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Mike,
That is the correct form you'd need to fill out. Here's some info on the VA vehicle grants programs:
Can the V.A. help a disabled veteran get an adapted vehicle?
The V.A. has grants to help some veterans with service-connected disabilities either buy a specially adapted vehicle or adapt an existing vehicle. The purpose of the adapted vehicle is to permit the veteran either to drive or ride in it.
V.A. grants for buying an adapted vehicle. The V.A. provides grants for certain veterans with service-connected disabilities to help buy a specially adapted new or used car, van, or other vehicle that can accommodate the veteran's disability. The grant is for the full value of the vehicle, but only up to $11,000. The grant is paid not to the veteran but directly to the seller of the vehicle. A veteran may receive only one such vehicle purchase grant in his or her lifetime.
V.A. grants to adapt a vehicle. The V.A. also offers grants to adapt a veteran's existing vehicle by adding adaptive equipment to accommodate certain service-connected disabilities, allowing the veteran either to drive or ride. This adaptive equipment includes power steering, power brakes, power windows, power seats, and special equipment to assist the veteran in getting into and out of the vehicle. Other adaptive equipment may be permitted if necessary, upon special application to the V.A.
How does a veteran qualify for a V.A. adapted vehicle grant?
A veteran with one of the following service-connected disabilities may qualify for a grant to buy a specially adapted vehicle:
Loss, or permanent loss of use, of one or both feet
Loss, or permanent loss of use, of one or both hands
Permanent impairment of vision in both eyes to a degree that makes driving impossible even with normal corrective lenses
Veterans who qualify for the vehicle purchase grant also qualify for the vehicle adaptation grant. Also, veterans with service-connected joint immobility (ankylosis) of a knee or hip may qualify for the adaptive equipment grant. An adaptive equipment grant may be paid more than once, and it may be paid directly to the veteran.
How can I apply for a V.A. adapted vehicle grant?
A veteran applies for either the vehicle purchase and/or the special adaptive equipment grant by filing V.A. form 21-4502 and submitting it to the V.A. regional office that handles the veteran's service-connected disability claim file. The instructions on the form list the adaptive equipment that has been preapproved for particular disabilities and explain the process of submitting the form and working with the seller of the vehicle or of the equipment.
Where can I get help applying for a V.A. adapted vehicle grant?
If a veteran wants to purchase equipment that isn't listed on the form, or that isn't preapproved for his or her disability, the veteran can contact a local V.A. medical center's Prosthetic Department for assistance before buying the equipment.
For general assistance with any V.A.-related question or problem by phone or in person, contact a V.A. Vet Center or V.A. Veterans Benefits Administration office. The V.A. also has a toll-free telephone help line at 800-827-1000.
Hope that helps some. Let me know if you need/want any further info on it!
Kassie
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