WRIISC Referral Process

VA primary care providers who see combat Veterans with chronic medically unexplained symptoms may refer Veterans to the WRIISC through a VA Interfacility Consult. Environmental health coordinators and clinicians can help facilitate the WRIISC referral process by encouraging Veterans who meet WRIISC eligibility criteria to ask their VA Patient Aligned Care Teams (PACTs) about a WRIISC referral and providing PACTs information on the WRIISC program, and referral process. WRIISC Referrals are completed using the Interfacility Consult (IFC) in VA's Computerized Patient Record System (CPRS). Detailed instructions are available here.

What information is needed to complete a WRIISC IFC?

Please provide a specific, medically unexplained clinical question that WRIISC can help address. For example:

Veteran complains of pain and fatigue since deployment. During past year, Veteran has been seen by pain, sleep, and psychiatry clinics. The Veteran has no symptom improvement despite treatment evaluations and follow-up. We request your assistance with this Veteran.

If workups are completed outside of VA, please have results in the VA medical record for review. Veterans who do not have initial workups for symptoms or had workups in the remote past will be asked to complete these evaluations first.

Local Environmental Health Registry exams are important first steps in evaluating deployment environmental exposure concerns. If a VA Registry exam has not been conducted, this may be recommended as a first step. Registry exams can be scheduled through your local VA Environmental Health Coordinator. If military environmental exposure concerns persist after VA Registry evaluation, please list environmental exposure concerns on the WRIISC consult.

How are referrals triaged?

Once a WRIISC IFC is placed, referrals are triaged to the appropriate regional WRIISC based on VA Medical Center Location (see map below). There are three WRIISC sites at VA Medical Centers in East Orange New Jersey, Washington, DC, and Palo Alto, California.

Once the IFC consult is received, the first step in triaging consults is for WRIISC staff to conduct medical record reviews to evaluate deployment status, presence of workups for symptoms, and eligibility for WRIISC services. Each WRIISC consult receives a medical record review, and WRIISC consults are completed initially as e-consults with clinical recommendations provided to the referring provider. Additional WRIISC services like WRIISC comprehensive interdisciplinary evaluations and environmental exposure assessments may be offered as needed.

If you have any questions about WRIISC services, please contact the WRIISC closest to you.

• For the CA WRIISC, call 1-888-482-4376.
• For the DC WRIISC, call 202-745-8249.
• For the NJ WRIISC, call 973-676-1000 ext. 202500