Everything below comes from the VA’s published HISA guidance. Where we are unsure, we say so. We are a federal contractor and an approved vendor and we still cannot tell you what will be approved for you.
What HISA is
A lifetime monetary benefit for medically necessary improvements and structural alterations to a veteran’s or servicemember’s primary residence.
The VA states it covers improvements for these purposes: allowing entrance to or exit from the primary residence; use of essential lavatory and sanitary facilities, such as roll-in showers; accessibility to kitchen or bathroom sinks or counters; improving entrance paths or driveways in the immediate area of the home through construction of permanent ramping; and improving plumbing or electrical systems made necessary by the installation of home medical equipment.
The amounts
Published as a lifetime benefit.
$6,800 is approved to address a service-connected disability; a compensable disability treated as if service-connected; or a non-service-connected disability where the veteran has a service-connected disability rated at least 50 percent. The VA notes that no combining of disability percentages is allowed for that last route.
$2,000 is approved to address a disability not covered above.
These are lifetime figures rather than annual ones, and the VA advises contacting your local Prosthetic and Sensory Aids Service to determine your remaining lifetime benefit. If HISA has been used before, some of it is already spent.
The exclusion list, which matters most
This is the part almost nobody in this trade publishes, and it is the reason plenty of veterans are disappointed.
The VA states HISA will not pay for walkways to exterior buildings, spa or hot tub or Jacuzzi installations, exterior decking, or new construction.
It further names among excluded alterations: home security systems; removable equipment or appliances such as portable ramps; porch lifts; stair glides; and routine repairs forming part of regular home maintenance, such as replacing roofs, furnaces or air conditioners.
Stair glide means stairlift. If you have been told HISA will buy a stairlift, that is worth checking against the VA’s own guidance before anybody plans around it.
Permanent ramping is inside the program. A portable ramp is not. A roll-in shower is inside. A porch lift is not.
The application package
The VA lists five items.
- A prescription written or approved by a VA physician, including the beneficiary’s name, address and telephone number; a description of the prescribed project covering the area of the home, the type of modification, all alternatives to the modification, and items requiring installation; and the diagnosis and medical justification. The VA states the medical justification should demonstrate the project’s clinical appropriateness.
- A completed and signed VA Form 10-0103, Veterans Application for Assistance in Acquiring Home Improvement and Structural Alterations. If you need an advance payment, request it on the application.
- For renters: a signed and notarized statement from the owner authorizing the work.
- A written itemized estimate of costs for labor, materials, permits and inspections.
- A color photograph of the unimproved area.
The VA notes an inspection of the site may be warranted.
Where applications go wrong
The prescription is vague. The VA asks for alternatives to the modification and a medical justification tying the diagnosis to the specific work. “Patient needs bathroom modified” does not do that. “Veteran requires a roll-in shower because he cannot step over a tub edge and cannot stand unsupported to wash” does.
The estimate is not itemized. Labor, materials, permits and inspections, separately.
The photograph is missing. A small thing that stalls a package.
Nobody checked the remaining lifetime balance. Call before planning.
What we do at no charge
We write the itemized estimate in the format the package requires, with measurements, and we will do it whether or not the work comes to us. A scope written the way a program expects is worth considerably more than the same job described loosely.
The regulations governing the program sit in 38 CFR Part 17 if you want the underlying rules rather than a summary.
The other programs
HISA is one of several. SAH and SHA, the Specially Adapted Housing and Special Home Adaptation grants, are administered separately by the Veterans Benefits Administration and are tied to specific service-connected disabilities. The VA links them here.
Automobile adaptive equipment is separate again, covering vehicle rather than home modification.
Our benefits checklist sets out what to gather before calling, and our stairlift guide covers the equipment question specifically.
Who to ask
Your local Prosthetic and Sensory Aids Service, which the VA’s facility locator will find. Then a VA social worker, and a Veterans Service Officer, who is free and whose whole job is navigating this.
Not a vendor, including us. We can tell you what we have supplied and how it reached us. We cannot tell you what will be approved.
Equipment that needs no determination from anybody ships free from our online shop.
What “medically necessary” is doing in that sentence
HISA has no list of qualifying conditions. Instead the work has to be medically justified for the disability, and the VA states the justification should demonstrate the project’s clinical appropriateness, meaning the clinical need should support the specific type of alteration prescribed.
That is why the prescription matters more than anything else in the package, and why a vague one stalls. The document has to connect a diagnosis to a functional problem to a specific piece of work.
The VA also asks the prescription to describe alternatives to the modification. That requirement catches people out: it is not enough to say a roll-in shower is needed, the prescription should show that lesser options were considered.
Owners and renters
Both can use HISA. Renters need a signed and notarized statement from the property owner authorizing the work, which takes time to obtain and is worth starting early.
Our rental and condo guide covers how to approach a landlord or an association, and the same written-request approach works here.
Using HISA alongside other programs
SAH and SHA are administered separately by the Veterans Benefits Administration and cover different ground. HISA covers modifications outside their scope, which means the programs can address different parts of the same house.
Your VA social worker or Prosthetic and Sensory Aids Service is the right place to work out which applies. A vendor is not.
A realistic view of the amounts
$6,800 is a meaningful contribution to a bathroom conversion or permanent ramping. It is not a full bathroom remodel in most markets, and it is a lifetime figure rather than a recurring one.
Plan what it is best spent on. Entrance access and bathing are the two things that most often decide whether somebody can stay in their home, and both sit squarely inside the program.
Before you spend it
Get the free things done first: lighting, rugs, grab bars, a threshold ramp. They cost a fraction of the grant and address a large share of the risk, and they leave the benefit for the work that genuinely needs it.
Our order of work is the sequence, and our checklist covers what to gather before calling.
Choosing a contractor for HISA work
The estimate has to be itemized across labor, materials, permits and inspections, which means whoever quotes needs to work that way rather than handing over a single number.
Ask whether they have done HISA work before, whether they will provide the estimate in the required format at no charge, and who handles the photograph and the site inspection if one is warranted.
Our vetting guide covers the questions that apply to any contractor, and they apply here too.
What we can and cannot tell you
We can tell you what the VA publishes, what an itemized estimate looks like, and what we have supplied through authorized work orders. We cannot tell you what will be approved for you, and any vendor who says otherwise is guessing with your money.
Equipment that needs no determination ships free from our online shop.