Veteran completing a VA advance directive for veterans at home with his daughter beside him

VA Advance Directive for Veterans: Form 10-0137, Health Care Agents and Living Wills Explained

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By David Kirkpatrick — Independent Veterans Benefits Writer | Reviewed & updated August 9, 2026

Independent and non-government. This site is not affiliated with, endorsed by, or sponsored by the U.S. Department of Veterans Affairs (VA) or any government agency. For official information, visit VA.gov.

What a VA advance directive for veterans is, and why families bring it up too late

A VA advance directive for veterans is a written document that records who should speak for you about medical care if you become unable to speak for yourself, and what kind of treatment you would or would not want. It is one of the quietest documents in the VA system and one of the most consequential. Families who have one describe difficult days as sad but clear. Families without one describe the same days as sad and, on top of that, contested — three adult children in a hallway, each certain they know what Dad would have wanted, none of them able to prove it.

This guide explains VA Form 10-0137, the difference between naming a health care agent and writing down treatment preferences, how the form is witnessed and filed, how VA treats directives written under state law, and what to expect when you raise the subject with your care team. It is written for veterans with an asbestos-related diagnosis and for their spouses and families, but the mechanics apply to any veteran enrolled in VA health care. Nothing here is legal or medical advice.

Veteran and spouse reading advance care planning paperwork together in a bright living room

Part 1: What the VA advance directive for veterans actually contains

VA uses a single combined form, VA Form 10-0137, VA Advance Directive: Durable Power of Attorney for Health Care and Living Will. The title tells you it does two separate jobs, and it helps to keep them mentally separate because they answer different questions.

  • Durable power of attorney for health care. This part names a person — VA calls them your health care agent — who is authorized to make medical decisions on your behalf when a clinician has determined you lack the capacity to make them yourself. You can name alternates in case your first choice is unavailable or unwilling.
  • Living will. This part records your preferences about treatment in specific situations: whether you would want cardiopulmonary resuscitation, mechanical ventilation, artificial nutrition and hydration, dialysis, or other life-sustaining measures under defined circumstances, and what matters most to you about comfort and quality of life.

You can complete both parts, or only one. Many clinicians will tell you that if you do only one thing, name an agent. No document can anticipate every clinical situation, but a trusted person who knows your values can respond to the situation that actually arises. The living will then serves as guidance for that person rather than as a rigid script.

The form also includes space for other instructions — beliefs and practices that should be honored, preferences about where you would want to be cared for, wishes about organ or tissue donation, and anything else you want the team to know. Veterans often use this space for things a checkbox cannot capture: that they want music playing, that a particular grandchild should be called, that they do not want to die in an intensive care unit.

The official form and its instructions, along with the companion booklet VA Form 10-0137A, are available through VA’s forms library. VA’s National Center for Ethics in Health Care, at ethics.va.gov, publishes the policy background and the guidance clinicians themselves follow.

Part 2: Who can complete one, and who should be your agent

Any veteran who is at least 18 years old (or an emancipated minor) and has decision-making capacity can complete a VA advance directive. You do not need to be sick, and you do not need a lawyer. Capacity here means the ability to understand the decision and its consequences and to communicate a choice — it is not the same as being in perfect health, and a serious diagnosis does not by itself take it away.

Choosing an agent deserves real thought. The right person is not automatically the eldest child or the person who lives closest. Consider:

  1. Will they actually be reachable? An agent overseas or unreachable by phone cannot help at 2 a.m.
  2. Can they hold a line under pressure? The job sometimes means telling a room full of relatives that this is not what he wanted.
  3. Do they know your values? Not just your medical preferences, but what you consider a life worth prolonging.
  4. Will they accept? Ask first. Being named without warning is a poor gift.
  5. Is there a conflict of interest? VA generally does not allow your treating clinician or a VA employee involved in your care to serve as your agent, absent a qualifying family relationship.

Naming co-agents who must agree is usually a mistake; it creates deadlock at the worst moment. Name one person and list alternates in order.

Then have the conversation. The document is a record of a discussion, not a substitute for it. Tell your agent, in plain words, what you would find acceptable and unacceptable. Many veterans find it easier to talk in terms of function than of machines: “If I could not recognize my wife and would not get that back, I would not want to be kept going.” That sentence will help an agent far more than a checkbox will.

Part 3: Filling it out, witnessing it, and getting it into the record

The mechanics are simpler than people fear. You complete and sign the form, and your signature must be either witnessed by two adults or notarized. Witnesses must be 18 or older and must not be the person you named as agent; VA’s instructions also exclude people with certain conflicts, so read the form’s own witness rules before you sign. Many VA medical centers have a notary on staff at no charge — ask the social work office or the front desk.

Getting the signed document into your VA electronic health record is the step that gets skipped, and skipping it defeats the purpose. A directive in a drawer at home does not help the team in the emergency department. Hand the signed original to VA staff — social work, the patient advocate’s office, or the release-of-information office all know what to do — and ask them to scan it into your record. Then ask for confirmation that it is in there.

Copy Who holds it
Scanned into the VA health record VA clinical teams, any VA facility
Original signed form You, somewhere findable — not a safe deposit box
Copy Your health care agent and alternates
Copy Any non-VA hospital, oncologist, or community provider you use
Copy Adult children or others who may show up at a hospital

Once it is scanned, you can generally confirm its presence through your VA online health account; the guide to setting up your VA patient portal account covers how to view what VA holds. Review the document after any major change — a new diagnosis, a hospitalization, a death or divorce in the family, or your agent moving away — and at least every few years regardless.

Part 4: Revoking or changing it

An advance directive is not permanent and not binding on your future self. You may revoke or change it at any time, as long as you have capacity, and you do not need anyone’s permission. Under VA policy a directive can generally be revoked in writing, by completing a new one, or orally by telling your care team clearly that you are revoking it. A newer valid directive supersedes an older one.

Two practical warnings. First, if you revoke or replace a directive, chase down the old copies. A superseded document circulating among relatives causes exactly the confusion the process is meant to prevent. Tell VA to update the record, and tell everyone holding a copy to destroy theirs and take the new one. Second, changing your mind is normal and is not a sign of confusion. People’s views shift as illness progresses — treatments that once seemed unacceptable become tolerable when the goal is a granddaughter’s wedding three months away, and the reverse happens too. What matters is that the document on file reflects what you think now.

Your agent’s authority, it is worth saying plainly, generally begins only when a clinician determines you cannot make your own decisions, and it ends if you regain capacity. As long as you can speak for yourself, you do. Naming an agent does not hand your care over to anyone.

Veteran discussing his VA advance directive with a VA social worker across a desk

Part 5: How a VA advance directive for veterans differs from a DNR and other documents

People use several documents interchangeably in conversation, and it causes real problems. Here is how they differ.

  • Advance directive. Your own statement of preferences and your choice of agent, written in advance, for hypothetical future situations. It is a planning document, not an order to staff.
  • Life-sustaining treatment orders. These are actual medical orders written by a clinician, after discussion with you or your agent, that direct what the team will do right now — including do-not-resuscitate orders. VA has a structured process for these discussions and documents them as orders in the health record. An advance directive informs those orders; it does not replace them.
  • State POLST or MOLST forms. In many states, portable medical orders that travel with the patient, often on brightly colored paper, honored by emergency medical services outside a hospital. Ask whether your state uses one and whether VA and local EMS will honor it.
  • Financial power of attorney. A different document entirely, covering money and property, not medical care. VA’s fiduciary program, which concerns management of VA benefit payments for beneficiaries who cannot manage them, is separate again and is not established by a health care directive.
  • Last will and testament. Takes effect only after death and has nothing to do with medical decisions.

The distinction between a directive and an actual order is the one that catches families out. A veteran may have written years ago that he would not want prolonged mechanical ventilation, but if no clinician has translated that into an order, a crew responding to a crisis will do everything. If your wishes are firm and your illness is advanced, ask your VA team directly about having the corresponding orders written into the chart. That conversation belongs alongside the ones about symptom control that come up in managing cancer pain through VA.

Part 6: State directives, travel, and what VA will honor

Veterans often already have a directive drawn up by a civilian attorney under state law, and reasonably ask whether they need VA’s version too. The general rule is that VA will honor a valid state advance directive as well as its own form, provided it is valid where it was executed and does not conflict with federal law or VA policy. VA Form 10-0137 has one meaningful advantage: it is designed to be recognized at any VA facility in any state, which matters for veterans who winter in another state, travel for treatment at a distant medical center, or move to be near family.

Practical guidance that clinicians commonly give:

  • If you have a state directive, get it scanned into your VA record too. Validity is useless if nobody can find the document.
  • Keep them consistent. Two documents naming different agents is a genuine mess. If you complete VA’s form, make sure it says the same thing as your state one, or formally revoke the older one.
  • If you receive care from both VA and community providers, give copies to both. Records do not automatically flow between systems, though VA’s health information exchange can help once you authorize it.
  • If you are traveling for a surgical consultation or a second opinion at a distant center, bring a copy in the folder with your imaging and medication list — the same folder recommended in the guide to seeking a second opinion as a veteran.

One more scenario worth naming: veterans without close family. If there is no obvious agent, options include a trusted friend, a former colleague, or a fellow veteran from your post. If truly no one is available, say so to your care team — VA has processes for decision-making when no surrogate exists, and it is far better for those to be anticipated than improvised.

Part 7: Having the conversation with your VA care team

Advance care planning is a normal part of VA health care, not a signal that anyone has given up. VA social workers, chaplains, palliative care clinicians, and primary care teams all discuss it routinely, and many facilities hold designated sessions where staff walk veterans through the form and provide witnesses on the spot. You are allowed to ask for that appointment. A simple sentence works: “I’d like some help completing my advance directive.”

Who can help, and what each brings:

  • Social workers know the paperwork, the witnessing rules, and how to get documents scanned. This is often the fastest route.
  • Chaplains are trained in exactly these conversations and serve veterans of any faith or none. Many veterans find it easier to talk about meaning and fear with a chaplain than with an oncologist. The guide to spiritual care at VA for veterans and families explains how to request one.
  • Palliative care teams specialize in matching treatment to goals and can help translate values into specific preferences.
  • Your oncologist or pulmonologist can tell you what decisions are realistically likely to come up given your particular disease and stage, which makes the hypotheticals concrete.
  • Patient advocates can unstick the process if paperwork disappears or nobody returns your calls.

Bring your prospective agent to the appointment if you can. Hearing the clinician describe the likely course of illness, in the same room, at the same time, is worth more than any amount of secondhand summary. And ask the team to explain the specific decisions that tend to arise with your condition — for mesothelioma and advanced asbestos-related lung disease, breathing support, fluid drainage, and hospitalization decisions are common themes, and they connect to the practical realities covered in the guide to home oxygen through VA.

Part 8: What spouses, caregivers, and adult children should know

If you are the family member reading this, you are probably the one who will have to act on the document. A few things are worth understanding before that day.

Your job is representation, not decision. A health care agent is asked to say what the veteran would choose, not what the agent would choose. That framing is a relief when it lands — it means the weight of the choice belongs to the person who made it, and you are carrying their words, not your own guilt.

You do not have to be a medical expert. The team will explain options. Your contribution is knowledge of the person: what he valued, what he feared, what he said at the kitchen table two winters ago.

Ask for the ethics consultation if you need it. Every VA facility has access to ethics consultation. If the family disagrees, or if the document seems not to fit the situation, you can request one. It is a normal service, not an escalation.

Expect to feel unsure. Agents who honored a directive exactly as written still lie awake wondering. That is a mark of taking it seriously, not of having got it wrong.

Know what this document does not do. It does not address benefits, survivor payments, or estate matters. Those run on separate tracks with separate forms and deadlines, and the time to learn about them is not during a crisis. Speak with an accredited Veterans Service Officer about the benefits side while there is time to ask questions calmly.

Finally: completing a VA advance directive for veterans is an act of care toward the people who love you. It is not a prediction, and it is not surrender. Veterans who spent careers writing standing orders and contingency plans generally understand this instinctively — you plan for the situation you hope not to face, precisely so that no one has to improvise.

Frequently Asked Questions

Do I need a lawyer to complete VA Form 10-0137?

No. The VA advance directive form is designed to be completed by the veteran without legal assistance, and VA staff — typically social workers — help veterans complete it every day. You need your signature plus either two qualifying witnesses or a notary. Some veterans with complex family or estate situations choose to consult an attorney anyway, which is reasonable, but the form itself does not require one and VA does not charge for assistance.

Does VA honor the advance directive I signed with my state attorney?

Generally yes. VA policy provides for honoring a valid state advance directive as well as VA’s own form, so long as it is valid where executed and does not conflict with federal law or VA policy. The practical issue is availability: get the document scanned into your VA record so clinicians can actually find it. If you hold both a state document and VA Form 10-0137, make sure they name the same agent and say consistent things.

What happens if I never complete one?

If you lose decision-making capacity without a directive, VA policy provides an order of surrogate decision-makers, typically beginning with a spouse and moving through adult children and other relatives. It works, but it can be slow and contentious, and it may not land on the person you would have chosen. It also gives that surrogate no written guidance about your wishes, which is the harder burden.

Can I change my mind after signing?

Yes, at any time, as long as you have decision-making capacity. You can revoke a directive in writing, by completing a new one that supersedes it, or by telling your care team clearly that you are revoking it. Changing your mind as circumstances change is expected. Just make sure the update reaches the VA record and everyone holding an old copy, so no superseded version is circulating.

Is an advance directive the same as a do-not-resuscitate order?

No. An advance directive is your written planning document about future care. A do-not-resuscitate instruction is an actual medical order written by a clinician into your chart, effective now. A directive can inform that order, but a clinician must still write it. If your wishes about resuscitation are settled and your illness is advanced, ask your VA team directly about the corresponding orders.

Can my health care agent decide about money or my benefits?

No. The authority is limited to health care decisions. Financial and property matters require a separate power of attorney under state law, and management of VA benefit payments for beneficiaries who cannot manage them runs through VA’s separate fiduciary process. Families are often surprised by this, so it is worth planning both sides rather than assuming one document covers everything.

Who is not allowed to witness my signature?

The form’s own instructions govern, and they exclude the person you name as your health care agent. VA’s rules also address people with conflicts of interest, such as certain individuals involved in your care. Witnesses must be adults. If arranging witnesses is awkward, the simplest solution is a notary — many VA medical centers provide notary services at no charge, so ask at the social work office.

Where should I keep the signed original?

Somewhere a family member can reach within minutes — a labeled folder with your other medical papers, not a bank safe deposit box that nobody can open on a Sunday. The most important copy is the one scanned into your VA electronic health record, because that is what a VA emergency department will see. Give copies to your agent, your alternates, and any community providers you use.

Resources

Final Thoughts: One page that spares your family an impossible argument

Most veterans put this off, and the reason is understandable — filling out the form means picturing a version of yourself who cannot speak. But the veterans who have sat on the other side of it, as the adult child in the hallway, rarely put it off a second time. They have seen what happens when nobody knows and everybody cares.

The document itself takes less than an hour. The conversation that should go with it takes longer and is harder, and it is the part that actually does the work. Tell your agent what a good day looks like to you and what you would not want to endure to get one more of them. Tell your spouse and your children the same thing, in the same words, so that no one is left guessing or arguing on your behalf.

Then put the signed page where it can be found, make sure VA has scanned it, and get on with living. Completing this does not accelerate anything. What it does is remove one enormous uncertainty from a future that already has enough of them, and hand your family something better than a guess: your own voice, written down in advance, in your own words.

Medical disclaimer: This article is for informational purposes only and is not medical advice, diagnosis, or treatment. Consult a licensed physician or your VA care team about your specific situation.

Legal disclaimer: This article is for general information only and is not legal advice and does not create an attorney-client relationship. Consult a VA-accredited attorney, claims agent, or a Veterans Service Officer (VSO) about your specific claim.

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