The Veterans Benefits Administration (VBA) will review and certify whether a Veteran or Servicemember meets the criteria.
Valid Driver's License or Permit in possession: if no, only entitled to ingress / egress equipment.
Purchased with VA Automobile Allowance: if yes, reimbursement for some adaptive equipment may not be approved by VA.
Payments: for payments to a registered provider, an eligible person or registered provider must submit an itemized estimate and final itemized invoice.
Documentation: you agree to provide all documentation for payments and reimbursements before VA will authorize payment or reimbursement.
| Question | Answer |
|---|---|
| Form Name | VA Form 10-1394 |
| Form Length | 2 pages |
| Fillable? | Yes |
| Fillable fields | 49 |
| Avg. time to fill out | 9 min |
| Edition | JUN 2024 |
| Where to submit | Prosthetic and Sensory Aids Services at your nearest VA Medical Center |
| Who signs | The Veteran/Servicemember |
| Matches the agency's file | Yes, checked October 1, 2026 |
| Other names | VA Form 10-1394, 10-1394, VA 10-1394, VA 1394, Form 10-1394, Application for Adaptive Equipment Automobile or Other Conveyance |
| Official source | VA Form 10-1394 (Rev JUN 2024), Department of Veterans Affairs |
Va Form 10 1394 isn’t the one you’re looking for?