VA Form 10-9028: Download Fillable Driver Evaluation PDF

VA Form 10-9028: Download Fillable Driver Evaluation PDF – Veterans with disabilities or medical conditions often need specialized support to drive safely. The Department of Veterans Affairs (VA) provides adaptive driver training and evaluation services. VA Form 10-9028, officially titled the Driver Training Functional Evaluation Record, is a key document used in these programs.

This comprehensive guide explains the form, its purpose, how to use the fillable version, and related VA driver rehabilitation services for U.S. veterans.

What Is VA Form 10-9028?

VA Form 10-9028 is the Driver Training Functional Evaluation Record. It is a standardized tool that VA clinicians, driver rehabilitation specialists, and therapists use to document a veteran’s driving history, functional abilities, medical conditions, and progress in adaptive driver training.

The form is fillable and available as a PDF, making it easy to complete electronically or print. The current version dates to November 1997, and it remains actively used in VA adaptive driving programs across the country.

Download the official fillable VA Form 10-9028 here:
Download VA Form 10-9028 Fillable PDF (Direct from VA.gov)

Purpose of the Driver Training Functional Evaluation Record

The primary purpose of VA Form 10-9028 is to evaluate whether a veteran can safely operate a motor vehicle, identify any functional limitations due to service-connected or other disabilities, and recommend adaptive equipment, training, or restrictions.

It covers:

  • Driving and medical history
  • Functional incapacitation (e.g., vision, neuromuscular ability, seizures, respiratory issues)
  • Pre-driving assessments (vision, strength, coordination, reaction time)
  • Recommendations for vehicle modifications
  • Training outcomes and total hours of instruction

This record helps ensure veterans receive personalized driver rehabilitation that promotes independence, safety, and compliance with state licensing requirements.

Who Should Use VA Form 10-9028?

This form is primarily for:

  • Veterans enrolled in VA driver rehabilitation or adaptive driving programs
  • Those with disabilities affecting driving (e.g., spinal cord injury, amputation, neurological conditions, vision impairment, or traumatic brain injury)
  • Active-duty service members transitioning to civilian life who need adaptive training
  • VA driver rehabilitation specialists documenting evaluations and training progress

It is commonly used at VA medical centers offering driver training services, such as Butler VA or other facilities with rehabilitation programs.

How to Download and Complete VA Form 10-9028

  1. Download the fillable PDF directly from the official VA source:
    Get VA Form 10-9028 Here
  2. Open the PDF in a compatible viewer (Adobe Acrobat Reader recommended for full fillable functionality).
  3. Complete sections on patient identification, history, functional assessments, medications, recommended equipment, and training outcomes.
  4. The form includes checkboxes for “WNL” (Within Normal Limits), “Deficit,” “Yes/No,” and space for detailed comments.
  5. A qualified VA professional (e.g., Driver Rehabilitation Specialist) typically completes or reviews the final report, including signatures and recommendations.

Always use the official VA.gov version to ensure compliance.

Key Sections of VA Form 10-9028

The two-page form includes these main areas:

  • History: Valid driver’s license status, prior suspensions, previous training, and driving experience.
  • Functional Incapacitation: Detailed evaluation of consciousness, cardiovascular health, mental condition, sensory perception, neuro-musculoskeletal ability (strength, range of motion, coordination, balance), respiratory function, medications, and more.
  • Vision Assessment: Acuity, visual field, dark adaptation, glare tolerance, and color vision.
  • Transfer and Mobility: Ability to transfer to/from vehicle and load/unload mobility aids.
  • Recommended Equipment: Hand controls, power steering/brakes, spinner knobs, lifts, wheelchair tie-downs, and other adaptive devices.
  • Training Outcomes: Classroom, simulation, behind-the-wheel (BTW) hours, state license/certificate results, and restrictions.

Comments sections allow for detailed notes on any “YES” or “DEFICIT” responses.

VA Driver Rehabilitation and Adaptive Driving Programs

VA driver training helps veterans regain or maintain driving independence. Services often include:

  • Clinical evaluations and functional testing
  • Behind-the-wheel training with adaptive equipment
  • Vehicle modification recommendations
  • Coordination with state DMVs for licensing

These programs are available through VA Polytrauma Centers, Spinal Cord Injury units, and various medical centers. Eligibility generally ties to service-connected disabilities that impact driving.

Contact your local VA facility or VA health care provider to inquire about driver rehabilitation services and whether Form 10-9028 applies to your situation.

Benefits of Completing Driver Training with VA Form 10-9028

  • Increased Independence: Safely return to driving or learn adaptive techniques.
  • Safety: Identify and address risks through professional evaluation.
  • Access to Equipment: Recommendations for VA-supported vehicle modifications.
  • Documentation: Official record for state licensing authorities or insurance purposes.
  • Comprehensive Support: Integrated with broader VA rehabilitation services.
  • VA Driver Rehabilitation Fact Sheet (search on VA.gov)
  • Vocational Rehabilitation and Employment (Chapter 31) benefits
  • Other medical forms via the VA Forms Library

For the most current information, visit VA.gov or speak with a VA care coordinator.

How to Access VA Driver Training Services

Veterans interested in driver evaluation should:

  1. Contact their VA primary care provider or rehabilitation specialist.
  2. Discuss eligibility for driver training.
  3. Participate in the evaluation process, which may involve VA Form 10-9028.

Services are location-dependent—availability is strongest at larger VA medical centers with dedicated rehabilitation programs.

Official Download Link:
Download Fillable VA Form 10-9028 PDF

This article is for informational purposes only and is based on official VA sources. Always consult a VA representative or qualified driver rehabilitation specialist for personalized advice. Form availability and program details can change—verify directly on VA.gov.