I've cut and welded on that frame area on my van, but I haven't needed to reinforce around the steering box. With the LF wheel removed you can get access to inspect the area yourself.
More often then not, the steering box bolts get loose, the steering action will 'wallow out' the holes and surrounding area over time, so bad that a simple tightening won't fix it for long.
The frames on these van are pretty stout, almost 3/16" thick steel. I wouldn't expect it to be so rusted that a skilled fabricator couldn't use the 'plate and tube sleeve' approach to repairing the area. You can search hard core 4x4 forums like Pirate 4x4, etc, that have lots of build threads where guys modify that area for a different steering gear. That will give you an idea of the work involved.
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1995 E350 7.3 Diesel, 4x4 high roof camper, UJOR 4" lift
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