Fillable Printable VA Form 10-0137B
Fillable Printable VA Form 10-0137B
VA Form 10-0137B
WHAT YOU SHOULD KNOW ABOUT ADVANCE DIRECTIVES
As a VA patient you have a say in the health care
you receive. Normally your doctor explains your
options for health care and you get to decide what
is best for you. But what happens if you are too ill
to make decisions for yourself? Who would you
want to make decisions for you? Does this person
know what you would or wouldn't want?
Questions like these can be hard to think about,
but they're important. That's why VA wants you
to know about a legal form you can complete. It's
called an advance directive.
What is an advance directive?
An advance directive is a legal form that helps
your doctors and loved ones understand your
wishes about medical and mental health care. It
can help them decide about treatments if you are
too ill to decide for yourself. For example, if you
are unconscious or too weak to talk. There are
two types of advance directives: durable power of
attorney for health care and living will. The VA
form contains both.
What is a durable power of attorney for health
care?
This form lets you name a person to make health
care decisions for you if you can't make them
yourself. This person is called your “health care
agent.” He or she will have the legal right to
make health care decisions for you. You can
choose any adult to be your agent. It's best to
choose someone you trust and who knows you
well. You should talk to that person to make sure
they are willing to be your health care agent.
Do I have to fill out a durable power of
attorney for health care?
No. It's up to you whether you complete a durable
power of attorney for health care. If you don't
choose a health care agent, your doctor will
choose a spokesperson to make decisions for you
in the following order: legal guardian (if you have
one), spouse, adult child, parent, sibling,
grandparent, grandchild, or a close friend. If your
doctor can't find anyone from this list, VA staff or
a court will make decisions for you.
What is a living will?
A living will is a legal form that communicates
what kinds of health care you would or wouldn't
want if you become ill and can't decide for
yourself.
Do I have to fill out a living will?
No. It's up to you whether you fill out a living
will. The purpose of a living will is to help your
spokesperson and your doctor make decisions
about your care. Whether or not you decide to fill
out a living will, it's important to discuss your
wishes with others. Talk to your health care
agent, your loved ones, your doctors, and your
health care team so they understand what is
important to you.
Does my spokesperson have to follow my living
will?
Most of the time, yes. Your spokesperson must
try to respect your wishes if they are known. But
it can be hard to imagine the future and say just
what treatment you would want at that time. So
sometimes your spokesperson may have to
interpret your wishes. In a VA advance directive,
you can say how strictly you want your wishes
followed. You can tell your health care agent to
do just what your living will says, or you can tell
them to make the decision they think is best for
you even if it isn't what the living will says.
Do health care providers have to follow my
living will?
Your advance directive provides important
guidance for your health care providers.
Generally, your advance directive will be
followed, unless there is conflicting information
about your wishes or it is unclear how to apply
your wishes. In a few cases, advance directives
can't be followed because they conflict with legal
or professional standards.
Should I have an advance directive?
Yes, it's a good idea to have one. An advance
directive helps protect your right to make your
own decisions. It helps make sure people respect
your wishes if you can't speak for yourself.
VA FORM
DEC 2013
10-0137B
WHAT YOU SHOULD KNOW ABOUT ADVANCE DIRECTIVES CONTINUED
Your advance directive is used only when you
aren't able to make your own health care
decisions.
What types of advance directive forms are
available?
VA recognizes all types of legal advance
directives, including VA, state, and Department
of Defense (DoD) advance directives.
•
The VA Advance Directive (Form 10-0137)
contains more detail than most other advance
directive documents. It also allows you to
attach worksheets and other documents if you
choose to do so. This lets you provide a more
complete understanding of your wishes.
•
State advance directives are legally binding
under a certain state's laws. Some states may
require you to use a particular form. Other
states may have restrictions about language.
•
A DoD advance directive is drafted by a
military lawyer for military personnel. It's
legally binding in VA and in every state.
How do I complete an advance directive?
Fill out VA Form 10-0137, “VA Advance
Directive: Durable Power of Attorney and Living
Will.” Or use any valid state advance directive
form. You can also fill out more than one form.
But if you do this, you should make sure they
don't conflict with each other. Your health care
provider or legal advisor can help determine
which form is best for you. You can fill out the
form on your own or get help from a health care
professional at your local VA health care facility.
This might be a social worker, your primary care
doctor, or your mental health professional. You
could also talk to your spiritual advisor or
attorney.
What should I do with my advance directive?
Give your advance directive to your VA health
care provider so they can put it in your medical
record. Also give a copy to your health care agent
and anyone else who might be involved in
making health care decisions for you.
Can I change my advance directive?
Yes, you may change or cancel your advance
directive at any time. In fact, you should review
your advance directive often, especially if there is
a change in your health, to make sure it's up to
date. If you change it, be sure to tell your health
care team and have them put it in your health
record. And share your new directive with your
family members and other loved ones.
What if my family members or health care
providers disagree about how to interpret my
advance directive?
All VA health care facilities and most non-VA
facilities have an Ethics Consultation Service that
can help resolve conflicts. Talking with your
spokesperson, loved ones, and health care
providers ahead of time can help to prevent
conflicts in the future.
I have homes in two states. Is my advance
directive valid in both places?
States often have different laws and different
forms. Check with your health care providers or
legal advisors in each place. However, the VA
advance directive is valid throughout the VA
system.
Outside of VA, will my advance directive be
legal in all 50 states?
The laws vary from state to state. However, most
states will recognize an advance directive from
another state. If you have a home in more than
one state, check with your health care provider or
legal advisor in each state. One form might work
for all places, or you may need to complete a
form to use in each state. A VA advance
directive is valid throughout the VA system, no
matter where your facility is located. A VA
advance directive may or may not be legally
binding outside of VA, depending on state law.
But it can still carry a lot of weight in medical
decisions by informing your providers and others
about your preferences.
VA FORM
DEC 2013
10-0137B
