Over a year after the U.S. Congress passed a bipartisan reform bill by Congress granting optometry physician-level recognition, optometrists (ODs) employed by The Department of Veterans Affairs (VA) are one step closer to being officially on par with physician pay rates.
The update follows an executive order published last month establishing the updated base and longevity pay schedule.
A major win! First, though: some background.
To start: See here for some background on ODs’ (and ophthalmologists’) employment history at the VA, which was kickstarted by the 1976 establishment of the department’s Specialty Care Services.
- Fast forward to today: Vision and eye health care is reportedly the third most requested service by veterans, with VA ODs offering around 70% of this care (plus 99% of services in low-vision clinics and blind rehabilitation centers).
But in regard to pay: The department’s 1,000+ employed ODs have long operated at a pay scale with a pay cap far below other physicians (check out the details on this situation).
Also keep in mind: The U.S. OD workforce is projected to see 8% growth over the next near-decade.
Noted. Now tell us about this reform bill.
Signed into law in January 2025, the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act is referred to as representing a major step toward “closing a widening doctor recruitment and retention gap” to meet U.S. veteran demand for eyecare, according to the American Optometric Association (AOA).
Specifically: The bill added “sweeping” policy changes to the VA’s programs, benefits, and services—including to the current pay scale limitations.
I’m listening …
As we previously reported, the pay scale change is noted in Section 142 of the bill, which modifies pay limitations for optometrists, physicians, podiatrists, and dentists employed within the VA.
- See here for a look at the exact verbiage of this section.
Notably: The VA’s pay system encompasses base, market—dependent on the needs of a physician’s specialty or assignment, experience, board certification, and accomplishments—and performance pay.
So did these changes require new VA regulations?
Indeed. In fact, the VA published an update to its regulations in October 2025 that essentially recognized the physician-level pay scale changes for ODs.
The regulations also detailed two key principles (see here) to be considered when analyzing and determining OD-specific pay table placement and annual salary rates.
- The intent for this pay table placement: To enhance the VA’s flexibility to “recruit, develop, and retain the most highly qualified optometrists to serve [U.S.] veterans and maintain a standard of excellence in the VA health care system.”
- The American Optometric Association (AOA) referred to these regulations as “a major win for the profession.”
Nice! But if this bill was signed last year, why are changes only just happening?
As with other legislative bills, several components—preparation (compliance), administrative and logistical preparations, and alignment with the fiscal or calendar years—require sufficient time before changes can go into effect.
In the case of these pay scale changes: An executive order published in December 2025 established ODs’ base and longevity pay schedule (as well as those other physicians listed).
Do we know the specifics on ODs’ new pay scale?
We do. The base pay range extends from $124,308 (minimum) to a maximum of $182,324, depending on an OD's tier.
To note, however: This base pay makes up only a portion of an OD's pay; VA ODs will also reportedly be eligible for market and performance pay—potentially enabling a total annual salary of up to $350,000.
And when did they go into effect?
While reports have noted theses new rate changes took effect on the first day of the first applicable pay period on or before Jan. 1, 2026, we're told that's actually note the case.
In reality: These changes are expected to take effect in the near future—and haven't yet been implemented, according to Carolyn Chakuroff, OD, a staff optometrist at the VA.
What ODs are waiting on: For final language in the bill to move them to a new pay table, after which then every provider will need a market review (in order to set their new salaries).
As such ... it could be several more months before this officially takes effect.
Editor's note: This article was updated on Jan. 21, 2026.