Michael T Mullen, NSO La Jolla, CA MOPH Training Orlando FL March 2014

Size: px
Start display at page:

Download "Michael T Mullen, NSO La Jolla, CA MOPH Training Orlando FL March 2014"

Transcription

1 Michael T Mullen, NSO La Jolla, CA MOPH Training Orlando FL March 2014

2 Automobile Adaptive Equipment Program Adapted Housing Grant HISA-Home Improvement and Structural Alterations Program SAH-Specially Adapted Housing Grant SHA-Special Home Adaptation Grant TSA - Temporary Residence Assistance Clothing Allowance

3 The VA automobile adaptive equipment program provides the necessary equipment and training to enable a disabled veteran to operate a motor vehicle safely and permit access to and from the vehicle in a safe manner. Automobile adaptive equipment is used to permit physically challenged persons to enter, exit, or operate a motor vehicle or other conveyance.

4 The Department of Veterans Affairs (VA) provides a one-time payment to disabled Veterans of no more than $18,900 toward the purchase of an automobile or other transportation.

5 The basic authority to provide automobile adaptive equipment is Title 38 United States Code (U.S.C.) Chapter 39. Eligibility Veterans service connected for the loss or loss of use of one or both feet or hands, or service connected ankylosis of one or both knees or hips. Veterans service connected for permanent impairment of vision of both eyes that have a central acuity of 20/200.

6 NSC veterans are eligible for equipment/modifications that will allow ingress and egress from a vehicle only. A severe burn injury defined by deep partial thickness or full thickness burns resulting in scar formation that cause contractures and limit motion of one or more extremities or the trunk and preclude effective operation of an automobile

7 Completed VAF , Application for Automobile or Other Conveyance and Adaptive Equipment Completed VAF , Application for Adaptive Equipment Copy of Valid Drivers License Bill of Sale, Invoice, Lease Agreement or Registration Form Window Sticker

8 Proof of Ownership (Title) Proof of release or disposal of a previously owned vehicle If veteran paid sale tax, adjust to reimburse Repairs Marked paid and include the certification statement signed by vender

9 VA may not reimburse a veteran for automobile adaptive equipment more than 2 times within a 4 year period. VA may not reimburse a veteran for adaptive equipment for more than 2 vehicles at one time to include; Automobile Full size or mini van Pick Up Trucks Motor Homes

10 Automatic Transmission Power Brakes Power Steering Power Seat Power Windows Air Conditioning Transfer of Controls Hand Controls accelerator and brake Power Door Openers Van Lift

11

12 A physician has to determine all medical conditions and physical deficits that could effect driving ability Veteran has to be referred to the nearest VA Driver Rehabilitation Center for driver training to include sensitized steering control

13 Routine service to items is NOT considered a repair Towing is not normally an authorized repair Reimbursement is only to the basic components authorized as adaptive equipment Every effort will be made to transfer add-on adaptive equipment from one vehicle to another as long as the equipment is adequate for the veterans disability.

14 How many times may a veteran be reimbursed for automobile adaptive equipment within a 4 year period? A. 1 B. 2 C. 3 D. No more than 4

15

16 There are several grants available through the Department of Veterans Affairs for constructing an adapted home or modifying an existing home. Specially Adapted Housing Grant SAH Special Home Adaptation Grant SHA Home Improvements and Structural Alterations Grant HISA Temporary Residence Assistance - TRA

17 SAH is a grant that is designed to help provide a barrier-free living environment that affords the individual a level of independent living they may not otherwise enjoy, such as creating a wheelchair accessible home The purpose of the grant is construct or modify a home to meet adaptive needs This grant is currently limited to $67,555

18 Loss or loss of use of both lower extremities, such as to preclude locomotion without the aid of braces, crutches, canes, or a wheelchair, or Blindness in both eyes, having only light perception, plus loss or loss of use of one lower extremity, or Loss or loss of use of one lower extremity together with (1) residuals of organic disease or injury, or (2) the loss or loss of use of one upper extremity, which so effects the functions of balance or propulsion as to preclude locomotion without the aid of braces, crutches, canes or a wheelchair, or Loss or loss of use of both upper extremities such as to preclude use of the arms at or above the elbow, or A severe burn injury

19 SHA is a grant for modifying an existing home to meet adaptive needs, such as assistance with mobility throughout the home Veterans and service members with specific service-connected disabilities may be entitled to this type of grant A temporary grant may be available to veterans and service members who are or will be temporarily residing in a home owned by a family member The grant is currently limited to $13,511

20 Blindness in both eyes with 5/200 visual acuity or less or, The anatomical loss or loss of use of both hands or extremities below the elbow, or A severe burn injury

21 Under the Home Improvements and Structural Alterations program, veterans with serviceconnected or non-service connected disabilities may receive assistance from any home improvement necessary for the continuation of treatment or for disability access to the home and essential lavatory and sanitary facilities A HISA grant is available to veterans who have received a medical determination indicating that improvements and structural alterations are necessary or appropriate for the effective and economical treatment of their disability A veteran may receive both a HISA grant and either a Special Home Adaptation (SHA) grant or a Specially Adapted Housing (SAH) grant

22 Allowing entrance or exit from veterans home Improving access for use of essential lavatory and sanitary facilities Improving access to kitchen and bathroom counters Handrails Lowered electrical outlets and switches Improving paths or driveways Improving plumbing/electrical work for dialysis patients What HISA will NOT pay for: Walkways to exterior buildings Widening of driveways (in excess of a 7ft x 6ft area) Spa, hot tub or Jacuzzi Exterior decking (in excess of 8ft x 8ft)

23 The HISA program is available for both SERVICE-CONNECTED veterans and NON- SERVICE CONNECTED veterans. Home improvement benefits up to $6,800 may be provided to service-connected veterans. Home improvement benefits up to $2,000 may be provided all other veterans enrolled in the VA Health Care system.

24 In order to receive a HISA grant, the veteran must first have a prescription from a VA or fee-basis physician. This must include: Specific items required The diagnosis with medical justification The veterans name, address, social security and phone number

25 A completed VA Form , Veterans Application for Assistance in Acquiring Home Improvement and Structural Alterations. If a leased or rented property, written permission from the owner. Quotes from at least 3 licensed contractors, to include: 1. The contractors name, address, telephone and Federal tax ID number or social security number. 2. The veterans name, address and telephone number. 3. Plans and drawings 4. An itemized list of estimated materials, to include cost and labor. 5. All permits required (it is the contractors responsibility to obtain these) 6. A picture of the work site prior to construction.

26 A temporary grant may be available to SAH/SHA eligible Veterans and Service members who are or will be temporarily residing in a home owned by a family member. The maximum amount available to adapt a family member s home for the SAH grant is $29,657 and for the SHA grant is $5,295.

27 Veterans who because of a service connected disability, wear or use a prosthetic or orthopedic appliance (including a wheelchair) which tends to wear out or tear clothing, and veterans, who because of a service connected skin condition use a medication that causes irreparable damage to outer garments are eligible for payment of an annual clothing allowance.

28 If you previously submitted a claim for disability compensation, send this application, VA Form to the Prosthetic and Sensory Aids Service at your local VA Medical Center. If you have not filed a application for disability compensation, send that form (VA Form ) to the VA regional office nearest your home. Payment: Applications are collected throughout the year and held until the closing date of August 1 st. They are then processed and veterans will receive payments between September 1 st and October 31 st. This is an annual payment and will only be made during this time frame.

29 True or False Will HISA pay for a jacuzzi? Clothing allowance is paid between Sept 1 st and October 31 st?

30 Automobile Adaptive Equipment Program Eligibility Documentation Reimbursement Adaptive Equipment Guidelines for Physicians Repairs Adaptive Housing Grants SAH Specially Adapted Housing Grant SHA Special Home Adaptation Grant HISA Home Improvement and Structural Alterations Grant TSA - Temporary Residence Assistance Clothing Allowance Where to file Payment

31 How much is the one time VA payment for the purchase of a specially adapted vehicle? A. $16,000 B. $16,900 C. $18,900 D. $20,000

32 Which program is a TSA grant not available for? A. SHA B. HISA C. SAH

33 Clothing Allowance payments begin on what date? A. August 1 st B. October 31 st C. September 1st

Benefits Available for Disabled Veterans

Benefits Available for Disabled Veterans Veterans Benefits: Benefits Available for Disabled Veterans Christine Scott Specialist in Social Policy Carol D. Davis Information Research Specialist July 31, 2009 Congressional Research Service CRS Report

More information

Department of Veterans Affairs VHA HANDBOOK 1173.14. Washington, DC 20420 April 18, 2008 HOME IMPROVEMENTS AND STRUCTURAL ALTERATIONS (HISA) PROGRAM

Department of Veterans Affairs VHA HANDBOOK 1173.14. Washington, DC 20420 April 18, 2008 HOME IMPROVEMENTS AND STRUCTURAL ALTERATIONS (HISA) PROGRAM Department of Veterans Affairs VHA HANDBOOK 1173.14 Veterans Health Administration Transmittal Sheet Washington, DC 20420 April 18, 2008 HOME IMPROVEMENTS AND STRUCTURAL ALTERATIONS (HISA) PROGRAM 1. REASON

More information

Mobility Ventures LLC

Mobility Ventures LLC Mobility Ventures LLC Understanding the Veterans Administration Vehicle Assistance Program From the VA website: http://www.benefits.va.gov/compensation/claims- special- auto- allowance.asp Automobile Allowance

More information

Loan Guaranty Service

Loan Guaranty Service Transition Tools for a Brighter Future Loan Guaranty Service This document contains U.S. Department of Veterans Affairs proprietary business information and may not be reproduced without permission. What

More information

Compensation Disability

Compensation Disability Transition Tools for a Brighter Future Compensation Disability April 2013 Zachary Johnson Compensation Service This document contains U.S. Department of Veterans Affairs proprietary business information

More information

BRIEF OVERVIEW SPECIALLY ADAPTED HOUSING & VA Website. Department of Veterans Affairs St. Petersburg, Florida Regional Office

BRIEF OVERVIEW SPECIALLY ADAPTED HOUSING & VA Website. Department of Veterans Affairs St. Petersburg, Florida Regional Office BRIEF OVERVIEW SPECIALLY ADAPTED HOUSING & VA Website Department of Veterans Affairs St. Petersburg, Florida Regional Office WELCOME Presentation objective: Provide a basic overview of the Specially Adapted

More information

Guidelines for providing car modifications or contribution towards the purchase cost of a car for injured workers

Guidelines for providing car modifications or contribution towards the purchase cost of a car for injured workers Car Modifications Guidelines for providing car modifications or contribution towards the purchase cost of a car for injured workers June 2013 The WorkSafe Agent (the Agent) can pay the reasonable costs

More information

Checklist of Benefits for Disabled Veterans and Survivors

Checklist of Benefits for Disabled Veterans and Survivors for Disabled Veterans and Survivors Note: Many of the listed benefits also have other eligibility requirements. Mention of a particular benefit is to establish the basic threshold level of disability required

More information

Veterans Benefits. Chapter. In This Chapter

Veterans Benefits. Chapter. In This Chapter Veterans Benefits Chapter Veterans of the United States armed services may be eligible for some or all of the benefits outlined in this chapter. For additional information or a list of benefits not covered

More information

Department of Veterans Affairs VHA HANDBOOK 1173.4. Washington, DC 20420 October 30, 2000 AUTOMOBILE ADAPTIVE EQUIPMENT PROGRAM

Department of Veterans Affairs VHA HANDBOOK 1173.4. Washington, DC 20420 October 30, 2000 AUTOMOBILE ADAPTIVE EQUIPMENT PROGRAM Department of Veterans Affairs VHA HANDBOOK 1173.4 Veterans Health Administration Transmittal Sheet Washington, DC 20420 October 30, 2000 AUTOMOBILE ADAPTIVE EQUIPMENT PROGRAM 1. REASON FOR ISSUE: This

More information

Driver s Licenses and Parking Privileges for People with Disabilities

Driver s Licenses and Parking Privileges for People with Disabilities WISCONSIN COALITION FOR ADVOCACY Driver s Licenses and Parking Privileges for People with Disabilities Tom Hlavacek, Milwaukee Office Director Wisconsin Coalition for Advocacy Chapter 343, Wis. Stats.

More information

Veterans Benefits Administration

Veterans Benefits Administration Veterans Benefits Administration Click to edit Master title style Connecting With Those We Serve 0 Goals Four Goals for Today s briefing: Provide an overview of Veterans Benefit Administration (VBA) Outline

More information

Factsheet DP43 Disability Pension and War Widow(er) s Pension Rates and Allowances

Factsheet DP43 Disability Pension and War Widow(er) s Pension Rates and Allowances Pension Rates and Allowances Purpose This Factsheet provides a brief description and the current rates under the Veterans Entitlements Act 1986 (VEA) of disability and war widow(er) s pensions and allowances

More information

Loan Guaranty. Home Loan Guaranty Program Objectives. Current Benefits. 631,142 Loans Guaranteed Average Loan $243,174 Total Loan Amount: $153 Billion

Loan Guaranty. Home Loan Guaranty Program Objectives. Current Benefits. 631,142 Loans Guaranteed Average Loan $243,174 Total Loan Amount: $153 Billion Loan Guaranty Home Loan Guaranty Program Objectives The objective of the VA Home Loan Guaranty program is to help eligible Veterans, active-duty personnel, surviving spouses, and members of the Reserves

More information

VA Form 21-2680 - DOCTOR'S EXAMINATION FOR A RATING

VA Form 21-2680 - DOCTOR'S EXAMINATION FOR A RATING VA Form 21-2680 - DOCTOR'S EXAMINATION FOR A RATING Instructions for Filling out VA Form 21-2680 Purpose of This Form This form is used by the Department of Veterans Affairs to determine whether a veteran

More information

Assistive Technology Fact Sheet

Assistive Technology Fact Sheet What is Assistive Technology (AT)? Assistive Technology Fact Sheet The term assistive technology refers to both devices and services. An assistive technology device is any item, piece of equipment, or

More information

use is the worker s property.

use is the worker s property. POLICY STATEMENT The Workers Safety and Compensation Commissionn (WSCC) provides severely injured workers or their dependents special allowances or services to reduce or eliminate the effects of a severe,

More information

MAJOR DYSFUNCTION OF JOINTS TREATING PHYSICIAN DATA SHEET

MAJOR DYSFUNCTION OF JOINTS TREATING PHYSICIAN DATA SHEET MAJOR DYSFUNCTION OF JOINTS TREATING PHYSICIAN DATA SHEET Short form FOR REPRESENTATIVE USE ONLY REPRESENTATIVE S NAME AND ADDRESS REPRESENTATIVE S TELEPHONE REPRESENTATIVE S EMAIL PHYSICIAN S NAME AND

More information

VOLUNTARY ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE

VOLUNTARY ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE SCOPE OF INSURANCE ELIGIBILITY VOLUNTARY ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE This Voluntary Accident Insurance Plan provides accident coverage 24 hours a day...365 days a year...worldwide...on or

More information

Information materials and application form for AccessRide

Information materials and application form for AccessRide 130 Nestor Street Nashville, TN 37210 ADA Paratransit for the Metropolitan Transit Authority Information materials and application form for AccessRide ADA/CIVIL RIGHTS INFORMATION CONTACT: (615) 862-5950

More information

Attention. DeKalb County Residents. You or someone you know may qualify to receive assistance with: Utility Costs Property Taxes Medicare

Attention. DeKalb County Residents. You or someone you know may qualify to receive assistance with: Utility Costs Property Taxes Medicare Attention DeKalb County Residents You or someone you know may qualify to receive assistance with: Utility Costs Property Taxes Medicare An Outreach Initiative Sponsored by: Atlanta Regional Commission,

More information

Information for VIAtrans Applicants

Information for VIAtrans Applicants Information for VIAtrans Applicants What is VIAtrans? VIAtrans is a transportation service for persons who, because of a disability, cannot independently use regular (fixed route and schedule) VIA buses.

More information

Department of Veterans Affairs. Chris Searing Assistant Valuation Officer Construction & Valuation

Department of Veterans Affairs. Chris Searing Assistant Valuation Officer Construction & Valuation Department of Veterans Affairs Chris Searing Assistant Valuation Officer Construction & Valuation History of VA In 1789, with the ratification of the U.S. Constitution, the first Congress assumed the responsibility

More information

ELDERLY SERVICES PROGRAM (ESP SM ) NON MEDICAL TRANSPORTATION SERVICE SPECIFICATIONS EFFECTIVE JANUARY 2010 (BCESP)

ELDERLY SERVICES PROGRAM (ESP SM ) NON MEDICAL TRANSPORTATION SERVICE SPECIFICATIONS EFFECTIVE JANUARY 2010 (BCESP) ELDERLY SERVICES PROGRAM (ESP SM ) NON MEDICAL TRANSPORTATION SERVICE SPECIFICATIONS 2010 EFFECTIVE JANUARY 2010 (BCESP) Page 1 of 9 ELDERLY SERVICES PROGRAM NON MEDICAL TRANSPORTATION SERVICE SPECIFICATIONS

More information

APPLICATION FOR HANDI-TRANSIT SERVICE

APPLICATION FOR HANDI-TRANSIT SERVICE APPLICATION FOR HANDI-TRANSIT SERVICE INSTRUCTIONS FOR APPLICATION 1. This application form is to be completed by the applicant (with assistance if required). Complete all questions. You are not required

More information

Team Leaders - Claims Services Department. 2014 Adjusters Seminar: I.M. Hurt v. Know Your Knot Tree Service

Team Leaders - Claims Services Department. 2014 Adjusters Seminar: I.M. Hurt v. Know Your Knot Tree Service Team Leaders - Claims Services Department Benefits Under the Act Wage Loss Benefits Temporary Total, Temporary Partial, Permanent Total and Fatal Permanent Partial Disability Benefits Loss of Use, Amputation,

More information

Answer Key: MRADL: Mobility Related Activity of Daily Living. (Within the home) Example: Feeding, toileting, dressing, grooming.

Answer Key: MRADL: Mobility Related Activity of Daily Living. (Within the home) Example: Feeding, toileting, dressing, grooming. 1. Canes & Crutches 2. Walkers & 4 wheeled walkers 3. Manual Wheelchairs 4. Seat and Back Cushions for Wheelchairs 5. Power Wheelchairs and Mobility Scooters 6. Medicare Coverage Criteria 7. Repairs Answer

More information

Laying the Foundation for Success in Home Mods: Funding!

Laying the Foundation for Success in Home Mods: Funding! Laying the Foundation for Success in Home Mods: Funding! GAMES 2015 Spring Meeting - Therapy for Revenue Replacement May 12, 2015 Savannah, GA Presented by Mark Higley, MBA Vice President Regulatory Affairs

More information

The federal government, generally through the Social Security Administration and

The federal government, generally through the Social Security Administration and CHAPTER 7: MISCELLANEOUS FEDERAL BENEFITS Introduction The federal government, generally through the Social Security Administration and the VA, offers various special benefits for which service members

More information

Adaptive Driving for Persons with Physical Limitations

Adaptive Driving for Persons with Physical Limitations with Physical Limitations Driver Rehabilitation Programs According to the Association of Driver Educators for the Disabled, a driver rehabilitation program should have a qualified driver rehabilitation

More information

Tax Highlights for Persons with Disabilities

Tax Highlights for Persons with Disabilities Department of the Treasury Internal Revenue Service Publication 907 Cat. No. 15308H Tax Highlights for Persons with Disabilities For use in preparing 2000 Returns Introduction This publication gives you

More information

Florida Department of Highway Safety and Motor Vehicles Division of Motorist Services

Florida Department of Highway Safety and Motor Vehicles Division of Motorist Services PROCEDURE Florida Department of Highway Safety and Motor Vehicles DESCRIPTION AND USE: THIS PROCEDURE PROVIDES INFORMATION AND INSTRUCTIONS TO ASSIST TAX COLLECTOR EMPLOYEES, LICENSE PLATE AGENCY EMPLOYEES,

More information

41 Bell Way, Greensburg, PA APPLYING FOR GO WESTMORELAND DISABILITY TRANSPORTATION SERVICES

41 Bell Way, Greensburg, PA APPLYING FOR GO WESTMORELAND DISABILITY TRANSPORTATION SERVICES 41 Bell Way, Greensburg, PA 15601 1-800-242-2706 APPLYING FOR GO WESTMORELAND DISABILITY TRANSPORTATION SERVICES GO Westmoreland will be utilizing the attached forms in determination of your eligibility

More information

Thank you for your interest in Northridge Hospital Medical Center s Driver Preparation Program.

Thank you for your interest in Northridge Hospital Medical Center s Driver Preparation Program. 18300 Roscoe Boulevard Northridge, CA 91328 (818) 885-5460 Telephone (818) 701-7367 Fax Thank you for your interest in Northridge Hospital Medical Center s Driver Preparation Program. Enclosed is a packet

More information

BUSINESS SERVICES POLICIES AND PROCEDURES

BUSINESS SERVICES POLICIES AND PROCEDURES BUSINESS SERVICES POLICIES AND PROCEDURES DEPARTMENT: Risk Management BSL 025 Fleet Safety/Vehicle Management Policy PURPOSE... 2 SCOPE... 2 POLICY... 2 DEFINITIONS... 2 RESPONSIBILITIES... 3 Employee

More information

WORKER S COMPENSATION TREATMENT AUTHORIZATION FORM

WORKER S COMPENSATION TREATMENT AUTHORIZATION FORM FLORIDA TECH EMPLOYEE ACCIDENT/ INJURY REPORT Contact Financial Affairs @ 674-7297 OR 8885 IMMEDIATELY regarding an Employee's Injury. Employee AND Supervisor must complete this report. EMPLOYEE INFORMATION

More information

Secondary Service Connection

Secondary Service Connection Secondary Service Connection Pat Byers American Lake VA Medical Center 9600 Veterans Drive Building 16, Room 110 Lakewood, WA 98493 Voice (253) 583-1079 Fax (253) 580-4052 1 Definition Any Disability that

More information

American with Disabilities Act (ADA) Transportation Medical Verification Form

American with Disabilities Act (ADA) Transportation Medical Verification Form American with Disabilities Act (ADA) Transportation Medical Verification Form To be completed by applicant s licensed physician Dear Health Care Professional: The applicant is requesting certification

More information

Benefits for Veteran s with Disabilities

Benefits for Veteran s with Disabilities Benefits for Veteran s with Disabilities Note: The contents of this paper were taken directly from the CWIC Initial Training Manual developed by the VCU WIPA National Training Center and available online

More information

Part 412.08. Name Motor Vehicle Modifications

Part 412.08. Name Motor Vehicle Modifications LRS Part 412.08 CHAPTER 4, TECHNICAL ASSISTANCE & GUIDANCE Manual Name Motor Vehicle Modifications I. MOTOR VEHICLE MODIFICATION SERVICES Motor vehicle modification services may be provided when necessary

More information

STATE OF MINNESOTA Department of Veterans Affairs

STATE OF MINNESOTA Department of Veterans Affairs STATE OF MINNESOTA Department of Veterans Affairs State Soldiers Assistance Program (S.S.A.P) Minimum Qualifications Must be a veteran as defined by MN Statute 197.447: Minnesota Statute 197.447 Veteran,

More information

Accidents Happen. AccidentAdvance SM accident insurance. Wouldn t you like extra protection for your family?

Accidents Happen. AccidentAdvance SM accident insurance. Wouldn t you like extra protection for your family? Accidents Happen. Wouldn t you like extra protection for your family? Underwritten by Transamerica Life Insurance Company, Cedar Rapids, Iowa. AccidentAdvance SM accident insurance Now there s help if

More information

MRC VEHICLE MODIFICATION PROGRAM FREQUENTLY ASKED QUESTIONS (FAQ S) 1. What kind of services does the MRC Vehicle Modification Program provide?

MRC VEHICLE MODIFICATION PROGRAM FREQUENTLY ASKED QUESTIONS (FAQ S) 1. What kind of services does the MRC Vehicle Modification Program provide? MRC VEHICLE MODIFICATION PROGRAM FREQUENTLY ASKED QUESTIONS (FAQ S) Vehicle modification services can be one of the most complex and costly vocational rehabilitation services offered by the Massachusetts

More information

UNION COLLEGE MOTOR VEHICLE POLICY

UNION COLLEGE MOTOR VEHICLE POLICY UNION COLLEGE MOTOR VEHICLE POLICY October 2015 1 TABLE OF CONTENTS Section Title I. Scope II. III. IV. Eligibility and Authorization Procedures Reserving a Fleet Vehicle Passengers V. Vehicle Use/Fleet

More information

PPM 591 HOME MODIFICATION

PPM 591 HOME MODIFICATION CONTENTS: 591.01 Purpose of Home Modification (p.1) 591.02 Qualifying Individuals (p.2) NATURE AND SCOPE OF ASSISTANCE 591.03 General Nature and Scope of Service Provision (p.2) 591.04 Home Modification

More information

Nursing Assistant Program Functional Ability Criteria

Nursing Assistant Program Functional Ability Criteria Nursing Assistant Program Functional Ability Criteria The Nursing Assistant Program is highly regulated by state and federal law. OBRA, 1987 and State of Wisconsin, DHS 129, 2009 offer specific criteria

More information

Product Marketing Guide. We re On The Road With You

Product Marketing Guide. We re On The Road With You Product Marketing Guide We re On The Road With You Underwriting Appetite Trucking with a radius of up to 1,000 miles between terminals Target classes include: + Waste Haulers + Concrete Mix-In Transit

More information

Severe Injury Advice Form

Severe Injury Advice Form If you need help to fill in this form or have any questions, call the Lifetime Care and Support Commissioner of the ACT on 13 22 81 or visit www.act.gov.au/ltcss Please provide as much information as you

More information

About purchasing zero-rated adapted vehicles (Guidance for customers)

About purchasing zero-rated adapted vehicles (Guidance for customers) About purchasing zero-rated adapted vehicles (Guidance for customers) This guidance tells you what you need to know about purchasing adapted vehicles free of VAT if you are: a disabled wheelchair user

More information

EXCLUSIONS AND EXEMPTIONS OF THE PA UNIFORM CONSTRUCTION CODE AS PER THE PA UNIFORM CONSTRUCTION CODE CHAPTER 403 ADMINISTRATION

EXCLUSIONS AND EXEMPTIONS OF THE PA UNIFORM CONSTRUCTION CODE AS PER THE PA UNIFORM CONSTRUCTION CODE CHAPTER 403 ADMINISTRATION EXCLUSIONS AND EXEMPTIONS OF THE PA UNIFORM CONSTRUCTION CODE AS PER THE PA UNIFORM CONSTRUCTION CODE CHAPTER 403 ADMINISTRATION EFFECTIVE 12/31/2009 403.1. Scope. GENERALLY (b) Exclusions and exemptions.

More information

Voluntary Term Life and AD&D Insurance

Voluntary Term Life and AD&D Insurance Voluntary Term Life and AD&D Insurance Prepared for the employees of Xavier University Voluntary Term Life Insurance Coverage What would happen to your family if you and your income were gone? - Could

More information

PROVIDER POLICIES & PROCEDURES

PROVIDER POLICIES & PROCEDURES PROVIDER POLICIES & PROCEDURES PATIENT LIFT SYSTEMS The purpose of this document is to provide guidance to providers enrolled in the Connecticut Medical Assistance Program (CMAP) on the requirements for

More information

Product Marketing Guide. We re On The Road With You. www.deep-south.com. We re On The Road With You

Product Marketing Guide. We re On The Road With You. www.deep-south.com. We re On The Road With You Product Marketing Guide www.deep-south.com Deep South Offers Coverage to Target Classes Deep South has earned a reputation as a specialist commercial automobile insurance provider. We take that expertise

More information

Our Goal is to Assist Veterans & Their Dependents in Obtaining All Federal, State & County Benefits They May Be Entitled to Receive

Our Goal is to Assist Veterans & Their Dependents in Obtaining All Federal, State & County Benefits They May Be Entitled to Receive Our Goal is to Assist Veterans & Their Dependents in Obtaining All Federal, State & County Benefits They May Be Entitled to Receive Misc Service Connected Comp Veterans Pension Survivor s Benefits Nebraska

More information

Upon completion of your application, please mail it to our office at 317 Main St., Worcester, MA We will not accept faxed copies.

Upon completion of your application, please mail it to our office at 317 Main St., Worcester, MA We will not accept faxed copies. Dear Applicant, Enclosed you will find an application for a Statewide Transportation Access Pass. If approved, this pass entitles you to reduced fares offered by the Commonwealth s Regional Transit Authorities

More information

COMMERCIAL AUTOMOBILE EXPANSION ENDORSEMENT

COMMERCIAL AUTOMOBILE EXPANSION ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTOMOBILE EXPANSION ENDORSEMENT This endorsement modifies insurance provided under the BUSINESS AUTO COVERAGE FORM The following

More information

The benefit also includes $10,000 of AD&D coverage. See certificate for breakdown of benefits.

The benefit also includes $10,000 of AD&D coverage. See certificate for breakdown of benefits. ACCIDENT MEDICAL BENEFIT Underwritten and insured by: If you are injured in a covered accident and receive treatment from a physician, you are eligible for benefits during the benefit period of 52 weeks;

More information

Motor Vehicle Collision Form

Motor Vehicle Collision Form Patients Name: Date: / / 1) Please choose the date of the MVC: / / 2) Please the time of the MVC: : am / pm 3) Please enter the number of vehicles involved in the MVC: 1 2 3 4 5 6 7 8 9 4) In dollars,

More information

Veterans Benefits Administration Connecting With Those We Serve

Veterans Benefits Administration Connecting With Those We Serve Veterans Benefits Administration Connecting With Those We Serve Department of Veterans Affairs Veterans Benefits Administration (VBA) Disability Compensation Vocational Rehabilitation & Employment Home

More information

Special Monthly Compensation (SMC) and the new SMC(t) Benefit. A General Overview

Special Monthly Compensation (SMC) and the new SMC(t) Benefit. A General Overview Special Monthly Compensation (SMC) and the new SMC(t) Benefit A General Overview Introduction to SMC SMC paid in addition to comp paid under Rating Schedule SMC Compensates vets for SC loss or loss of

More information

ADA PARATRANSIT APPLICATION FORM

ADA PARATRANSIT APPLICATION FORM BOARD OF COUNTY COMMISSIONERS WASHINGTON COUNTY, MARYLAND ADA PARATRANSIT APPLICATION FORM WASHINGTON COUNTY TRANSIT All questions must be answered. Incomplete forms will be returned. In compliance with

More information

McMaster University Voluntary Accidental Death & Dismemberment Insurance (AD&D) CHUBB Insurance Company of Canada Policy #6477 45 51-04

McMaster University Voluntary Accidental Death & Dismemberment Insurance (AD&D) CHUBB Insurance Company of Canada Policy #6477 45 51-04 McMaster University Voluntary Accidental Death & Dismemberment Insurance (AD&D) CHUBB Insurance Company of Canada Policy #6477 45 51-04 CHUBB Insurance Company of Canada SCOPE OF INSURANCE This Voluntary

More information

.25 Schedule of [Attorneys'] Attorney's Fees.

.25 Schedule of [Attorneys'] Attorney's Fees. .25 Schedule of [Attorneys'] Attorney's Fees. A. The Commission shall approve [attorneys'] attorney's fees in accordance with the schedule of fees established from time to time by the Commission and set

More information

Getting certain goods VAT free if you have a disability: helpsheet

Getting certain goods VAT free if you have a disability: helpsheet Getting certain goods VAT free if you have a disability: helpsheet If you re disabled you ll generally have to pay VAT on the things you buy. However, VAT relief s available on a limited range of goods

More information

Policy Analysis PMD Compliance Manual Mobility Seating and positioning Repairs

Policy Analysis PMD Compliance Manual Mobility Seating and positioning Repairs June 2009 Policy Analysis PMD Compliance Manual Mobility Seating and positioning Repairs Basic Principals We learn by going from the specific to the general We apply our learning by going from the general

More information

MARCH 7, 2007. Madame Chairwoman and members of the Subcommittee, I appreciate the

MARCH 7, 2007. Madame Chairwoman and members of the Subcommittee, I appreciate the STATEMENT OF KEITH PEDIGO, DIRECTOR LOAN GUARANTY SERVICE VETERANS BENEFITS ADMINISTRATION BEFORE THE SUBCOMMITTEE ON ECONOMIC OPPORTUNITY HOUSE COMMITTEE ON VETERANS AFFAIRS MARCH 7, 2007 Madame Chairwoman

More information

Business Opportunities with VISN 12 Prosthetics. Jon Ohnesorge VISN 12 Prosthetic Supervisor/COR

Business Opportunities with VISN 12 Prosthetics. Jon Ohnesorge VISN 12 Prosthetic Supervisor/COR Business Opportunities with VISN 12 Prosthetics Jon Ohnesorge VISN 12 Prosthetic Supervisor/COR Overview Prosthetics Supervisor Prosthetics & Sensory Aids (PSAS) VISN 12 Milwaukee, WI Oversee all aspects

More information

Office of the Attorney General. Idaho Lemon Law. LAWRENCE WASDEN Attorney General 700 West Jefferson Street Boise, ID 83720-0010 www.ag.idaho.

Office of the Attorney General. Idaho Lemon Law. LAWRENCE WASDEN Attorney General 700 West Jefferson Street Boise, ID 83720-0010 www.ag.idaho. Office of the Attorney General Idaho Lemon Law LAWRENCE WASDEN Attorney General 700 West Jefferson Street Boise, ID 83720-0010 www.ag.idaho.gov State of Idaho Office of Attorney General Lawrence Wasden

More information

Red Cross Patient Transport Service Frequently Asked Questions for Referring Agencies in Victoria

Red Cross Patient Transport Service Frequently Asked Questions for Referring Agencies in Victoria Red Cross Patient Transport Service Frequently Asked Questions for Referring Agencies in Victoria Q1 What is the Red Cross Eligibility Criteria? Clients eligible for transport: are unable to access suitable

More information

Student Accident Insurance for Ontario Pharmacists Association

Student Accident Insurance for Ontario Pharmacists Association Student Accident Insurance for Ontario Pharmacists Association JMT/CGD 1. PLAN DESIGN Coverage Coverage is applicable to any injury sustained while participating in the work experience program sponsored

More information

RULE V. VOCATIONAL REHABILITATION RULES APPLICABLE TO CLAIMS BASED UPON AN INJURY OR ILLNESS OCCURRING PRIOR TO JULY 2, l987 at 4:16 p.m.

RULE V. VOCATIONAL REHABILITATION RULES APPLICABLE TO CLAIMS BASED UPON AN INJURY OR ILLNESS OCCURRING PRIOR TO JULY 2, l987 at 4:16 p.m. RULE V VOCATIONAL REHABILITATION RULES APPLICABLE TO CLAIMS BASED UPON AN INJURY OR ILLNESS OCCURRING PRIOR TO JULY 2, l987 at 4:16 p.m. A. STATEMENT OF BASIS AND PURPOSE The rules of procedure governing

More information

Ontario Renovates Application

Ontario Renovates Application For Office Use Only Date Received: Time Received: Date and time that all required documents were provided: Ontario Renovates funding is limited. Complete and submit your application as soon as possible.

More information

American Heritage Life Insurance Company

American Heritage Life Insurance Company Policy GVAP1 pays the following benefits for covered on and off the job accidental injuries that result within 90 days (180 days for Accidental Death or Dismemberment) from the date of the accident. A

More information

212.3 Allowable Deductions for Households with Aged/Disabled Members

212.3 Allowable Deductions for Households with Aged/Disabled Members 212.1 Purpose DEDUCTIONS Section 212 Page 1 This section describes the allowable Food Supplement Program (FSP) deductions. 212.2 General Information Only certain deductions are allowed when determining

More information

Cars and Insurance - Getting a Set of Wheels

Cars and Insurance - Getting a Set of Wheels Name Period All Classes Cars and Insurance - Getting a Set of Wheels Overview Few of us live, work, and shop within a small geographic area. Most of us need transportation to go to work or school or for

More information

POST OFFER-OF-EMPLOYMENT MEDICAL INQUIRY LOUISIANA

POST OFFER-OF-EMPLOYMENT MEDICAL INQUIRY LOUISIANA POST OFFER-OF-EMPLOYMENT MEDICAL INQUIRY LOUISIANA Completion of this report is requested to assist your employer in the knowledge requirement of the Louisiana Second Injury Fund. FAILURE TO ANSWER THE

More information

A. Guide to Medicare Coverage

A. Guide to Medicare Coverage A. Guide to Medicare Coverage Who qualifies for Medicare benefits? Individuals 65 years of age or older Individuals under 65 with permanent kidney failure (beginning three months after dialysis begins),

More information

Evaluating muscle injuries and residuals of shell fragment and gunshot wounds

Evaluating muscle injuries and residuals of shell fragment and gunshot wounds Evaluating muscle injuries and residuals of shell fragment and gunshot wounds Training conducted by: Michael Fishman and Sandrine Fisher 1 Objectives To become familiar with the application of the rating

More information

DISABILITY CLAIM APPLICATION FORMS For Standard / Partial Payment and Dismemberment Plans

DISABILITY CLAIM APPLICATION FORMS For Standard / Partial Payment and Dismemberment Plans DISABILITY CLAIM APPLICATION FORMS For Standard / Partial Payment and Dismemberment Plans INSTRUCTIONS ALL OF THE FOLLOWING PROPERLY COMPLETED FORMS ARE ESSENTIAL TO THE PROMPT PROCESSING OF YOUR DISABILITY

More information

POLICIES AND PROCEDURES TO GUIDE THE IMPLEMENTATION OF ASSISTIVE TECHNOLOGY SERVICES WITHIN THE SPECIAL EDUCATION SETTING

POLICIES AND PROCEDURES TO GUIDE THE IMPLEMENTATION OF ASSISTIVE TECHNOLOGY SERVICES WITHIN THE SPECIAL EDUCATION SETTING POLICIES AND PROCEDURES TO GUIDE THE IMPLEMENTATION OF ASSISTIVE TECHNOLOGY SERVICES WITHIN THE SPECIAL EDUCATION SETTING Preface Rationale Purpose Philosophy Legalities Definition of Terms Categories

More information

BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION

BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION MONICA HERNANDEZ ) Claimant ) VS. ) ) Docket No. 1,045,669 THE HAMM COMPANIES ) Respondent ) ) AND ) ) NEW HAMPSHIRE INSURANCE COMPANY

More information

Life and Accident Insurance

Life and Accident Insurance Life and Accident Insurance Honda offers basic life and accident insurance and business travel insurance benefits for you or your survivors in the event of your accidental death or serious injury. Table

More information

MAJOR DYSFUNCTION OF JOINTS TREATING PHYSICIAN DATA SHEET

MAJOR DYSFUNCTION OF JOINTS TREATING PHYSICIAN DATA SHEET MAJOR DYSFUNCTION OF JOINTS TREATING PHYSICIAN DATA SHEET Long form FOR REPRESENTATIVE USE ONLY REPRESENTATIVE S NAME AND ADDRESS REPRESENTATIVE S TELEPHONE REPRESENTATIVE S EMAIL PHYSICIAN S NAME AND

More information

OFFICE OF INSURANCE REGULATION Property and Casualty Product Review

OFFICE OF INSURANCE REGULATION Property and Casualty Product Review OFFICE OF INSURANCE REGULATION Property and Casualty Product Review NOTIFICATION OF PERSONAL INJURY PROTECTION BENEFITS YOUR PERSONAL INJURY PROTECTION RIGHTS AND BENEFITS UNDER THE FLORIDA MOTOR VEHICLE

More information

Alberta WCB Policies & Information

Alberta WCB Policies & Information 1. What self-care aids does WCB provide? To promote independence, WCB provides aids and devices, allowances, and skills training that, based on the worker s medical condition, are required as a result

More information

Chair Herseth Sandlin, Ranking Member Boozman and distinguished Members of the Subcommittee:

Chair Herseth Sandlin, Ranking Member Boozman and distinguished Members of the Subcommittee: STATEMENT OF CATHERINE A. TROMBLEY, ASSISTANT DIRECTOR NATIONAL ECONOMIC COMMISSION THE AMERICAN LEGION BEFORE THE SUBCOMMITTEE ON ECONOMIC OPPORTUNITY COMMITTEE ON VETERANS AFFAIRS UNITED STATES HOUSE

More information

VEHICLES UNIVERSITY OR RENTED

VEHICLES UNIVERSITY OR RENTED VEHICLES UNIVERSITY OR RENTED Summary/Purpose: Defines policy for drivers, use, requirements, and rental of vehicles to conduct University business. Section I defines the policy for vehicles owned by the

More information

PERSONAL INJURY QUESTIONNAIRE. NAME: Date of Accident

PERSONAL INJURY QUESTIONNAIRE. NAME: Date of Accident PERSONAL INJURY QUESTIONNAIRE NAME: Date of Accident Where did accident happen? Describe the accident in your own words: What was your position in the car? Driver: if Driver were your hands on the steering

More information

DRIVING RELATED ISSUES. Student Legal Service University of Illinois at Urbana-Champaign

DRIVING RELATED ISSUES. Student Legal Service University of Illinois at Urbana-Champaign DRIVING RELATED ISSUES Student Legal Service University of Illinois at Urbana-Champaign License Issues You are not required to obtain an Illinois Driver s license while you are enrolled as a student in

More information

Corporate Medical Policy Durable Medical Equipment (DME)

Corporate Medical Policy Durable Medical Equipment (DME) Corporate Medical Policy Durable Medical Equipment (DME) File Name: Origination: Last CAP Review: Next CAP Review: Last Review: durable_medical_equipment_(dme) 1/2000 9/2015 9/2016 9/2015 Description of

More information

PARALYZED VETERANS OF AMERICA Veterans Benefits Department. A Basic Guide to Special Monthly Compensation Ratings Under 38 USC 1114

PARALYZED VETERANS OF AMERICA Veterans Benefits Department. A Basic Guide to Special Monthly Compensation Ratings Under 38 USC 1114 PARALYZED VETERANS OF AMERICA Veterans Benefits Department A Basic Guide to Special Monthly Compensation Ratings Under 38 USC 1114 Seventh Edition 2004 Table of Contents How to Use this Guide...1 38 USC

More information

Greater Cleveland Regional Transit Authority Application For ADA Paratransit Service

Greater Cleveland Regional Transit Authority Application For ADA Paratransit Service Greater Cleveland Regional Transit Authority Application For ADA Paratransit Service The Americans with Disabilities Act of 1990 (ADA) is a civil rights bill that bans discrimination against people with

More information

Physical Therapy Contract. Reference guide to understanding your contract

Physical Therapy Contract. Reference guide to understanding your contract Physical Therapy Contract Reference guide to understanding your contract Revised February 2011 HC-429 REV FEB 2011 Copyright 2009 at WCB Health Care Services Page 2 of 13 PHYSICAL THERAPY PROVIDER EXPECTATIONS

More information

American Fidelity Assurance Company s. Accident Only. Insurance Plan. Accidents Happen. Are You Prepared?

American Fidelity Assurance Company s. Accident Only. Insurance Plan. Accidents Happen. Are You Prepared? American Fidelity Assurance Company s Accident Only Insurance Plan Accidents Happen. Are You Prepared? Accident Only Plan Accidents can happen to anyone at any time. You cannot plan for when an accident

More information

BCRTA ADA Transportation Application

BCRTA ADA Transportation Application BCRTA ADA Transportation Application All questions must be answered before your application will be considered. PART A. To be completed by applicant or on behalf of the applicant. PLEASE PRINT Applicant

More information

Transmittal 55 Date: MAY 5, 2006. SUBJECT: Changes Conforming to CR3648 for Therapy Services

Transmittal 55 Date: MAY 5, 2006. SUBJECT: Changes Conforming to CR3648 for Therapy Services CMS Manual System Pub 100-03 Medicare National Coverage Determinations Department of Health & Human Services (DHHS) Centers for Medicare & Medicaid Services (CMS) Transmittal 55 Date: MAY 5, 2006 Change

More information

Expanding Your Market

Expanding Your Market U.S. Department of Justice Civil Rights Division Disability Rights Section Expanding Your Market Maintaining Accessible Features in Retail Establishments Introduction More than 50 million Americans with

More information

Indications for a PMD as Reasonable and Necessary and Types of PMD Categories Available

Indications for a PMD as Reasonable and Necessary and Types of PMD Categories Available Appendix K The face-to-face examination provides the clinical information needed to determine if a patient needs a Power Mobility Device (PMD) and what type of PMD may be needed. This information needs

More information

Application for ADA Paratransit Service

Application for ADA Paratransit Service Application for ADA Paratransit Service IMPORTANT INFORMATION FOR APPLICANTS This packet includes information and forms you need to apply for paratransit eligibility in the San Francisco Bay Area. As part

More information

OCCUPATIONAL THERAPY

OCCUPATIONAL THERAPY OCCUPATIONAL THERAPY This document is subject to change. Please check our web site for updates. This provider manual outlines policy and claims submission guidelines for claims submitted to the North Dakota

More information