ptsd Need Info On Hisa And Independent Living Program

[farmall]

Hi again: I have some questions for the great people here;I am trying to figure out the process for HISA (Home Improvements and Structural Alterations) Program. The info states "A prescription from a VA, or fee-basis, physician for HISA modifications is required and must include the following". My question is that I don't know where to get the application for the physician to complete--there is also a form # 10-0103 called Veterans Application for Assistance in Acquiring HISA-this form is for the contractor to complete. I have this form(10-0103). Has anyone dealt with this program? ALSO, in regard to the Independent Living Program, Testvet briefly described this program-could this be given more detail. Roger got 100% PTSD and TDIU, P&T, the decision stated "Your disabilities are felt to be preventing you from being able to get a job which could be classified as substantially gainful employment." How does this program work? I am wondering if we could get assistance in regard to a handicap toilet as he also has IBS, and also a window installed in our dining room,-such installation would provide him with clear vision to our front entrance door giving him the knowledge that no one is sneaking up on him. Currently that is the feeling he has. This relates to the PTSD. Any info on this will be greatly appreciated. We applied and got his disabled veteran license plate, we live in Michigan. I still can't believe it only took VA a few months after the C&P exam to give their decision; we have been struggling financially and believe me when I say the deposit made to the bank account the first of the month really allows us to breathe easier.(The retro payment took care of a lot of outstanding items, now maybe we can relax). Sandra, wife of Roger.

[Guest allanopie]

http://thomas.loc.gov/cgi-bin/query/F?

c108:5:./temp/~c108qI5lZl:e38807:

S.2486

Veterans Benefits Improvement Act of 2004 (Enrolled as Agreed to or

Passed by Both House and Senate)

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TITLE III--BENEFITS MATTERS

TITLE IV--HOUSING MATTERS

SEC. 401. AUTHORITY TO PROVIDE SPECIALLY ADAPTED HOUSING TO CERTAIN

DISABLED VETERANS.

The text of section 2101 is amended to read as follows:

`(a) Acquisition of Housing With Special Features- (1) Subject to

paragraph (3), the Secretary may assist a disabled veteran described

in paragraph (2) in acquiring a suitable housing unit with special

fixtures or movable facilities made necessary by the nature of the

veteran's disability, and necessary land therefor.

`(2) A veteran is described in this paragraph if the veteran is

entitled to compensation under chapter 11 of this title for a

permanent and total service-connected disability that meets any of

the following criteria:

`(A) The disability is due to the loss, or loss of use, of both lower

extremities such as to preclude locomotion without the aid of braces,

crutches, canes, or a wheelchair.

`(:) The disability is due to--

`(i) blindness in both eyes, having only light perception, plus

`(ii) loss or loss of use of one lower extremity.

`© The disability is due to the loss or loss of use of one lower

extremity together with--

`(i) residuals of organic disease or injury; or

`(ii) the loss or loss of use of one upper extremity,

which so affect the functions of balance or propulsion as to preclude

locomotion without the aid of braces, crutches, canes, or a

wheelchair.

`(D) The disability is due to the loss, or loss of use, of both upper

extremities such as to preclude use of the arms at or above the

elbows.

`(3) The regulations prescribed under subsection © shall require

that assistance under paragraph (1) may be provided to a veteran only

if the Secretary finds that--

`(A) it is medically feasible for the veteran to reside in the

proposed housing unit and in the proposed locality;

`( the proposed housing unit bears a proper relation to the

veteran's present and anticipated income and expenses; and

`© the nature and condition of the proposed housing unit are such

as to be suitable to the veteran's needs for dwelling purposes.

`(B) Adaptations to Residence of Veteran- (1) Subject to paragraph

(3), the Secretary shall assist any disabled veteran described in

paragraph (2) (other than a veteran who is eligible for assistance

under subsection (a))--

`(A) in acquiring such adaptations to such veteran's residence as are

determined by the Secretary to be reasonably necessary because of

such disability; or

`(B) in acquiring a residence already adapted with special features

determined by the Secretary to be reasonably necessary for the

veteran because of such disability.

`(2) A veteran is described in this paragraph if the veteran is

entitled to compensation under chapter 11 of this title for a

permanent and total service-connected disability that meets either of

the following criteria:

`(A) The disability is due to blindness in both eyes with 5/200

visual acuity or less.

`(B) The disability includes the anatomical loss or loss of use of

both hands.

`(3) Assistance under paragraph (1) may be provided only to a veteran

who the Secretary determines--

`(A) is residing in and reasonably intends to continue residing in a

residence owned by such veteran or by a member of such veteran's

family; or

`(B) if the veteran's residence is to be constructed or purchased,

will be residing in and reasonably intends to continue residing in a

residence owned by such veteran or by a member of such veteran's

family.

`© Regulations- Assistance under this section shall be provided in

accordance with such regulations as the Secretary may prescribe.'.

[Guest allanopie]

Independent Living Services

§21.6160 Independent living services.

(a) Services must be part of a vocational training program. Independent living services may be provided as a part of a veteran’s IWRP when such services are indispensable to the achievement of the vocational goal, but may not be provided as the sole program of rehabilitation for the veteran, since a vocational training program for the veteran must be found reasonably feasible before the IWRP is prepared. (Authority: 36 U.S.C. 1524(:)(2))

( Independent living services which may be furnished under this program. The independent living services which may be furnished include:

(1) Training in independent living skills;

(2) Health management programs;

(3) Identification of appropriate housing accommodations; and

(4) Personal care service for a transitional period not to exceed two months. (Authority: 38 U.S.C. 1524(B))

© Coordination with other VA elements and other Federal, State, and local programs. Provision of independent living services and assistance will generally require extensive coordination with other VA and non-VA programs. The resources of VA medical centers shall be utilized as prescribed in §21.6242 of this part. If appropriate arrangements cannot be made to provide these services through VA medical centers, other governmental and private nonprofit programs may be used to secure necessary services if the facility or individual providing services meets the requirements of §21.294 of this part. (Authority: 38 U.S.C. 253, 1524(B))

(d) Applicability of chapter 31 rules. Neither §21.160 nor §21.162 of this part are applicable to provision of independent living services under this program. (Authority: 38 U.S.C. 1524(B))

Next Section is §21.6180

[Guest allanopie]

Independent Living Services

§21.160 Independent living services.

(a) Purpose. The purpose of independent living services is to assist eligible veterans whose ability to function independently in family, community, or employment is so limited by the severity of disability (service and nonservice-connected) that vocational or rehabilitation services need to be appreciably more extensive than for less disabled veterans. (Authority: 38 U.S.C. 3104(a)(15), 3109, 3120)

(:) Definitions. The term “independence in daily living” means the ability of a veteran, without the services of others or with a reduced level of the services of others, to live and function within the veteran’s family and community. (Authority: 38 U.S.C. 3101(2))

© Situations under which independent living services may be furnished. Independent living services may be furnished:

(1) As part of a program to achieve rehabilitation to the point of employability;

(2) As part of an extended evaluation to determine the current reasonable feasibility of achieving a vocational goal;

(3) Incidental to a program of employment services; or

(4) As a program of rehabilitation services for eligible veterans for whom achievement of a vocational goal is not currently reasonably feasible. This program of rehabilitation services may be furnished to help the veteran:

(i) Function more independently in the family and community without the assistance of others or a reduced level of the assistance of others;

(ii) Become reasonably feasible for a vocational rehabilitation program; or

(iii) Become reasonably feasible for extended evaluation. (Authority: 38 U.S.C. 3104(a)(15), 3109, 3120)

(d) Services which may be authorized. The services which may be authorized as part of an IILP (Individualized Independent Living Plan) include:

(1) Any appropriate service which may be authorized for a vocational rehabilitation program as that term is defined in §21.35(i), except for a course of education or training as described in §21.120; and

(2) Independent living services offered by approved independent living centers and programs which are determined to be necessary to carry out the veteran’s plan including:

(i) Evaluation of independent living potential;

(ii) Training in independent living skills;

(iii) Attendant care;

(iv) Health maintenance programs; and

(v) Identifying appropriate housing accommodations.

(Authority: 38 U.S.C. 3104(a)(15), 3109, 3120)

(e) Coordination with other VA elements and other Federal, State, and local programs. Implementation of programs of independent living services and assistance will generally require extensive coordination with other VA and non-VA programs. If appropriate arrangements cannot be made to provide these services through VA, other governmental, private nonprofit and for profit agencies and facilities may be used to secure necessary services if the requirements contained in §21.294 are met. (Authority: 38 U.S.C. 3104(a)(15), 3109, 3115, 3120)

[49 FR 40814, Oct. 18, 1984, as amended at 53 FR 50957, Dec. 19, 1988; 55 FR 42186, Oct. 18, 1990; 62 FR 17708, Apr. 11, 1997]

Supplement Highlights reference: 30(2)

Next section is §21.162

[Guest allanopie]

§21.162 Participation in a program of independent living services.

(a) Approval of a program of independent living services. A program of independent living services and assistance is approved when:

(1) VA determines that achievement of a vocational goal is not currently reasonably feasible;

(2) VA determines that the veteran’s independence in daily living can be improved, and the gains made can reasonably be expected to continue following completion of the program;

(3) All steps required by §§21.90 and 21.92 of this Part for the development and preparation of an Individualized Independent Living Plan (IILP) have been completed; and

(4) The VR&E Officer concurs in the IILP. (Authority: 38 U.S.C. 3104(a)(15), 3109, 3120)

(:) Considerations for the VR&E Officer. The VR&E Officer will consider the following factors in administering programs providing independent living services:

(1) If VA resources available limit the number of veterans who may be provided a program of independent living services and assistance, the first priority shall be given to veterans for whom the reasonable feasibility of achieving a vocational goal is precluded solely as a result of service-connected disability; and

(2) To the maximum extent feasible, a substantial portion of veterans provided with programs of independent living services and assistance shall be receiving long-term care in VA medical centers and nursing homes. (Authority: 38 U.S.C. 3120©)

[49 FR 40814, Oct. 18, 1984, as amended at 53 FR 50957, Dec. 19, 1988; 55 FR 48842, Nov. 23, 1990; 62 FR 17708, Apr. 11, 1997; 66 FR 44053, Aug. 22, 2001]

Supplement Highlights reference: 30(2)

Next section is §21.180

[formfatigue]

I also need info on the HISA process. My husband is rated 100% service-connected disabled and he is a POW from WWII. He is 82.

The occupational therapist that the VA contracted with to evaluate our house for safety said that he needs safety bars installed, toilet assistive devices (which we got free from a recycled health aides group), alarm monitors, and the addition of a shower for our half bath so that he won't have to be carried up stairs to the shower. We will turn our dining room into a bedroom since the bedroom is also upstairs. Converting the dining room won't cost anything. Adding a shower involves plumbing changes and moving a wall and toilet.

His VA doctor added the notes to his file that said we need these adaptations as well. Now I'm not sure how to proceed. Does anyone have advise. The OT was told by the VA that the remodel grant process is very, very slow. My husband may not have a lot of time left. His muscles seem strong but his balance, coordination and breathing are very poor.

How long does the HISA process take from application to decision?

How long from the Aid and Attendance assessment exam until the VA Benefits board makes a decision? How much does Aid and Attendance pay for homebound? He already gets a pension for his 100% service connected disability.

When I complalned to the doctor that I don't understand why the VA is willing to pay $300 per day for a VA contracted care facility but not willing to help me keep him at home, he told me that I was making the mistake of trying to apply logic to an illogical system.

I am spending much more money each month than I have coming in and will go broke very soon. The person who helps me care for my husband is charging $15 per hour for a 12 hour minimum. If we use less hours, it is $20 per hour. I can't lift my husband. The VA tells me I can put him in the VA hospital for the rest of his life but that would be like returning him to "prison". He already spent time as a POW and I can't place him in the hospital, it would definitely be the end of him.

Does anyone out there have a way to put some time effectiveness into both the Aid and Attendance decision and a way to fast-track the HISA application? Time is running out for my husband.

Thanks for reading. Any and all advise appreciated.

God, please save all of those who are suffering and have suffered for their country.