src/applications/hca/config/form.js
import fullSchemaHca from 'vets-json-schema/dist/10-10EZ-schema.json';
// platform imports
import environment from '@department-of-veterans-affairs/platform-utilities/environment';
import FormFooter from '@department-of-veterans-affairs/platform-forms/FormFooter';
import { VA_FORM_IDS } from '@department-of-veterans-affairs/platform-forms/constants';
import { externalServices } from '@department-of-veterans-affairs/platform-monitoring/DowntimeNotification';
// internal imports
import { prefillTransformer, transform } from '../utils/helpers';
import {
isLoggedOut,
isSigiEnabled,
isRegOnlyEnabled,
isMissingVeteranDob,
hasDifferentHomeAddress,
hasLowDisabilityRating,
hasNoCompensation,
hasHighCompensation,
notShortFormEligible,
includeRegOnlyAuthQuestions,
includeRegOnlyGuestQuestions,
showRegOnlyAuthConfirmation,
showRegOnlyGuestConfirmation,
dischargePapersRequired,
includeTeraInformation,
includeGulfWarServiceDates,
includeOtherExposureDates,
includeOtherExposureDetails,
showFinancialConfirmation,
includeHouseholdInformation,
includeSpousalInformation,
spouseDidNotCohabitateWithVeteran,
spouseAddressDoesNotMatchVeterans,
includeDependentInformation,
collectMedicareInformation,
useJsonFacilityList,
useLighthouseFacilityList,
} from '../utils/helpers/form-config';
import { SHARED_PATHS } from '../utils/constants';
import migrations from './migrations';
import manifest from '../manifest.json';
import IntroductionPage from '../containers/IntroductionPage';
import ConfirmationPage from '../containers/ConfirmationPage';
import SubmissionErrorAlert from '../components/FormAlerts/SubmissionErrorAlert';
import DowntimeWarning from '../components/FormAlerts/DowntimeWarning';
import PreSubmitNotice from '../components/PreSubmitNotice';
import GetFormHelp from '../components/GetFormHelp';
// Before you begin
import IdentityPage from '../containers/IdentityPage';
import PersonalInformationPage from '../containers/PersonalInformationPage';
import AuthBenefitsPackagePage from '../containers/AuthBenefitsPackagePage';
import AuthRegistrationOnlyPage from '../containers/AuthRegistrationOnlyPage';
// chapter 1 Veteran Information
import VeteranInformation from '../components/FormPages/VeteranInformation';
import veteranDateOfBirth from './chapters/veteranInformation/veteranDateOfBirth';
import birthInformation from './chapters/veteranInformation/birthInformation';
import maidenNameInformation from './chapters/veteranInformation/maidenNameInformation';
import birthSex from './chapters/veteranInformation/birthSex';
import demographicInformation from './chapters/veteranInformation/demographicInformation';
import veteranAddress from './chapters/veteranInformation/veteranAddress';
import veteranGender from './chapters/veteranInformation/veteranGender';
import veteranHomeAddress from './chapters/veteranInformation/veteranHomeAddress';
import contactInformation from './chapters/veteranInformation/contactInformation';
// chapter 2 VA Benefits
import basicInformation from './chapters/vaBenefits/basicInformation';
import pensionInformation from './chapters/vaBenefits/pensionInformation';
import benefitsPackage from './chapters/vaBenefits/benefitsPackage';
import DisabilityConfirmationPage from '../components/FormPages/DisabilityConfirmation';
import RegistrationOnlyGuestPage from '../components/FormPages/RegistrationOnlyGuest';
import CompensationTypeReviewPage from '../components/FormReview/CompensationTypeReviewPage';
// chapter 3 Military Service
import serviceInformation from './chapters/militaryService/serviceInformation';
import additionalInformation from './chapters/militaryService/additionalInformation';
import toxicExposure from './chapters/militaryService/toxicExposure';
import radiationCleanup from './chapters/militaryService/radiationCleanup';
import gulfWarService from './chapters/militaryService/gulfWarService';
import gulfWarServiceDates from './chapters/militaryService/gulfWarServiceDates';
import combatOperationService from './chapters/militaryService/combatOperationService';
import agentOrangeExposure from './chapters/militaryService/agentOrangeExposure';
import otherToxicExposure from './chapters/militaryService/otherToxicExposure';
import otherToxicExposureDetails from './chapters/militaryService/otherToxicExposureDetails';
import otherToxicExposureDates from './chapters/militaryService/otherToxicExposureDates';
import documentUpload from './chapters/militaryService/documentUpload';
// chapter 4 Household Information
import FinancialDisclosure from './chapters/householdInformation/financialDisclosure';
import MaritalStatus from './chapters/householdInformation/maritalStatus';
import SpouseBasicInformation from './chapters/householdInformation/spouseBasicInformation';
import SpouseContactInformation from './chapters/householdInformation/spouseContactInformation';
import SpouseAdditionalInformation from './chapters/householdInformation/spouseAdditionalInformation';
import SpouseFinancialSupport from './chapters/householdInformation/spouseFinancialSupport';
import DependentSummary from './chapters/householdInformation/dependentSummary';
import SpouseAnnualIncome from './chapters/householdInformation/spouseAnnualIncome';
import VeteranAnnualIncome from './chapters/householdInformation/veteranAnnualIncome';
import DeductibleExpenses from './chapters/householdInformation/deductibleExpenses';
import FinancialOnboarding from '../components/FormPages/FinancialOnboarding';
import FinancialConfirmation from '../components/FormPages/FinancialConfirmation';
import FinancialInformation from '../components/FormPages/FinancialInformation';
import DependentInformationPage from '../components/FormPages/DependentInformation';
import DependentSummaryPage from '../components/FormPages/DependentSummary';
import DependentsReviewPage from '../components/FormReview/DependentsReviewPage';
// chapter 5 Insurance Information
import medicaid from './chapters/insuranceInformation/medicaid';
import medicare from './chapters/insuranceInformation/medicare';
import medicarePartAEffectiveDate from './chapters/insuranceInformation/medicarePartAEffectiveDate';
import general from './chapters/insuranceInformation/general';
import insurancePolicyPages from './chapters/insuranceInformation/insurancePolicies';
import vaFacilityJsonPage from './chapters/insuranceInformation/vaFacility_json';
import vaFacilityApiPage from './chapters/insuranceInformation/vaFacility_api';
import InsuranceInformationPage from '../components/FormPages/InsuranceInformation';
// declare shared paths for custom form page navigation
const { dependents: DEPENDENT_PATHS } = SHARED_PATHS;
// declare schema definitions
const { date } = fullSchemaHca.definitions;
/**
* NOTE: Prefill message data values can be found in
* `vets-api/config/form_profile_mappings/1010ez.yml`
*/
const formConfig = {
rootUrl: manifest.rootUrl,
urlPrefix: '/',
submitUrl: `${environment.API_URL}/v0/health_care_applications`,
trackingPrefix: 'hca-',
formId: VA_FORM_IDS.FORM_10_10EZ,
saveInProgress: {
messages: {
inProgress:
'Your health care benefits application (10-10EZ) is in progress.',
expired:
'Your saved health care benefits application (10-10EZ) has expired. If you want to apply for health care benefits, please start a new application.',
saved: 'Your health care benefits application has been saved.',
},
},
version: migrations.length,
migrations,
prefillEnabled: true,
prefillTransformer,
savedFormMessages: {
notFound: 'Please start over to apply for health care.',
noAuth: 'Please sign in again to resume your application for health care.',
},
downtime: {
dependencies: [externalServices['1010ez']],
message: DowntimeWarning,
},
transformForSubmit: transform,
introduction: IntroductionPage,
v3SegmentedProgressBar: true,
additionalRoutes: [
{
path: 'id-form',
component: IdentityPage,
pageKey: 'id-form',
depends: isLoggedOut,
},
{
path: 'check-your-personal-information',
component: PersonalInformationPage,
pageKey: 'verify-personal-information',
depends: isRegOnlyEnabled,
},
{
path: 'va-benefits-package',
component: AuthBenefitsPackagePage,
pageKey: 'auth-va-benefits-package',
depends: includeRegOnlyAuthQuestions,
},
{
path: 'care-for-service-connected-conditions',
component: AuthRegistrationOnlyPage,
pageKey: 'auth-reg-only-confirmation',
depends: showRegOnlyAuthConfirmation,
},
],
confirmation: ConfirmationPage,
submissionError: SubmissionErrorAlert,
title: 'Apply for VA health care',
subTitle: 'Form 10-10EZ',
preSubmitInfo: {
required: true,
field: 'privacyAgreementAccepted',
CustomComponent: PreSubmitNotice,
},
footerContent: FormFooter,
getHelp: GetFormHelp,
defaultDefinitions: { date },
chapters: {
veteranInformation: {
title: 'Veteran information',
pages: {
veteranProfileInformation: {
path: 'veteran-information/personal-information',
title: 'Veteran\u2019s personal information',
CustomPage: VeteranInformation,
CustomPageReview: null,
uiSchema: {},
schema: { type: 'object', properties: {} },
depends: formData => !isRegOnlyEnabled(formData),
},
dobInformation: {
path: 'veteran-information/profile-information-dob',
title: 'Date of birth',
initialData: {},
depends: isMissingVeteranDob,
uiSchema: veteranDateOfBirth.uiSchema,
schema: veteranDateOfBirth.schema,
},
birthInformation: {
path: 'veteran-information/birth-information',
title: 'Place of birth',
initialData: {},
uiSchema: birthInformation.uiSchema,
schema: birthInformation.schema,
},
maidenNameInformation: {
path: 'veteran-information/maiden-name-information',
title: 'Mother\u2019s maiden name',
initialData: {},
uiSchema: maidenNameInformation.uiSchema,
schema: maidenNameInformation.schema,
},
birthSex: {
path: 'veteran-information/birth-sex',
title: 'Sex assigned at birth',
initialData: {},
uiSchema: birthSex.uiSchema,
schema: birthSex.schema,
},
veteranGender: {
path: 'veteran-information/veteran-gender',
title: 'Gender',
initialData: {},
depends: isSigiEnabled,
uiSchema: veteranGender.uiSchema,
schema: veteranGender.schema,
},
demographicInformation: {
path: 'veteran-information/demographic-information',
title: 'What is your race, ethnicity, or origin?',
initialData: {
'view:demographicCategories': {
isSpanishHispanicLatino: false,
},
},
uiSchema: demographicInformation.uiSchema,
schema: demographicInformation.schema,
},
veteranAddress: {
path: 'veteran-information/veteran-address',
title: 'Mailing address',
initialData: {},
uiSchema: veteranAddress.uiSchema,
schema: veteranAddress.schema,
},
veteranHomeAddress: {
path: 'veteran-information/veteran-home-address',
title: 'Home address',
initialData: {},
depends: hasDifferentHomeAddress,
uiSchema: veteranHomeAddress.uiSchema,
schema: veteranHomeAddress.schema,
},
contactInformation: {
path: 'veteran-information/contact-information',
title: 'Contact information',
initialData: {},
uiSchema: contactInformation.uiSchema,
schema: contactInformation.schema,
},
},
},
vaBenefits: {
title: 'VA benefits',
pages: {
vaBenefits: {
path: 'va-benefits/basic-information',
title: 'VA benefits',
depends: hasLowDisabilityRating,
CustomPageReview: CompensationTypeReviewPage,
uiSchema: basicInformation.uiSchema,
schema: basicInformation.schema,
},
vaBenefitsPackage: {
path: 'va-benefits/benefits-package',
title: 'VA benefits package',
depends: includeRegOnlyGuestQuestions,
CustomPageReview: () => null,
uiSchema: benefitsPackage.uiSchema,
schema: benefitsPackage.schema,
},
vaRegOnlyConfirmation: {
path: 'va-benefits/service-connected-care',
title: 'Care for service-connected conditions',
initialData: {},
depends: showRegOnlyGuestConfirmation,
CustomPage: RegistrationOnlyGuestPage,
CustomPageReview: null,
uiSchema: {},
schema: { type: 'object', properties: {} },
},
vaPayConfirmation: {
path: 'va-benefits/confirm-service-pay',
title: 'Disability confirmation',
initialData: {},
depends: hasHighCompensation,
CustomPage: DisabilityConfirmationPage,
CustomPageReview: null,
uiSchema: {},
schema: { type: 'object', properties: {} },
},
vaPension: {
path: 'va-benefits/pension-information',
title: 'VA pension',
depends: hasNoCompensation,
uiSchema: pensionInformation.uiSchema,
schema: pensionInformation.schema,
},
},
},
militaryService: {
title: 'Military service',
pages: {
serviceInformation: {
path: 'military-service/service-information',
title: 'Service periods',
depends: notShortFormEligible,
uiSchema: serviceInformation.uiSchema,
schema: serviceInformation.schema,
},
additionalInformation: {
path: 'military-service/additional-information',
title: 'Service history',
depends: notShortFormEligible,
uiSchema: additionalInformation.uiSchema,
schema: additionalInformation.schema,
},
toxicExposure: {
path: 'military-service/toxic-exposure',
title: 'Toxic exposure',
uiSchema: toxicExposure.uiSchema,
schema: toxicExposure.schema,
},
radiationCleanup: {
path: 'military-service/radiation-cleanup-efforts',
title: 'Radiation cleanup or response efforts',
depends: includeTeraInformation,
uiSchema: radiationCleanup.uiSchema,
schema: radiationCleanup.schema,
},
gulfWarService: {
path: 'military-service/gulf-war-service',
title: 'Gulf War service locations',
depends: includeTeraInformation,
uiSchema: gulfWarService.uiSchema,
schema: gulfWarService.schema,
},
gulfWarServiceDates: {
path: 'military-service/gulf-war-service-dates',
title: 'Gulf War service dates',
depends: includeGulfWarServiceDates,
uiSchema: gulfWarServiceDates.uiSchema,
schema: gulfWarServiceDates.schema,
},
combatOperationService: {
path: 'military-service/operation-support',
title: 'Operations',
depends: includeTeraInformation,
uiSchema: combatOperationService.uiSchema,
schema: combatOperationService.schema,
},
agentOrangeExposure: {
path: 'military-service/agent-orange-exposure',
title: 'Agent Orange exposure',
depends: includeTeraInformation,
uiSchema: agentOrangeExposure.uiSchema,
schema: agentOrangeExposure.schema,
},
otherToxicExposure: {
path: 'military-service/other-toxic-exposure',
title: 'Other toxic exposures',
depends: includeTeraInformation,
uiSchema: otherToxicExposure.uiSchema,
schema: otherToxicExposure.schema,
},
otherToxicExposureDetails: {
path: 'military-service/other-toxins-or-hazards',
title: 'Other toxin or hazard exposure',
depends: includeOtherExposureDetails,
uiSchema: otherToxicExposureDetails.uiSchema,
schema: otherToxicExposureDetails.schema,
},
otherToxicExposureDates: {
path: 'military-service/other-toxic-exposure-dates',
title: 'Other toxic exposure dates',
depends: includeOtherExposureDates,
uiSchema: otherToxicExposureDates.uiSchema,
schema: otherToxicExposureDates.schema,
},
documentUpload: {
title: 'Upload your discharge papers',
path: 'military-service/documents',
depends: dischargePapersRequired,
editModeOnReviewPage: true,
uiSchema: documentUpload.uiSchema,
schema: documentUpload.schema,
},
},
},
householdInformation: {
title: 'Household financial information',
pages: {
FinancialOnboarding: {
path: 'household-information/financial-information-use',
title: 'Financial information use',
depends: notShortFormEligible,
CustomPage: FinancialOnboarding,
CustomPageReview: null,
uiSchema: {},
schema: { type: 'object', properties: {} },
},
FinancialDisclosure: {
path: 'household-information/share-financial-information',
title: 'Share financial information',
depends: notShortFormEligible,
uiSchema: FinancialDisclosure.uiSchema,
schema: FinancialDisclosure.schema,
},
FinancialConfirmation: {
path: 'household-information/share-financial-information-confirm',
title: 'Share financial information confirmation',
depends: showFinancialConfirmation,
CustomPage: FinancialConfirmation,
CustomPageReview: null,
uiSchema: {},
schema: { type: 'object', properties: {} },
},
FinancialInformation: {
path: 'household-information/financial-information-needed',
title: 'Financial information needed',
depends: includeHouseholdInformation,
CustomPage: FinancialInformation,
CustomPageReview: null,
uiSchema: {},
schema: { type: 'object', properties: {} },
},
MaritalStatus: {
path: 'household-information/marital-status',
title: 'Marital status',
initialData: {},
depends: notShortFormEligible,
uiSchema: MaritalStatus.uiSchema,
schema: MaritalStatus.schema,
},
SpouseBasicInformation: {
path: 'household-information/spouse-personal-information',
title: 'Spouse\u2019s personal information',
initialData: {},
depends: includeSpousalInformation,
uiSchema: SpouseBasicInformation.uiSchema,
schema: SpouseBasicInformation.schema,
},
SpouseAdditionalInformation: {
path: 'household-information/spouse-additional-information',
title: 'Spouse\u2019s additional information',
initialData: {},
depends: includeSpousalInformation,
uiSchema: SpouseAdditionalInformation.uiSchema,
schema: SpouseAdditionalInformation.schema,
},
SpouseFinancialSupport: {
path: 'household-information/spouse-financial-support',
title: 'Spouse\u2019s financial support',
depends: spouseDidNotCohabitateWithVeteran,
uiSchema: SpouseFinancialSupport.uiSchema,
schema: SpouseFinancialSupport.schema,
},
SpouseContactInformation: {
path: 'household-information/spouse-contact-information',
title: 'Spouse\u2019s address and phone number',
initialData: {},
depends: spouseAddressDoesNotMatchVeterans,
uiSchema: SpouseContactInformation.uiSchema,
schema: SpouseContactInformation.schema,
},
DependentSummary: {
path: DEPENDENT_PATHS.summary,
title: 'Dependents',
depends: includeHouseholdInformation,
CustomPage: DependentSummaryPage,
CustomPageReview: DependentsReviewPage,
uiSchema: DependentSummary.uiSchema,
schema: DependentSummary.schema,
},
DependentInformation: {
path: DEPENDENT_PATHS.info,
title: 'Dependent information',
depends: includeDependentInformation,
CustomPage: DependentInformationPage,
CustomPageReview: null,
uiSchema: {},
schema: { type: 'object', properties: {} },
},
VeteranAnnualIncome: {
path: 'household-information/veteran-annual-income',
title: 'Your annual income',
initialData: {},
depends: includeHouseholdInformation,
uiSchema: VeteranAnnualIncome.uiSchema,
schema: VeteranAnnualIncome.schema,
},
SpouseAnnualIncome: {
path: 'household-information/spouse-annual-income',
title: 'Spouse\u2019s annual income',
initialData: {},
depends: includeSpousalInformation,
uiSchema: SpouseAnnualIncome.uiSchema,
schema: SpouseAnnualIncome.schema,
},
DeductibleExpenses: {
path: 'household-information/deductible-expenses',
title: 'Deductible expenses',
initialData: {},
depends: includeHouseholdInformation,
uiSchema: DeductibleExpenses.uiSchema,
schema: DeductibleExpenses.schema,
},
},
},
insuranceInformation: {
title: 'Insurance information',
pages: {
medicaid: {
path: 'insurance-information/medicaid',
title: 'Medicaid coverage',
initialData: {},
uiSchema: medicaid.uiSchema,
schema: medicaid.schema,
},
medicare: {
path: 'insurance-information/medicare',
title: 'Medicare coverage',
initialData: {},
depends: notShortFormEligible,
uiSchema: medicare.uiSchema,
schema: medicare.schema,
},
medicarePartAEffectiveDate: {
path: 'insurance-information/medicare-part-a-effective-date',
title: 'Medicare Part A effective date',
initialData: {},
depends: collectMedicareInformation,
uiSchema: medicarePartAEffectiveDate.uiSchema,
schema: medicarePartAEffectiveDate.schema,
},
insuranceIntro: {
path: 'insurance-information/your-health-insurance',
title: 'Your health insurance',
CustomPage: InsuranceInformationPage,
CustomPageReview: null,
uiSchema: {},
schema: { type: 'object', properties: {} },
},
general: {
path: 'insurance-information/general',
title: 'Other coverage',
depends: formData => !formData['view:isInsuranceV2Enabled'],
uiSchema: general.uiSchema,
schema: general.schema,
},
healthInsurancePolicySummary: {
...insurancePolicyPages.healthInsurancePolicySummary,
depends: formData => formData['view:isInsuranceV2Enabled'],
},
healthInsurancePolicyInformation: {
...insurancePolicyPages.healthInsurancePolicyInformation,
depends: formData => formData['view:isInsuranceV2Enabled'],
},
vaFacilityJson: {
path: 'insurance-information/va-facility-json',
title: 'VA Facility',
initialData: {
isEssentialAcaCoverage: false,
},
depends: useJsonFacilityList,
uiSchema: vaFacilityJsonPage.uiSchema,
schema: vaFacilityJsonPage.schema,
},
vaFacilityLighthouse: {
path: 'insurance-information/va-facility-api',
title: 'VA Facility',
initialData: {
isEssentialAcaCoverage: false,
},
depends: useLighthouseFacilityList,
uiSchema: vaFacilityApiPage.uiSchema,
schema: vaFacilityApiPage.schema,
},
},
},
},
};
export default formConfig;