Combat-Related Disability Travel Benefit Forms

If you meet the CRDT Benefit Program qualifications, you must submit the following required documents packet to the TRICARE CRDT Benefit program representative.

Getting Started

Required Documents

If you don't include all of the required documents, TRICARE can’t process your claim. Be sure to make copies of everything for your records. See tips below if you're having problems accessing any of the forms.

Form/Document Instructions
DHA 131
Patient Information Worksheet

You must completely fill out and sign the form. Be sure to complete the CRDT portion of the form. Also, include the following information in the ‘Additional Information’ section of the form.

  • All treated verified combat-related disabilities or illnesses.

Travel Claim Forms:

DD Form 1351-2
DD From 1351-2c
DD Form 1351-3

Patients and non-active duty Non-Medical Attendants (NMAs). Complete both forms.

Active duty NMAs: Complete only the DD Form 1351-2

View the Instructions and Examples for help completing the DD 1351-2 form.
Combat-Related Special Compensation (CRSC) Letter

Need more information about the CRSC Letter? Contact your branch of service.
Itemized Receipts

Include legible, itemized receipts for all travel claims.

Credit card or bank statements don't qualify as receipts.

Receipts must be dated during the approved travel timeline. If not, TRICARE can’t reimburse.
Referral

Be sure the following information is included on your referral letter.

  • Referral printed on office letterhead or accompanied by office letterhead fax sheet
  • Patient’s Name
  • Date referral written by PCP
  • PCP Name and contact information
  • The verified combat related injury or illness (that can be found on the CRSC Letter)
  • Name and contact information of the specialty careSpecialized medical/surgical diagnosis, treatment, or services a primary care provider isn’t qualified to provide. provider (SCP) that the patient is being referred to by the PCP
  • The medical specialty of the SCP (i.e. oncology, radiology)
  • If a NMA is medically necessaryTo be medically necessary means it is appropriate, reasonable, and adequate for your condition. for the travel
  • The beginning and ending date you will need to travel to get the medical care. This date range must not exceed one year.

If your PCP needs more help, they may contact the CDRT Program Representative.
Proof that you
Attended the
Appointment

DHA 126 Confirmation of Specialty Care

The SCP must complete and sign the DHA 126 Confirmation of Specialty Care Form. The information below
must be included in the ‘Additional Information’ section of the form:

  • All verified combat-related disabilities or illnesses that were treated.
  • A list of the health services provided and current procedural terminology (CPT) codes if available.
Non-Medical
Attendant Letter
(Needed for adult
patients who are 18
years or older)
 A letter from your doctor stating that a non-medical attendant (NMA) is appropriate and medically-necessary.
We only require this if you have an NMA. For chronic conditions, your doctor may request the letter be valid for up to one year.
Direct Deposit Authorization Form
 All payments are by electronic funds transfer (EFT).

Submit Packages

Send all required documents via email, fax, or mail.

Email DHA.CRDT@health.mil

And the DoD SAFE (Secure Access File Exchange)
  • Note: DoD SAFE is a service to make it easy for you to exchange unclassified files up to 8.0 GB that you can’t send through email.
  • Visithttps://safe.apps.mil/. If you don’t have a Common Access Card (CAC), let us know by the email above. We'll send you a drop-off request so you can use DoD SAFE.
  • Don’t send Protected Health Information via unencrypted email. Also, don’t send encrypted messages to DHA.CRDT@health.mil.

Fax

1-210-536-6176

 Please include social security numbers if faxing.
Mail Combat-Related Disability Travel
7800 W Interstate 10, Suite 400
San Antonio, TX 78230

Your Reimbursement

  • We process your travel claims using the Defense Travel System (DTS).
  • Include legible, itemized receipts for all travel expensesAmounts you pay when traveling to and from your appointment.  This includes mileage, meals, tolls, parking, lodging, local transportation, and tickets for public transportation. with each claim. You don’t need to include fuel receipts when using your personal vehicle.
  • The CRDT Benefit uses government rates to reimburse the reasonable expenses. This includes City Pairs for flight allowances.
  • Please allow up to four weeks for your payment to be processed.

Tips for Downloading and Signing Forms

To download certain forms:

  • Due to security settings, you may need to download and install the Adobe Acrobat Reader software.
  • Right-click on the form number.
  • Select "Save Link As" to sign certain forms. If you’re:
  • Getting the forms on a non-government computer:
    • Create a digital signature ID.
    • Digitally sign the form.
  • Getting the forms on your phone or tablet:
    • Use the “Fill & Sign” tool in Adobe Acrobat to create a digital signature ID.
    • Digitally sign the form.

    Note: If your devices aren’t compatible, you’ll need to print and manually sign the forms.

Please send all Combat Related Disability Travel email correspondences to dha.crdt@health.mil.

Accessing DD Forms
Due to security settings, you may have to right-click and select "Save As" to download certain DD Forms.

Last Updated 2/14/2023