The process moves at the speed of the documentation. Everything here is free to do and most of it can be done before anybody makes a decision.
Before you call anyone
Write down what has become difficult. Not the diagnosis, the tasks. Cannot get up the sixteen stairs to the bedroom without stopping twice. Cannot step over the tub edge. Cannot get up the front steps carrying anything.
Those sentences become the medical justification. The VA asks that a prescription demonstrate clinical appropriateness, and specific functional descriptions are what that is built from.
Photograph the problem areas. Both ends of the staircase, the bathroom, the front entrance. A color photograph of the unimproved area is a required item in the HISA package anyway.
Measure roughly. Number of steps, width of the staircase, height of the front step, width of the bathroom door.
Find your service details. Dates of service, discharge paperwork, disability rating if you have one, and whether the rating is service-connected.
The calls, in order
1. Your VA primary care team
Everything routes through a clinician eventually. Ask for a referral to whoever handles home modification and equipment at your facility.
2. Prosthetic and Sensory Aids Service
The service that handles HISA and a great deal of equipment. The VA’s facility locator finds your local one.
Ask three things: what is my remaining lifetime HISA balance, what does the package need, and who writes the prescription.
3. A VA social worker
Frequently the most useful person in the building, and the one who knows what your specific facility is currently approving.
4. A Veterans Service Officer
Through a service organization or a county veterans office. Free, independent of the VA, and navigating this is their entire job. If you make one call from this page, make this one.
What nobody tells veterans
Once equipment has been authorized, you are generally allowed to ask for a specific provider by name.
Plenty of veterans accept whoever is assigned because nobody mentioned there was a choice. If a company has already surveyed your house and written the scope, say so to whoever is processing the authorization.
Our veterans page sets out the wording.
What to have ready for a vendor
- The authorization, if one exists, and exactly what it says.
- Photographs and rough measurements.
- A description of the difficulty in functional terms.
- Whether you own or rent. Renters need a notarized owner authorization for HISA.
- Any previous modifications, and roughly when.
The itemized estimate
HISA requires a written itemized estimate covering labor, materials, permits and inspections. Not a single figure.
We produce those at no charge, in that format, whether or not the work comes to us. Ask any vendor to do the same, and treat unwillingness as information.
Know what is excluded before you plan
The VA’s published exclusion list names stair glides and porch lifts among things HISA does not cover, alongside portable ramps, hot tubs, exterior decking and home security systems.
Permanent ramping and bathroom work are inside the program. A seated stairlift is not. Our HISA guide covers the detail.
Vehicles are a separate route
Automobile adaptive equipment is administered separately from home modification. The VA publishes guidance on automobile adaptive equipment, and there is separate guidance covering vehicle modifications for non-service-connected veterans.
Our driving aids guide and vehicle lift guide cover the equipment.
Timelines, honestly
Weeks to months. That is a system with steps rather than anybody being slow, and it means starting before you are desperate.
Have an interim plan. Lighting, rugs, a grab bar at the toilet and the shower entry, a threshold ramp, a properly fitted rollator. None of that needs a determination from anybody and it addresses most of the immediate risk. The CDC reports falls as the leading cause of injury death for adults 65 and over, and the waiting period is exactly when somebody is exposed.
Our order of work is the sequence, and that equipment ships free from our online shop.
If you are helping a veteran
Let them make the first call where they can, because the system is built around their record. Then take on the documentation, the chasing and the notes, which is where families genuinely add value and where things otherwise stall.
Keep a folder. Every letter, every reference number, every name. Denials in this process frequently turn on a missing document rather than a missing qualification.
Keep a single folder
Paper or digital, one place. Every letter, every form, every reference number, the name and date of every call.
Denials in this process frequently turn on a missing document rather than a missing qualification, and a folder is what lets you answer a question in a minute rather than a fortnight.
Include: discharge paperwork, disability rating letter, the physician prescription, VA Form 10-0103, the itemized estimate, photographs, and any correspondence.
Ask for everything in writing
Verbal answers evaporate, and staff change. When somebody tells you what is covered or what the remaining balance is, ask for it in writing or note the name, date and reference.
Check the remaining lifetime balance first
HISA is a lifetime benefit. If any of it has been used before, some is already spent, and the VA advises contacting your local Prosthetic and Sensory Aids Service to determine what remains.
That is a five-minute call and it prevents planning around money that is not there. Our HISA guide covers the amounts and the rules.
The underlying regulations
If you want the rules rather than a summary, the program sits in 38 CFR Part 17. It is dry and it is authoritative, and it settles disagreements about what the program does.
SAH and SHA
Administered separately by the Veterans Benefits Administration and tied to specific service-connected disabilities. The VA publishes them here.
They are larger than HISA and narrower in eligibility. Ask a Veterans Service Officer which, if any, applies to you before assuming.
If the answer is no
The house has not changed and the equipment is still needed. Our funding guide covers the six routes beyond the VA.
A realistic week-by-week
- Week one: write the functional list, take photographs and rough measurements, find service paperwork.
- Week one: call a Veterans Service Officer and your local Prosthetic and Sensory Aids Service. Ask the remaining lifetime balance.
- Week two: ask your VA primary care team for the referral and the prescription, taking the functional list with you.
- Week two: get an itemized estimate from a vendor, free.
- Week three: assemble the package, including the notarized owner statement if renting.
- Meanwhile: do the cheap things that need nobody’s approval.
Nothing in the first three weeks costs anything, and doing it in that order is what stops a package sitting incomplete for a month.
If something stalls
Ask what specifically is outstanding and who holds it. Most delays are a single missing document rather than a decision, and a named person with a date is what moves it.
A Veterans Service Officer will chase on your behalf, which is why that call comes first. Our HISA guide covers what the package needs.