The history and evolution of the U.S. Department of Veterans Affairs are inextricably intertwined and dependent on the history of America's wars, as wounded former soldiers and other U.S. military veterans are the population the VA cares for. The
list of wars involving the United States from the
American Revolutionary War to the present totals ninety-nine wars. The majority of the
United States military casualties of war, however, occurred in the following eight wars: American Revolutionary War (est. 8,000),
American Civil War (218,222),
World War I (53,402),
World War II (291,567),
Korean War (33,686),
Vietnam War (47,424),
Iraq War (3,836), and the
War in Afghanistan (1,833). It is these wars that have primarily driven the mission and evolution of the VA. The VA maintains a detailed list of war wounded, as it is this population that comprises the VA care system.
Origins The
Continental Congress of 1776 encouraged enlistments during the
American Revolutionary War by providing pensions for soldiers who were disabled. Three weeks after passing the law compensating the injured, the Continental Congress in September 1776 also approved a resolution awarding grants of public land to all who served in the Continental Army for the duration of the conflict. Direct medical and hospital care given to veterans in the early days of the U.S. was provided by the individual states and communities. In 1811, the
first domiciliary and medical facility for veterans was authorized by the federal government but not opened until 1834. In the 19th century, the nation's veterans assistance program was expanded to include benefits and pensions not only for veterans but also their widows and dependents. Prior to the end of the
American Civil War in 1865, Delphine Baker, a volunteer nurse during the war, rallied support to petition the federal government to create a national home for Civil War veterans, based on the
U.S. Soldiers Home in Washington, D.C., and the Naval Asylum in Philadelphia for U.S. active-duty veterans. The bill establishing the
National Home for Disabled Volunteer Soldiers was passed on March 3, 1865. The very next day, President
Abraham Lincoln vouched for the mission of the future facilities in his second inaugural address: With malice toward none; with charity for all; with firmness in the right, as God gives us to see the right, let us strive on to finish the work we are in; to bind up the nation's wounds; to care for him who shall have borne the battle, and for his widow, and his orphan—to do all which may achieve and cherish a just and a lasting peace, among ourselves, and with all nations.The middle section of that quote would later form the guiding principle for the future Department of Veterans Affairs. While domiciliary care for Civil War veterans was managed by the National Home system at 11 various campuses, the pension benefits was split amongst various agencies in the federal government. Throughout the mid-to-late 19th Century, the
Bureau of Pensions managed financial benefits to veterans, widows and dependent children. With the completion of the Civil War and an expansion of eligibility in 1890, pension numbers soared, from 303,000 to 966,000 in 1893. Eventually the workforce had to be housed in a new purpose-built home, the Pension Bureau building, which housed the organization from 1885 to 1926. Furthermore, many state
veterans' homes were established. Since domiciliary care was available at all state veterans homes, incidental medical and hospital treatment was provided for all injuries and diseases, whether or not of service origin. Indigent and disabled veterans of the Civil War,
Indian Wars,
Spanish–American War, and Mexican Border periods, as well as discharged regular members of the Armed Forces, were cared for at these homes.
Veterans' Bureau The United States' entrance into
World War I in 1917 caused a massive increase in veterans, overwhelming the federal system. When the
Republican nominee for president,
Warren G. Harding, accepted his party's nomination to the
1920 presidential election, he issued a promise to the more than four million Americans who served in the war: It is not only a duty, it is a privilege to see that the sacrifices made shall be requited, and that those still suffering from casualties and disabilities shall be abundantly aided and restored to the highest capabilities of citizenship and enjoyment.At the time of the election, dissatisfaction with the benefits programs for World War I veterans ran rampant throughout the country. To receive benefits, veterans had to navigate through three different federal agencies: the
Bureau of War Risk Insurance (BWRI) for insurance and compensation, the
U.S. Public Health Service (PHS) for medical and hospital care, and the
Federal Board for Vocational Education for rehabilitation, education, and job training. Veterans from previous conflicts continued to rely on the Bureau of Pensions and National Homes for Disabled Volunteer Service for their compensation and medical care respectively. After winning the election, President Harding appointed a committee in April 1921 to identify a solution. On August 8, 1921, Harding signed Public Law 67-47, popularly known as the Sweet Act, which established the Veterans' Bureau, which absorbed the War Risk Bureau and the Rehabilitation Division of the Federal Board for Vocational Education. In 1922, it gained a large number of veterans' hospital facilities from the Public Health Service, most of which had been recently established on former U.S. Army bases. One of the landmark measures included in the new law was removing the burden of proof for two disabilities that veterans claimed - tuberculosis and neuropsychiatric disorders. While the legislation only applied to those two categories, it was groundbreaking in establishing presumptive conditions for future claims. Charles Forbes led the fledgling agency through its initial two years, before resigning in 1923. His replacement, former
brigadier general Frank T. Hines took on director of the Veterans' Bureau. By the 1920s, the various benefits were administered by three different federal agencies: the Veterans' Bureau, the Bureau of Pensions, and the National Home for Disabled Volunteer Soldiers.
World War II In 1940, with war already raging in Europe and Asia, VA began preparing for potential American involvement in the conflict. Hines informed Congress that the agency was coordinating with the
War Department to assist in the event of a national emergency with both hospital bed space and highly trained medical staff. Following the Japanese attack on
Pearl Harbor and America's entry into World War II, the U.S. Army's need for physicians and other healthcare professionals was acute. As the surgeon general of the Army, Maj. Gen. Norman T. Kirk, bluntly reported, "It was difficult during the past year to secure the additional Medical Corps officers needed to meet the requirements of the increasing Army since there are not sufficient physicians available to meet both military and civilian medical needs." The military's demand for healthcare professionals drained staff from the civilian medical community and VA alike. Between 1942 and mid-1944, 16 percent of VA employees were furloughed for military service. A December 1943 agreement between Secretary of War
Henry L. Stimson and the VA's administrator paved the way for a collaborative use of limited medical personnel. Their solution included inducting select VA doctors and dentists into the Army but allowing them to remain at VA facilities. While detailed to VA, Army personnel wore a distinctive shoulder sleeve insignia designed by the Heraldic Section of the Army's Office of the Quartermaster General. One of the most notable to wear this patch was Gen.
Omar N. Bradley. The close of
World War II resulted in not only a vast increase in the veteran population but also a large number of new benefits enacted by Congress for veterans of the war. Prior to World War II, in response to scandals at the Veterans Bureau, programs that cared for veterans were centralized in Washington, D.C. This centralization caused delays and bottlenecks as the agency tried to serve World War II veterans. As a result, the VA went through a decentralization process, giving more authority to the field offices. The
Servicemen's Readjustment Act, commonly known as the GI Bill, was signed into law on June 22, 1944, by
President Franklin D. Roosevelt. "The United States government began serious consolidated services to veterans in 1930. The GI Bill of Rights, which was passed in 1944, had more effect on the American way of life than any other legislation—with the possible exception of the
Homestead Act." Unlike previous legislation, the GI Bill stipulated that all benefits were to be managed by the VA. Further educational assistance acts were passed for the benefit of veterans of the
Korean War.
Promotion to Department of Veterans Affairs The
Department of Veterans Affairs Act of 1988 () changed the former Veterans' Administration, an independent government agency established in 1930 into a Cabinet-level Department of Veterans Affairs. It was signed into law by President Ronald Reagan on October 25, 1988, but came into effect under the term of his successor, George H. W. Bush, on March 15, 1989. The reform period of 1995 to 2000 saw the
Veterans Health Administration (VHA) dramatically improve care access, quality, and efficiency. This was achieved by leveraging its national integrated electronic health information system (
VistA) and in so doing, implementing universal primary care, which increased patients treated by 24%, had a 48% increase in ambulatory care visits, and decreased staffing by 12%. By 2000, the VHA had 10,000 fewer employees than in 1995 and a 104% increase in patients treated since 1995, and had managed to maintain the same cost per patient-day, while all other facilities' costs had risen by over 30% to 40% during the same period. Authored by Senator
Jim Webb, the
Post-9/11 Veterans Educational Assistance Act of 2008 doubled the GI Bill's college benefits and provided a 13-week extension to federal unemployment benefits. The new GI Bill more than doubled the value of the benefit from $40,000 to about $90,000. In-state public universities are essentially covered to provide full scholarships for veterans under the new education package. For those veterans who served at least three years, a monthly housing stipend was also added to the law. Congress and President Barack Obama extended the new GI Bill in August 2009 at a cost of roughly $70 billion over the next decade. The Department of Defense (DoD) allows individuals who, on or after August 1, 2009, have served at least six years in the Armed Forces and who agree to serve at least another four years in the U.S. Armed Forces to transfer unused entitlement to their surviving spouse. Service members reaching 10-year anniversaries could choose to transfer the benefit to any dependents, such as their spouse or children. In May 2014, critics of the VA system reported problems with scheduling timely access to medical care. In May 2014, a retired doctor said that veterans died because of delays in getting care at the Phoenix, Arizona, Veterans Health Administration facilities. An investigation of delays in treatment in the Veterans Health Administration system conducted by the Veterans Affairs Inspector General of 3,409 veteran patients found that there were 28 instances of clinically significant delays in care associated with access or scheduling. Of these 28 patients, six were deceased. The same OIG report stated that the Office of Investigations had opened investigations at 93 sites of care in response to allegations of wait time manipulations, and found that wait time manipulations were prevalent throughout the VHA. On May 30, 2014,
Secretary of Veterans Affairs Eric Shinseki resigned from office due to the fallout from the scandal, saying he could not explain the lack of integrity among some leaders in VA healthcare facilities. "That breach of integrity is irresponsible, it is indefensible, and unacceptable to me. I said when this situation began weeks to months ago that I thought the problem was limited and isolated because I believed that. I no longer believe it. It is systemic. I was too trusting of some and I accepted as accurate reports that I now know to have been misleading with regard to patient wait-times," Shinseki said in a statement. In September 2017, the VA declared its intent to abolish a 1960s conflict of interest rule prohibiting employees from owning stock in, performing service for, or doing any work at
for-profit colleges; arguing that, for example, the rule prohibits VA doctors from teaching veterans at for-profit universities with special advantages for veterans. In 2018, the VA instead established a process for employees to seek waivers of the policy based on individual circumstances. In 2023, the VA adopted a new mission statement: "To fulfill President Lincoln's promise to care for those who have served in our nation's military and for their families, caregivers, and survivors." The VA's previous mission statement, established in 1959, was "To fulfill President Lincoln's promise ‘to care for him who shall have borne the battle, and for his widow, and his orphan’ by serving and honoring the men and women who are America's veterans." The VA increased its staff by more than 60,000 in 2023 and 2024 to address more than a million
burn pit–related claims following passage of the
Honoring our PACT Act of 2022. More than 80,000 VA employees, including many of those hired under PACT Act funding, were targeted in 2025 to be fired by President Donald Trump and the
Department of Government Efficiency, which would delay benefits for affected veterans. ==Functions==