Clinical Services and Referrals Overview

The War Related Illness and Injury Study Center (WRIISC) is a tertiary care, post-deployment health center located at the East Orange, NJ, Palo Alto, CA, and Washington, DC Veterans Affairs Medical Centers. The WRIISC partners with VA referring providers and health care teams to support the care of Veterans. The WRIISC is part of the VA Central Office Health Outcomes Military Exposures (HOME).

Every Veteran referred for WRIISC clinical services receives an electronic consult (E-Consult). The E-consult consists of a medical record review by an interdisciplinary team that assesses the post-deployment health conditions identified by the WRIISC interdisciplinary team review. The WRIISC team provides an E-Consult report that summarizes recommended next steps , helpful resources for the Veterans' post-deployment health concerns. These clinical recommendations may include additional WRIISC clinical services such as:

• Military Exposure assessments
• Comprehensive Interdisciplinary post-deployment health evaluations
• Integrative Health and Wellness initiatives

WRIISC clinical services are primarily conducted through virtual health as the three WRIISC centers provide services for Veterans throughout the country. Follow-up recommendations may require in-person care through the Veteran's local VA medical facility. On-site evaluations at specific WRIISC sites may be recommended on a case-by-case basis.

WRIISC Services Eligibility

Veterans who may benefit from WRIISC referrals include:

• Deployed Veterans with medically unexplained symptoms lasting for more than six months and persisting despite local workup and trials of appropriate treatments. If workups are completed outside VA, please have records in VA medical record for review.
• Veterans who are medically and psychiatrically stable with no recent substance abuse for the past six months. WRIISC is unable to evaluate Veterans with active substance use disorder.
• Deployed Veterans who have military environmental exposure concerns that persist despite local workup and Registry evaluation may benefit from WRIISC environmental exposure assessments.
• Veterans who do not have a combat deployment, are not medically or psychiatrically stable, and/or have not completed an initial evaluation of their health symptoms may not be eligible for WRIISC specific services but will be directed to other VA services to help address their needs.

Common eligible deployments include:

• Vietnam War (1962-1975)
• Gulf War 1 (Operation Desert Shield/Desert Storm) (1990-1991)
• Somalia (1992-1994)
• Bosnia-Herzegovinia (1995-1996)
• Operation Enduring Freedom — Afghanistan
• Operation Iraqi Freedom/Operation New Dawn — Iraq
• For combat deployments not listed, please provide specifics on combat deployment.

WRIISC Referrals

Like many specialty consultations, WRIISC encourages Veterans' primary care providers (PCPs) or Patient Aligned Care Teams (PACTs) to make WRIISC referrals. WRIISC consultations that come from the Veteran's primary care providers optimize the likelihood that Veterans referred to WRIISC are appropriate referrals and that WRIISC recommendations are followed by the Veteran's PACT team.