Code of Federal Regulations · Section
§ 17.3120 — Application For Hisa Benefits
38 C.F.R. § 17.3120
(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notice will indicate that the application may be re-opened by submitting the requested documentation and updating any outdated information from the original application.
Authorizing Statute
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Rules and regulations38 U.S.C. § 501
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Medical care for survivors and dependents of certain veterans38 U.S.C. § 1781
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Definitions38 U.S.C. § 1701
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Definitions38 U.S.C. § 101
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Assistance for providing automobile and adaptive equipment38 U.S.C. § 3902
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Clothing allowance38 U.S.C. § 1162
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Eligibility for hospital, nursing home, and domiciliary care38 U.S.C. § 1710
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Community residential care38 U.S.C. § 1730
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Agreements with eligible entities or providers; certification processes38 U.S.C. § 1703A
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Contracts and personal services38 U.S.C. § 513
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Definitions38 U.S.C. § 3901
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Establishment38 U.S.C. § 7691
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Care and services during certain disasters and emergencies38 U.S.C. § 1785
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Benefits for discharged members of allied forces38 U.S.C. § 109
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Emergent suicide care38 U.S.C. § 1720J
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Recovery by United States42 U.S.C. § 2651
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Transplant procedures with live donors and related services38 U.S.C. § 1788
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Access to walk-in care38 U.S.C. § 1725A
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Assistance and support services for caregivers38 U.S.C. § 1720G
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Functions of Veterans Health Administration: in general38 U.S.C. § 7301
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Medicaid and CHIP Payment and Access Commission42 U.S.C. § 1396
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Regulations38 U.S.C. § 7304
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Requirement for program38 U.S.C. § 7698
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Hospital care, medical services, and nursing home care abroad38 U.S.C. § 1724
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Veterans Community Care Program38 U.S.C. § 1703
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Center for Innovation for Care and Payment38 U.S.C. § 1703E