VA Form FL-10-216: Prosthetic Service Card Instructions

VA Form FL-10-216: Prosthetic Service Card Instructions – Veterans relying on prosthetic devices for mobility, daily function, or rehabilitation often need quick access to repairs without repeated prior authorizations. VA Form FL-10-216, titled Instructions for Issuance of New Prosthetic Service Card, plays a key role in this process by guiding the issuance or replacement of VA Form 10-2501, the official Prosthetic Service Card (PSC).

This article explains the form’s purpose, who needs it, how to use it, and steps for obtaining or replacing your card. Information draws from official VA sources and handbooks.

What Is VA Form FL-10-216?

VA Form FL-10-216 (also referenced as FL10216N) provides instructions when the VA issues a new or replacement Prosthetic Service Card (VA Form 10-2501). It accompanies a blank card for the veteran to sign and return, or explains the new card’s details and usage.

The form ensures veterans understand:

  • Why they received the new card (initial issue, replacement for lost/destroyed card, appliance change, or format/price update).
  • How to sign and handle the old card.
  • Limits on repair costs without prior authorization.

Download VA Form FL-10-216 Instructions
Download the official PDF here

Purpose of the VA Prosthetic Service Card (VA Form 10-2501)

The Prosthetic Service Card allows eligible veterans to obtain repairs and replacement parts for listed prosthetic appliances, orthotics, or related equipment (including guide dog veterinary services in some cases) at commercial repair shops or VA facilities across the United States or Puerto Rico, often without advance authorization for repairs under a set cost limit.

Key benefits include:

  • Immediate access to repairs.
  • Streamlined billing via VA Form 10-2520 (Prosthetic Service Card Invoice).
  • Convenience for veterans with ongoing prosthetic needs.

Note: The card does not cover new appliances—only repairs and parts.

Who Is Eligible for a VA Prosthetic Service Card?

Eligibility generally requires:

  • Enrollment in the VA health care system.
  • A medical need for prosthetic items or services, typically determined by a VA provider (e.g., physical medicine and rehabilitation physician).
  • Assignment of the card through the Prosthetic and Sensory Aids Service (PSAS) at your local VA medical center.

Additional criteria may apply for specific programs. Contact your local PSAS for personalized eligibility review.

When Is VA Form FL-10-216 Used?

The VA issues FL-10-216 in scenarios such as:

  • Initial issuance of a Prosthetic Service Card.
  • Replacement for a lost, destroyed, or damaged card.
  • Updates due to a new appliance or changes in card format/price limits.
  • Mail requests where personal information needs verification (veteran signs and returns the form with the old card or loss statement).

After processing the signed return, the VA mails the finalized card with additional instructions (often FL 10-215).

Step-by-Step: How to Obtain or Replace Your Prosthetic Service Card?

  1. Contact Your Local VA PSAS — Reach out to the Prosthetics and Sensory Aids Service at your nearest VA medical center. Use the VA Facility Locator to find contact details.
  2. Request the Card — Submit a request for a new or replacement card. For mail requests, the VA may send FL-10-216 with a blank card and return envelope.
  3. Complete and Return FL-10-216 — Sign the blank Prosthetic Service Card in the designated area. Verify personal information, return the signed card (and old card or loss statement if applicable).
  4. Receive Your New Card — The VA processes and sends the updated VA Form 10-2501. Sign it upon receipt and destroy the old card.
  5. Use the Card Responsibly — Present the card with photo ID at approved repair locations. Stay within repair cost limits or seek authorization for higher amounts.

For lost cards, provide a statement explaining the circumstances.

  • VA Form 10-2520: Prosthetic Service Card Invoice for vendors.
  • VA Form 10-2421: Prosthetics Authorization for Items or Services.
  • Broader PSAS benefits include clothing allowances, home improvements, adaptive equipment, and more. Visit the official VA Prosthetics and Sensory Aids Service page.

Tips for Veterans Using Prosthetic Services

  • Always carry photo ID with your PSC.
  • Keep repair records and invoices.
  • Report lost cards promptly to avoid unauthorized use.
  • Enroll in or update your VA health care if needed via VA Form 10-10EZ

For the most current guidance, consult your local VA PSAS team, as policies can evolve.