9 Have signed by the Veterans Service Center VA Form 21-4502 Manager (VSCM) or by a designee no lower than coach. 10 Release the original to the applicant and send VA Form 21-4502 him/her a notification letter, unless referral to an outpatient clinic is required, and clear the pending EP 290. For more information on the requirement of referring Reference: claims to an outpatient clinic, see M21-1, Part IX, Subpart i, 2.6.f. 11 Place a copy of the form in the claims folder. b. Applying for Prior to taking any action on the application, if the Type of Conveyance Applied For field on is a “Other” Types VA Form 21-4502 checked “Other,” make of Conveyance determination of approval or disapproval of the type of conveyance in the form of an administrative decision in the format prescribed in M21-1, Part III, Subpart v, 1.A.2 for the approval of the VSCM or a designee no lower than a coach. Follow the steps in the table below when the applicant is found eligible for a c. Processing Applications conveyance other than an automobile or similar vehicle and has submitted a for “Other” with Section I, completed. VA Form 21-4502 Application, Types of Conveyances Step Action 1 Complete and approve Section II, of Certificate of Eligibility, VA Form 21-4502. 2 Refer the form to the outpatient clinic with a copy of the rating decision. 3 Annotate the copy of to show the date and place VA Form 21-4502 of referral. 4 File a copy of in the claims folder. VA Form 21-4502 After determination of any adaptive equipment for a conveyance other than an d. Releasing VA Forms automobile or similar vehicle, the outpatient clinic must release VA Form and and supplemental authorization on to the applicant. VA Form 10-1394 to the The applicant must send the forms to finance activity for payment. Applicant for a Conveyance
9 Have VA Form 21-4502 signed by the Veterans Service Center Manager (VSCM) or by a designee no lower than coach. 10 Release the original VA Form 21-4502 to the applicant and send him/her a notification letter, unless referral to an outpatient clinic is required, and clear the pending EP 290. Reference: For more information on the requirement of referring claims to an outpatient clinic, see M21-1, Part IX, Subpart i, 2.6.f. 11 Place a copy of the form in the claims folder. b. Applying for “Other” Types of Conveyance Prior to taking any action on the application, if the Type of Conveyance Applied For field on VA Form 21-4502 is checked “Other,” make a determination of approval or disapproval of the type of conveyance in the form of an administrative decision in the format prescribed in M21-1, Part III, Subpart v, 1.A.2 for the approval of the VSCM or a designee no lower than a coach. c. Processing Applications for “Other” Types of Conveyances Follow the steps in the table below when the applicant is found eligible for a conveyance other than an automobile or similar vehicle and has submitted a VA Form 21-4502 with Section I, Application, completed. Step Action 1 Complete and approve Section II, Certificate of Eligibility, of VA Form 21-4502. 2 Refer the form to the outpatient clinic with a copy of the rating decision. 3 Annotate the copy of VA Form 21-4502 to show the date and place of referral. 4 File a copy of VA Form 21-4502 in the claims folder. d. Releasing VA Forms and to the Applicant for a Conveyance After determination of any adaptive equipment for a conveyance other than an automobile or similar vehicle, the outpatient clinic must release VA Form and supplemental authorization on VA Form 10-1394 to the applicant. The applicant must send the forms to finance activity for payment.