post-op recovery, PT/rehab, oncology symptom support, or sports medicine. These follow-ups may be covered through VA Community Care—if you’re eligible, your provider is in the Community Care Network (CCN), and VA issues an authorization.

Right now, VA clinicians still cannot recommend cannabis or fill out state paperwork. However, Congress has advanced bills that could allow VA doctors to recommend cannabis in legal states. The final law and VA policy updates are still pending. (Veterans Affairs, Stripes, Marijuana Moment, Congress.gov)

Why the First Visit Matters (and Why You Pay for It)

That first private appointment with a state-qualified DO serves two key purposes:

1. Certification & eligibility for your state program (e.g., Florida OMMU).
The physician reviews your medical history, confirms qualifying conditions, and, if appropriate, enters you into the state registry so you can apply for a medical cannabis ID.

2. Education & safety.
You’ll learn about dosing forms (like tinctures, capsules, topicals, and vaporized flower, where permitted), possible drug interactions, and what realistic goals look like. Medical cannabis can be helpful for conditions such as chronic pain, PT/rehab recovery, oncology symptom support, and more—but setting the right expectations matters.

Because VA is a federal agency—and cannabis is still federally illegal—VA-employed clinicians cannot certify you or complete state paperwork. VA also does not pay for cannabis products or certification visits. That’s why the first visit is usually self-pay. That said, the landscape could change soon. The House and Senate have already moved bills to allow VA physicians to recommend cannabis in legal states. Until a final law passes, the President signs it, and VA updates its directive, the current policy stays in place. (Veterans Affairs)

Two Lanes, Clean Lines: VHA vs. VBA (and Where Community Care Fits)

Think of VA care as two separate but parallel lanes:

VHA (Veterans Health Administration) = health care.
This lane handles your medical needs—primary care, consults, imaging, PT, pain management, and Community Care authorizations when you qualify (e.g., drive-time/wait-time standards, service availability, or veteran preference within VA rules).

VBA (Veterans Benefits Administration) = disability ratings and compensation.
This lane reviews medical evidence to determine your benefits. VBA may consider records from VA clinicians and community doctors, but it doesn’t manage your treatment plan.

Keeping these lanes separate prevents confusion. You can absolutely use private cannabis certification under state law and still coordinate follow-up care through VA or Community Care for treatable conditions. VA cannot certify you for cannabis, but it also should not deny you care or benefits just because you use cannabis in a state program. (Veterans Affairs)

The 2025 Federal Update (Where Things Stand Today)

House action (June–July 2025): The House passed a VA spending-bill amendment that would allow VA doctors to recommend medical cannabis in legal states. If signed into law, this would suspend the current prohibition in VA policy for that fiscal year. (Stripes)

Senate action (July–August 2025): The Senate advanced similar language. On August 1, 2025, the chamber approved a package including permission for VA clinicians to recommend cannabis in legal states. But the process isn’t finished—the House and Senate must pass a final conference bill, the President must sign it, and then VA has to update its policy (VHA Directive 1315) before anything changes. (Marijuana Moment, Congress.gov)

What’s true today: You will not lose VA benefits for using cannabis. In fact, you should feel comfortable discussing your cannabis use with your VA providers so your record stays accurate and your care plan remains safe. However, VA clinicians are still prohibited from recommending cannabis or completing state paperwork until the law is finalized and VA updates its directive. (Veterans Affairs)

Florida-Specific Notes (For Many Mendry/Veterans Desk Readers)

Florida manages its medical cannabis program through the Office of Medical Marijuana Use (OMMU). To participate, you must:

• Be a Florida resident (permanent or seasonal).
  
• Be diagnosed with a qualifying condition by a qualified physician who is registered with OMMU.
  
• Be entered into the state registry.
  
• Apply for and receive a state-issued medical cannabis ID card.
  

Physicians must follow the Florida Board of Medicine and Board of Osteopathic Medicine standards for evaluation, documentation, and follow-up. These steps are all state requirements—not VA processes. (Medical Marijuana Use, Florida Board of Medicine)

Key Florida Reminders for Physicians and Patients

• Qualified physicians must comply with state rules (e.g., 64B8-9.0181 / 64B15-14.013), including informed consent, proper documentation, and periodic review.
  
• The OMMU website is the go-to resource for up-to-date rules, physician requirements, and registry steps. The registry and ID card are mandatory before you can purchase products. (Florida Board of Medicine, Medical Marijuana Use in Florida)
  

After Certification: How to Use VA Community Care (Covered Follow-Ups)

Once you have your state cannabis card from that initial private visit, you may still need ongoing care for treatable conditions—things like pain management, PT/rehab, post-op recovery, oncology symptom support, or sports medicine. These follow-ups can be covered through VA or Community Care—if you’re eligible and properly authorized. The key is keeping the lanes separate: cannabis certification stays private/out-of-pocket; clinical follow-ups may be VA-covered.

The Eight-Step Roadmap

1. Get your private DO’s visit note. Make sure it includes diagnoses, ICD-10 codes, relevant history, and a treatment plan.
   
2. Share it with your VA PCP. Request a Community Care referral if you meet access standards (wait-time, drive-time, or unavailable VA services). Be clear about which services you need—e.g., “PT twice a week for six weeks” or “post-op OMT visits.”
   
3. Wait for the authorization. A consult isn’t enough. You need the written authorization before scheduling community visits.
   
4. Confirm network status. The provider must be in CCN (TriWest or Optum, depending on your region). An excellent clinician outside the network won’t be covered.
   
5. Authorize the provider’s office. This ensures they know the scope, dates, and billing instructions.
   
6. Ensure notes flow back to VA. Community providers must send documentation from each visit back to VA. This keeps your VA record current and helps VBA consider your case if benefits are in play.
   
7. Verify billing. Covered services are billed directly to VA—not you. Watch out for “market rate” invoices outside the authorization.
   
8. Track renewals. If your plan changes or extends, your provider may need to submit VA Form 10-10172 (Request for Service) to add or adjust services. (Veterans Affairs)
   

Bottom line: Cannabis certification visits (initial and renewal) remain private/out-of-pocket. But clinical follow-ups—like PT, OMT, imaging, or oncology symptom care—can be covered through VA or Community Care if you’re eligible and authorized. (Veterans Affairs)

What VA Covers (and What It Doesn’t)

• Covered (with eligibility & authorization): clinical evaluations, OMT, PT/OT, imaging, surgical follow-ups, pain management, oncology support, and similar medically necessary services.
• Not covered: cannabis certifications, state ID fees, or cannabis products. (Veterans Affairs)

Clean-Hands Compliance for Dual-Role DOs

Many DOs both understand cannabis pharmacology and participate in VA Community Care. This can help veterans—if boundaries are respected:

• Separate scheduling & records: Private certification vs. VA/CCN follow-ups.
  
• No bundling: Don’t mix certification renewals with VA-paid visits.
  
• Follow state rules first: In Florida, comply with Board and OMMU standards. (Florida Board of Medicine)
  

Common Pitfalls (and How to Avoid Them)

• Don’t rush the schedule: Hold off on booking community follow-ups until you actually have the VA authorization letter in hand and you’ve double-checked that the provider is in the CCN network. Skipping this step can leave you with surprise bills.
  
• Know what’s not covered: VA won’t pay for state cannabis certifications or renewal paperwork. Those visits stay private and out-of-pocket.
  
• Keep the records flowing: Remind your community clinic to send every visit note back to VA. Your VA PCP and care team rely on those updates to guide safe, connected care.
  
• Stay on top of renewals: If your recovery plan needs more time or services, your community provider may need to file a VA Form 10-10172 to extend or adjust your authorization. (Veterans Affairs)
  

“Will VA Doctors Soon Be Able to Recommend Cannabis?”

Maybe—but not yet. Here’s the accurate, current read:

• What moved: Both chambers advanced provisions in mid-2025 to allow VA doctors to recommend cannabis in legal states.  (Stripes, Marijuana Moment)
  
• What’s required: A final signed law, VA policy update (Directive 1315), and implementation. (Congress.gov)
  
• What’s true today: VA providers may discuss and document cannabis use, but cannot yet certify or recommend. (Veterans Affairs)

Florida Veteran? A Quick How-To

• Confirm your DO is “qualified” under Florida OMMU (and in CCN if you’ll seek covered follow-ups).
  
• First visit (private/out-of-pocket): evaluation, documentation, possible entry to the Medical Marijuana Use Registry; then you apply for the state card. (Medical Marijuana Use in Florida)
  
• Bring notes to your VA PCP and ask whether your clinical follow-ups (PT, OMT, imaging, etc.) are best delivered in VA or via Community Care.
  
• If Community Care is appropriate: wait for the authorization, confirm CCN status, and ensure the clinic will send notes back to VA.
  
• Keep everything separate: certification visits in the private lane; covered follow-ups in the VA/CCN lane.
  
• Reassess quarterly: If your plan changes, your community provider can submit 10-10172 for new or extended services (when appropriate). (Veterans Affairs)

Conversation Starters for Your VA PCP

• “Here’s my private DO’s note. For PT/OMT/symptom care, is VA or Community Care more appropriate?”
  
• “If we use Community Care, can we authorize twelve OMT visits + PT, with notes sent back to VA?”
  
• “What medication interactions should we monitor alongside my cannabis use?”

Bring a copy of your DO’s note and medication list. Clear communication prevents denials and keeps you safe.

FAQs

Q: Will VA deny me care because I use cannabis?
A: No. VA’s policy states veterans must not be denied VHA services solely for cannabis use or participation in a state program; providers should document use and plan care accordingly. (Veterans Affairs)

Q: Can my VA doctor fill out the state cannabis paperwork?
A: Not yet. Pending federal changes may allow VA physicians to recommend, but the policy remains in force until a final law is enacted and VHA updates Directive 1315. (Congress.gov, Veterans Affairs)

Q: Can my community DO be both a cannabis certifier and a CCN clinician?
A: Yes—with strict separation. No bundling of visits. Certification is private/out-of-pocket; covered clinical services run under VA/CCN authorization with notes returned to VA.

Q: What paperwork should my community provider know?
A: For services not on the original authorization, community providers use VA Form 10-10172 (Request for Service) with supporting records and plan. (Veterans Affairs)

How Mendry & Veterans Desk Help

• Plain-English education: We break down the “two-lane system” — private state cannabis certification on one side, VA-covered medical care on the other — so veterans understand where each piece fits and don’t slip through the cracks.
  
• Provider visibility (no booking, no sales): We highlight CCN-participating osteopathic doctors who understand cannabis care, with links to their websites and contact info. No gimmicks, no samples, no marketing — just clear connections.
  
• Checklists & templates: We create ready-to-use tools — Community Care checklists for veterans, quick-reference guides for providers, and Florida-specific reminders — to make coordination smoother for everyone.
  
• Policy tracking: We keep an eye on Congress and VA rule changes, especially the FY2026 appropriations process. The moment VA updates Directive 1315, we’ll share clear, plain-English updates so you know exactly what’s changed.
  

Bottom Line (2025)

• First visit (state certification) = private/out-of-pocket.
  
• Follow-up clinical care (PT, OMT, post-op, symptom management) may be covered via VA or Community Care with a proper authorization and an in-network provider—keep the documentation flowing back to VA.
  
• Policy watch: Congress advanced provisions to let VA doctors recommend cannabis in legal states, but final law and VA implementation are still pending. Until VA updates Directive 1315, the current rules apply. (Stripes, Marijuana Moment, Congress.gov, Veterans Affairs)

Sources & Policy Anchors

• VHA Directive 1315 (current policy): Veterans aren’t denied care for cannabis use; VA clinicians cannot recommend/register patients for state programs (until policy changes). (Veterans Affairs)
  
• 2025 Hill activity: House approved amendment; Senate passed related language; final enactment/implementation pending. (Stripes, Marijuana Moment, Congress.gov)
  
• Florida practice basics: OMMU patient steps & physician standards (Board of Medicine/Osteopathic Medicine rules). (Medical Marijuana Use, Florida Board of Medicine)
  
• Community Care mechanics: VA Form 10-10172 (Request for Service), revised May 2025. (Veterans Affairs)