Section 17.3120 - Application for HISA benefits(a)Application package. To apply for HISA benefits, the beneficiary must submit to VA a complete HISA benefits application package. A complete HISA benefits application package includes all of the following: (1) A prescription, which VA may obtain on the beneficiary's behalf, written or approved by a VA physician that includes all of the following:(i) The beneficiary's name, address, and telephone number.(ii) Identification of the prescribed improvement or structural alteration.(iii) The diagnosis and medical justification for the prescribed improvement or structural alteration.(2) A completed and signed VA Form 10-0103, Veterans Application for Assistance in Acquiring Home Improvement and Structural Alterations, including, if desired, a request for advance payment of HISA benefits.(3) A signed statement from the owner of the property authorizing the improvement or structural alteration to the property. The statement must be notarized if the beneficiary submitting the HISA benefits application is not the owner of the property.(4) A written itemized estimate of costs for labor, materials, permits, and inspections for the home improvement or structural alteration.(5) A color photograph of the unimproved area.(b)Pre-award inspection of site. The beneficiary must allow VA to inspect the site of the proposed improvement or structural alteration. VA will not approve a HISA application unless VA has either conducted a pre-award inspection or has determined that no such inspection is needed. No later than 30 days after receiving a complete HISA benefits application, VA will conduct the inspection or determine that no inspection is required.(c)Incomplete applications. If VA receives an incomplete HISA benefits application, VA will notify the applicant of the missing documentation. If the missing documentation is not received by VA within 30 days after such notification, VA will close the application and notify the applicant that the application has been closed. The closure notice will indicate that the application may be re-opened by submitting the requested documentation and updating any outdated information from the original application. Authority: 38 U.S.C. 501 , 1717
The Office of Management and Budget has approved the information collection requirements in this section under control number 2900-0188