VA Form 10-0103: Veterans Application for Assistance in Acquiring Home Improvements and Structural Alterations
VA Form 10-0103 is the application for the Home Improvements and Structural Alterations (HISA) grant, which helps veterans pay for medically necessary changes to their home, such as ramps, roll-in showers, widened doorways, and accessible fixtures.
This is the genuine VA PDF, unmodified. Source: VA official page.
What is VA Form 10-0103?
VA Form 10-0103, Veterans Application for Assistance in Acquiring Home Improvements and Structural Alterations, requests a HISA grant through the Veterans Health Administration. HISA pays for improvements and alterations that are medically necessary for the treatment of a veteran's condition or that make the home accessible, including access ramps, bathroom modifications for wheelchair use, doorway widening, and improvements to essential lavatory and sanitary facilities.
HISA is a health care benefit administered through VA medical centers, separate from the larger Specially Adapted Housing grants handled by the Veterans Benefits Administration. A prescribing VA or VA-authorized clinician documents the medical need, and the local facility reviews the application. HISA has lifetime benefit limits that differ for service-connected and non-service-connected conditions; check the current amounts with your VA medical center. The current form revision is dated February 2025.
Who files VA Form 10-0103?
- Veterans who need home modifications that are medically necessary for treatment of a condition
- Veterans who need alterations for wheelchair access or safe entry and exit from their home
- Veterans living in a home owned by a family member, with the owner's written consent for the alterations
- Caregivers or family members helping an eligible veteran prepare the application
How to fill out VA Form 10-0103
- Talk with your VA provider about the modifications you need; a prescription or clinical documentation of medical necessity supports the application.
- Complete the one page form with your identifying information and a description of the improvements or alterations requested.
- Gather the supporting items your facility requires, which typically include an itemized contractor estimate and, if you do not own the home, the owner's written permission.
- Sign and date the application.
- Submit the package to the HISA coordinator at your VA medical center, usually through the Prosthetic and Sensory Aids Service, and wait for approval before starting work.
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Frequently asked questions
What does the HISA grant pay for?
Medically necessary improvements such as ramps and accessible entrances, bathroom and shower modifications for wheelchair use, widened doorways, lowered counters where medically indicated, and improvements to essential sanitary facilities. It generally does not cover exterior decks, spas, or improvements that are not tied to medical need.
How is HISA different from the SAH and SHA grants?
HISA is a health care benefit available through VA medical centers to veterans with qualifying medical needs, including many with non-service-connected conditions. Specially Adapted Housing (SAH) and Special Home Adaptation (SHA) grants are larger construction grants from the Veterans Benefits Administration for veterans with specific serious service-connected disabilities, applied for on VA Form 26-4555. Some veterans qualify for HISA and an SAH or SHA grant.
Can I start the work before approval?
No. Get the HISA approval from your VA medical center before beginning construction. Work done before approval is generally not reimbursable, and the facility may need to inspect or review the plans first.