VA Form 10-7959E: Claim for Miscellaneous Expenses

VA Form 10-7959E: Claim for Miscellaneous Expenses – If you’re a parent or guardian of a child with spina bifida or other covered birth defects linked to a veteran’s service, understanding VA Form 10-7959E is essential for getting reimbursed for miscellaneous healthcare expenses. This guide explains eligibility, how to file, required documentation, and submission details to help you navigate the process smoothly.

What Is VA Form 10-7959E?

VA Form 10-7959E, officially titled “Claim for Miscellaneous Expenses,” is a U.S. Department of Veterans Affairs (VA) form used to request reimbursement for miscellaneous expenses related to the treatment of spina bifida and other covered birth defects. It applies to children of qualifying veterans under specific VA health care programs.

The form is **not** for standard medical claims (those use VA Form 10-7959A for CHAMPVA). It focuses on miscellaneous costs, including travel to covered care. The current revision date is June 2025, with OMB approval valid through December 31, 2027.

Who Is Eligible to Use VA Form 10-7959E?

Eligibility targets children with spina bifida or certain other birth defects associated with a parent’s military service:

  • Children of Vietnam, Korea, or Thailand veterans with spina bifida or associated conditions.
  • Children of women Vietnam veterans born with covered birth defects.

These benefits fall under the Spina Bifida Health Care Benefits Program and the Children of Women Vietnam Veterans program. The child must be enrolled in the program, and expenses must relate to approved treatment.

Contact the VA at 1-833-930-0816 to confirm eligibility or program status.

When to Use VA Form 10-7959E?

Use this form for:

  • Reimbursement of miscellaneous expenses (e.g., lodging, meals, parking, tolls) tied to covered medical care.
  • Travel expenses to and from approved treatment for the child or an attendant.
  • Claims where providers are not directly billing the VA for services.

Note: Receipts are mandatory. Claims must generally be filed within 1 year of the date of service.

How to Fill Out VA Form 10-7959E Step by Step?

The form has four main sections. Sections I, II, and IV are mandatory. Section III is only for travel claims.

Section I: Patient Information

Provide the child’s full name, Social Security number, address, date of birth, and phone number.

Section II: Sponsor Information

Details about the qualifying veteran (parent), including name and SSN.

Section III: Travel (If Applicable)

Include dates, mode of travel (POV, air, etc.), locations, attendant info if relevant, and itemized expenses like lodging and meals. Attach receipts (except for POV mileage in some cases). Provider certification of service is required.

Section IV: Certification

Sign and date the form. Include your information if signing on behalf of the patient. False claims can result in penalties under federal law.

Download the fillable PDF here: VA Form 10-7959E (Fillable PDF)

Required Supporting Documents

To avoid delays or denials:

  • Itemized receipts for all claimed expenses.
  • Proof of medical service dates (for travel claims).
  • Any other documentation requested by the program.

Single-sided copies are preferred for scanning.

Where and How to Submit VA Form 10-7959E?

Mail or fax the completed form and documents to the appropriate address based on your program:

Spina Bifida Health Care Benefits Program / Children of Women Vietnam Veterans:
VHA Office of Integrated Veteran Care
P.O. Box 400
Spring City, PA 19475

Phone: 1-833-930-0816
Fax: 1-303-331-7807

Keep copies for your records. Reimbursement is paid directly to the beneficiary.

Common Questions About VA Form 10-7959E

Can I submit online?

Currently, this form is submitted by mail or fax. Check the official VA site for any new digital options.

What if I need more space?

Continue on a separate sheet in the same format and attach it.

Is there a Spanish version?

Yes, a Spanish version (S10-7959e) is available on the VA website.

Tips for a Successful Claim

  • Double-check all information for accuracy.
  • Submit within the 1-year window.
  • Organize documents clearly.
  • Contact the VA helpline early if you have questions.

Processing times vary; follow up if needed.

Additional Resources for VA Benefits

For more information:

This article is for informational purposes only and is based on official VA sources. Always verify details on VA.gov as policies can update.