VA neurology appointments carry the longest new-patient waits nationally, and most facilities remain far above VA's own standard despite recent improvement from early-2026 peaks

Summary

Neurology is consistently the specialty with the longest new-patient waits across the VA system, and it is currently the worst-performing of the 10 specialties tracked in the most recent national analysis -- only 7% of facilities met VA's own 28-day access standard for a new neurology appointment in the most recent reporting period. Pulling VA's own live public wait-time data directly (accesstocare.va.gov, snapshot 2026-09-26), the longest current new-patient neurology waits I could verify are at the Austin, TX VA Clinic (109 days), Omaha VA Medical Center (96 days), the Audie L. Murphy VA Hospital in San Antonio (94 days), and the Dallas VA Medical Center (79 days) -- all 2.6x to 3.9x VA's own 28-day standard for specialty care.

On trend: mixed, but net worse than a year ago, with some pullback from an early-2026 peak. At both Omaha and Dallas, waits spiked sharply in the months right after the current administration took over VA operations (Omaha: 27 days a year earlier → 127 days in the Oct 2025-Jan 2026 period), then eased somewhat by September 2026 (96 days) -- still more than 3x the year-ago baseline. Dallas shows the same shape (87 → 130 → 79 days). Nationally, a Government Executive analysis of VA data obtained via FOIA found 42% of facility-specialty combinations saw wait times worsen by 2+ days versus 37% that improved (comparing Oct 2025-Jan 2026 to the same months a year earlier); a separate Vet Voice Foundation study of 21 VA medical centers (Aug 2025-Feb 2026) found wait times increased at 71% of facilities studied. VA leadership publicly maintains that wait times are stabilizing or declining overall, a claim the FOIA-based facility-level data does not uniformly support.

A data-quality note that shaped this answer

This connector's own dedicated table for this question, health.va_access_to_care_wait_times, returned zero rows total when queried live on 2026-09-27. I ran two exploratory queries against it filtered with WHERE new_patient_wait_days IS NOT NULL to look for the longest current waits, and both returned no rows; a direct, unfiltered SELECT count(*) against the same table (with no WHERE clause at all) confirmed why -- the table holds zero rows in total, for every column, not just for the new_patient_wait_days column. So the IS NOT NULL filter excluded nothing beyond what an unfiltered query also returns: there was no set of populated rows it was hiding, and removing the filter does not change the headline (0 rows either way). That table's own documentation describes it as a daily-refreshed mirror of VA's public wait-time API and had been verified with real data as recently as mid-September 2026, so this looks like a broken or stalled ETL refresh, not a genuine absence of VA wait-time data -- I filed it as a defect. To confirm, I fetched VA's underlying public source (accesstocare.va.gov/PWT/getRawData) directly: it is live and current (slice date 2026-09-26 on facilities with an active metric), so the figures in this report were pulled directly from that source rather than through the connector's broken table.

Coverage limits to flag directly: VA operates roughly 170 medical centers with wait-time-tracked specialties across ~20 categories and 50 states. Fetching the live source for every facility x specialty combination nationwide was outside this session's practical budget (the source returns one full state's cross-product of facilities at a time, so a true national ranking requires roughly 50 sequential fetches per specialty). What is reported here is therefore: (a) directly-verified, current figures for a sample of the facilities independent reporting had already flagged as outliers (Omaha, Dallas, San Antonio, Austin, Abilene, Waco), confirming those figures are still elevated as of the most recent data, plus (b) the best available *national* facility-by-facility studies -- Government Executive's analysis of 134 of VA's 170 medical centers via FOIA data, and Vet Voice Foundation's 21-facility study spanning 13 of VA's 18 regional networks -- for the system-wide ranking-by-specialty and trend-direction claims. Neither of those national studies is this connector's own data; both are independent journalism/advocacy analyses of VA's own released figures, cited and linked below.

Which specialty and facilities have it worst right now

Across the 10 specialties with the most complete VA new-patient wait-time data (primary care, mental health individual and group, substance use, PTSD, neurology, physical therapy, pulmonology, oncology, urology), neurology stands out as the worst performer: as of early 2026 just 7% of facilities met the 28-day access standard for a new neurology appointment -- the lowest compliance rate of any specialty tracked, and worse even than oncology or PTSD care. A parallel study by the Vet Voice Foundation covering 21 VA medical centers put the average neurology wait at 76.3 days, exceeding the 28-day standard at literally every one of the 21 facilities it examined.

Pulling VA's own live wait-time API directly for neurology confirms this is still true as of late September 2026. The longest current new-patient neurology waits found among the facilities checked: Austin, TX VA Clinic (109 days), Omaha VA Medical Center (96 days), Audie L. Murphy Memorial VA Hospital, San Antonio (94 days), Dallas VA Medical Center and Abilene, TX VA Clinic (79 days each), and the Doris Miller VA Medical Center in Waco (74 days). Oncology, substance-use treatment, and PTSD care follow neurology as the next-worst specialties nationally, per the same reporting.

Has it gotten better or worse recently?

The honest answer is both -- worse than a year ago, but improved from an early-2026 peak at the two facilities I could directly re-check. Government Executive's FOIA-based comparison of the first four months of fiscal 2026 (Oct 2025-Jan 2026) against the same months a year earlier found neurology wait times rose sharply at many facilities: Omaha's average new-patient neurology wait jumped from 27 days to 127 days, and Dallas's from 87 days to 130 days, over that one-year span. Checking those same two facilities against VA's live source as of 2026-09-26, both have come down noticeably from that January 2026 peak (Omaha: 96 days; Dallas: 79 days) but remain well above both their year-ago baseline and VA's 28-day standard.

System-wide, the picture is genuinely mixed rather than a clean trend in either direction. Across all specialties in the 134-facility FOIA dataset, about 42% of facility-specialty combinations saw wait times worsen by 2 or more days year over year, versus 37% that improved by the same margin -- roughly a wash, tilted slightly negative. Primary care and pulmonology were the only two specialties where more facilities improved than worsened; neurology, oncology, substance-use treatment, and PTSD care all saw more facilities get worse than get better. The Vet Voice Foundation's independent study, covering a slightly different and more recent window (Aug 2025-Feb 2026), found an even starker deterioration: wait times increased at 71% of the 21 medical centers it studied and at 64% of specialty-care categories, including large single-facility swings (e.g., group therapy wait at the Hampton, VA medical center rising from 30 to 87 days; Togus, ME from 25 to 68 days).

VA leadership (Secretary Doug Collins and department spokespeople) has publicly and repeatedly stated that wait times are stabilizing or falling system-wide, and noted that existing patients (over 80% of VA's total patient volume) have seen lower average waits than in FY2024. VA has not published the overall, department-wide average wait-time figures that would let an independent party check that broader claim; the facility-level data obtained via FOIA and analyzed independently is what this report relies on for the new-patient trend specifically, and it does not show the uniform improvement VA's public statements have claimed.

Context: what's driving it

VHA has lost a net 18,626 employees since the start of 2025 after accounting for hiring, per Office of Personnel Management data cited in the reporting below -- including a net loss of about 1,100 physicians, nearly 3,000 nurses, and 800 medical support staff who handle scheduling. A former VHA chief operating officer quoted in the reporting characterized the pattern as a capacity-versus-demand mismatch at facilities already failing to meet the standard, which he said would require added hiring or clinical infrastructure rather than efficiency gains to fix. Demand has also risen: the PACT Act (2022) expanded eligibility for millions of veterans exposed to burn pits and other toxins, and VA reports enrollment growth continuing into 2026.

What This Report Does Not Answer

• Grounding in this connector's own data where available: This connector's dedicated table for VA wait times (health.va_access_to_care_wait_times) was found completely empty (0 rows) live during this session -- reported as a defect. All current-facility figures therefore came from fetching VA's public source API directly rather than through this connector's SQL layer.

Every query behind this report

3 warehouse calls ran in this session, in order. Each is reproducible against the same snapshot.

SELECT facility_name, state, city, appt_type_name, new_patient_wait_days, slice_end_date
FROM health.va_access_to_care_wait_times
WHERE new_patient_wait_days IS NOT NULL AND facility_type = 'Health Care System'
ORDER BY new_patient_wait_days DESC
LIMIT 25

SELECT appt_type_name, avg(new_patient_wait_days) as avg_wait, count(*) as n
FROM health.va_access_to_care_wait_times
WHERE new_patient_wait_days IS NOT NULL
GROUP BY appt_type_name
ORDER BY avg_wait DESC

SELECT count(*) as total, count(new_patient_wait_days) as has_new_wait, count(established_patient_wait_days) as has_est_wait, count(distinct slice_end_date) as distinct_dates, max(slice_end_date) as max_date, min(slice_end_date) as min_date
FROM health.va_access_to_care_wait_times