BACKGROUND Quality gaps in care of military and Veterans with upper limb amputation have been reported. In 2008, amputees receiving prosthetic care in the VA were reported to be less satisfied than counterparts receiving care in the private sector. In 2011, reported widespread dissatisfaction amongst combat Veterans with upper limb loss led to calls for efforts to evaluate needs of Veterans with traumatic upper limb amputations to improve satisfaction. Major efforts to improve quality of prosthetic care have been made since these studies were conducted. In 2009, the VA reorganized its amputation system of care, and in 2014 the VA and DOD released the Evidence-Based Clinical Practice Guidelines (CPGs) for the rehabilitation of persons with upper limb amputation. It is now time for a comprehensive study to assess the current state of quality and outcomes of amputation rehabilitation for upper limb amputees and to track quality and outcomes over time. OBJECTIVES Our objective is to provide comprehensive cross-sectional and longitudinal data on function, needs, preferences, and satisfaction of Veterans and service members with major upper limb amputation. This project modification adds subaims 1a and 2a to provide comprehensive data on women Veterans with upper limb amputation. SPECIFIC AIMS/HYPOTHESES 1) Describe patterns of prosthesis use; identify the impact of amputation and prosthesis use on function, activities and participation; and identify unmet prosthetic needs This aim will test 5 major hypotheses: 1) rates of prosthesis use and scores on prosthesis satisfaction scales will be higher for transradial (TR) amputees as compared to persons with more proximal amputations ; 2) there will be higher rates of prosthesis use and satisfaction amongst those with amputation in the past 5 years as compared to those who sustained amputation 6 or more years ago; 3) any prosthesis use, and myoelectric use will be associated with lower ratings of disability and neck pain compared to no prosthesis use and body-powered use respectively; 4) perceived difficulty of everyday activity function will be rated similarly for persons with unilateral upper limb amputation regardless of level, with no differences between users by type of prosthetic device. However, perceived difficulty in performing activities that require bimanual involvement will be greater for persons with more proximal as compared to TR amputation; 5) a greater proportion of activities will be performed using the prosthesis by persons with TR amputation as compared to more proximal amputation. 1a. Compare findings by gender. This sub aim will test the hypotheses that there will be an effect modification by gender, with female upper limb amputees being less satisfied with their prosthesis regardless years since amputation, 2) Conduct a one year longitudinal follow-up survey to examine changes in satisfaction with care and prosthetic services, physical performance, self-reported quality of life and...