VA HISA Application Instructions
"I had no idea where I could look for help when an accident totaled our van and left us helpless miles from home. Nor-Cal Mobility rescued us with a rental delivered! We were saved by Nor-Cal!" - Beverly B.
"Workmanship is absolutely outstanding!" - Bud R.
"Greg is our angel -- he is very compassionate, understanding and knows his business. Our family is very grateful! Thank you!" - Cathy M.
"The van was exactly what my wife wanted! Thanks!" - Chester K.
"Thank you for all of your help. I love my new van!" - Deborah F.
"Thank you for everything! We love our new van!" - Gary & Tracy S.
"Terrance was great! This process was frustrating and he was always there to help. Could not have done it without him." - Jerry F.
"Thank you for everything you have done for our boys. We appreciate how fast and easy everything went." - Judy L.
"Extremely courteous and knowledgeable staff. Should I ever need another special needs vehicle, I will, without a doubt, return to Nor-Cal Mobility for my vehicle." - Larry S.
"Alex is the best! He took such great care with Mom, made her feel very special and took lots of time explaining all factors to her and I." - Linda C.
"We had an excellent experience dealing with Al. He was very courteous and knowledgeable. We were very satisfied. Thank you!" - Lylliam D.
"Al was generous and absolutely accomodating. He was kind and patient." - Pacific Institute
"I am very happy with my van. It makes my life so much easier!" - Pam C.
"My buying experience couldn't have been better. Alex is great!" - Ray M.
"Terrance is a great salesman and helped us through all of the confusion. He is great to work with -- very professional and helpful. He gets an A+ from us." - Richard and Nelma B.
"Nor-Cal Mobility makes us feel like family!" - Robert W.
"I'm a very satisfied customer at Nor-Cal Mobility. Good place, good crew!" - Robin W.
"The people at Nor-Cal Mobility are just great to work with!" - Stephen C.
"Al and his staff are great! They are all very knowledgeable and demonstrated great customer service!" - Suzanne Z.
"Courtney was extremely helpful throughout the whole process and was impeccable in his follow-up. Because of his dilligence, I've already been able to recommend Nor-Cal Mobility to two other disabled persons interested in buying a vehicle." - Thomas L.
In order to ensure your claim for Home Improvement and Structural Alterations (HISA) benefits is processed as quickly as possible; the following is a list of things you should know, and do, to assist us in processing your claim:
1. The HISA Program provides a one-time maximum benefit of $4,100 to service connected veterans 50% or more or for a service connected injury requiring the alterations and $1,200 to non-service connected veterans or veterans service connected 50% or less that require the alterations for a non service connected disability. Any additional costs exceeding the grant amount will be incurred by the veteran.
2. Please complete: VA Form 10-0103, "Veterans Application forAssistance”, "Statement of Understanding for HISA”, "Doctor’s Order’s if from Outside Physician”, "Statement in Support of Claim” return packet to the above address along with:
a. A written estimate from a licensed contractor. The estimate should include the contractor’s address, telephone number, Federal Tax Identification number, license number, a full description of the improvements, the cost of supplies and labor and
permits if required by local government agency which are the licensed contractor’s responsibility. Contractor must be willing to accept the credit card VISA this is the government’s preferred method of payment.
b. The following will be required from the contractor:
(1) Contractor bids will provide a complete description of the proposed project to include:
• A sketch of the area to be altered or improved as it appears now. It must show the location of permanent fixtures such as walls, doors, windows, shower stalls, driveways or walks, if appropriate. The sketch must
include measurements and specifications of these items.
• A sketch showing the area as it will appear after the proposed project. The items mentioned in (b), should be shown with the new specifications and measurements.
(2) If a ramp is to be constructed, include an individual sketch of the ramp indicating type of construction materials, slope width and height. The slope of a ramp cannot be approved if it exceeds 1 inch increase in height per running foot of ramp. In general, a ramp cannot be approved if it is has more than 5 percentgrade or has a maximum slope of 1:12 or less. Any ramp must include railings and guards to prevent a wheelchair or scooter from running off the edges.
(3) If a driveway or walkway is to be improved, include information about the material composing the existing area, such as gravel, concrete, asphalt, etc.
(2) If a ramp is to be constructed, include an individual sketch of the ramp indicating type of construction materials, slope width and height. The slope of a ramp cannot be approved if it exceeds 1 inch increase in height per running foot of ramp. In general, a ramp cannot be approved if it is has more than 5 percentgrade or has a maximum slope of 1:12 or less. Any ramp must include railings and guards to prevent a wheelchair or scooter from running off the edges.
(3) If a driveway or walkway is to be improved, include information about the material composing the existing area, such as gravel, concrete, asphalt, etc.
(4) Contractor must itemize the construction materials, the material costs, and the labor costs for each part of the project, and the total cost of labor and materials for the entire project.
(5) Contractor is responsible for complying with all state and local building codes.
(5) Contractor is responsible for complying with all state and local building codes.
3. The completed application package will be reviewed by the Chief, Prosthetics and Sensory Aids Service or submitted to the HISA Committee for consideration.
4. A letter will be sent to the veteran notifying you of the Chiefs/HISA Committee’s decision.
5. Upon completion of work, the contractor will certify that the work meets Americans with Disabilities Act (ADA) standards and VA specifications as contained in the scope of work and a statement of satisfaction, signed by the veteran, must accompany the contractors invoice.
6. Keep a copy of all information submitted.
7. It is important to note:
a. Modifications should not begin before approval has been received from the Prosthetic Service.
b. The VA cannot reimburse the veteran, but is required by regulation to pay the vendor directly.
