Below are the most commonly used forms veterans and their survivors may use to apply for benefits like VA Compensation, Dependency and Indemnity Compensation (DIC), Burial, HISA, VA Pension (Survivor Pension), or Health Benefits from the Department of Veterans Affairs. These forms and the other documents below are routinely updated by our staff.
Order Military Records
- SF 180 – Request Pertaining to Military Records (used to obtain DD 214 discharge records)
- Aarvark Research – Government Approved DD214 Expeditors (Fees Apply)
Checklists, Rates, and Where to Submit Forms
- Fully Developed Compensation Claims Checklist
- General Checklist for Submitting Fully Developed Claims for Compensation
- Checklist 1 – Pension – Veteran in Facility or Home Care
- Checklist 2 – Pension – Veterans Unhealthy Spouse – Facility or Home Care
- Checklist 3 – Survivors (Death) Pension – Surviving Spouse – Facility or Home Care
- VA 2025 Compensation SMC and DIC Rates
- VA 2025 Pension Rates & Survivor Pension Rates
- VA 2025 Rates for Burial, Special Benefits, Grants and Special Allowances
- Where to Mail-Fax Claims, Intents, Evidence, and Requests
- Fiduciary Hub Contacts
Intent to File to Establish an Effective Date
Application Forms
- VA Form 21-526EZ – Veteran’s Application for Disability Compensation & Related Benefits
- VA Form 21p-527EZ – Veteran’s Application for Pension
- VA Form 21p-534EZ – Dic, Survivors Pension, and/or Accrued Benefits
- VA Form 21p-530EZ – Burial Benefits
- VA Form 21p-601 – Accrued Amounts Due a Deceased Beneficiary
- VA Form 10-0103 – Veterans Application For Assistance in Acquiring Home Improvements And Structural Alterations
- VA Form 10-10EZ – Application for Health Care
- VA Form 10-10d – Application for Champva Benefits
- VA Form 10-10cg – Application for Comprehensive Assistance for Family Caregivers Program (More about this program)
Supporting Forms
- VA Form 21-0969 – Income and Assets Statement
- VA Form 21-22a – Appointment of Individual as Claimant’s Representative
- VA Form 21-2680 – Examination for Housebound Status or Permanent need for Regular Aid and Attendance
- VA Form 21-0781 – Statement in Support of Claim For Service Connection For Post-traumatic Stress Disorder (PTSD)
- VA Form 21-8940 – Veteran’s Application For Increased Compensation Based On Unemployability (TDIU)
- VA Form 21-4142 – Consent To Release Medical Information to the VA
- VA Form 21-4142a – General Release for Medical Provider Information
- VA Form 20-10206 – Freedom of Information Act or Privacy Act Request
- VA Form 21-4142a – General Release for Medical Provider Information
- VA Form 21-10210 – Lay / Witness Statement
- VA Form 21-4170 – Statement of Marital Relationship
- VA Form 21P-4171 – Supporting Statement Regarding Marriage
- VA Form 21-4176 – Report of Accidental Injury in Support of Claim for Compensation
- VA Form 21-4192 – Employment Information in Connection with Claim for Disability Benefits
- VA Form 4138 – Statement in Support of Claim
- VA Form 21-0845 – Authorization to Disclose Personal Information
- Care Provider Certification of Services
- Independent Living Certification of Services
- VA Form 21-0779 – Request for Nursing Home Information
- VA Form 21-686c – Declaration of Status of Dependents
- VA Form 10-10HS Request for Hardship Determination
- VA Form 21-0972 Alternate Signer Certification Form
Disability Benefit Questionnaires (DBQs)
- Public Disability Benefits Questionnaires (DBQs)
Supplemental Information Forms
- VA Form 21-8049 – Request for Details of Expenses
- VA Form 21P-8416 – Medical Expense Report
- VA Form 21P-8416b – Report of Medical, Legal, and Other Expenses Incident to Recovery for Injury or Death
- VA Form 21-0516 – EVR Veteran with No Children
- VA Form 21-0517 – EVR Veteran with Children
- VA Form 21-0518 – EVR Surviving Spouse with No Children
- Incompetency Notice Response
Decision Review Forms
- VA Form 20-0995 – Supplemental Claim
- VA Form 20-0996 – Request for Higher-Level Review
- VA Form 10182 – Request for Board Appeal
Waivers for VA Benefit Debt
- VA Form 5655 – Financial Status Report
- When you write Debt Management include a personal statement to officially request the waiver and tell your story.
Reference Material
- 38 CFR Part 4 – Schedule for Rating Disabilities
- Title 38 Code of Federal Regulations
- M21-1, Adjudication Procedures Manual, Table of Contents
- A Complete Guide to CHAMPVA Services
- PTSD Guide
- Adjudication Manual Rules for DIC, Accrued Benefits and Substitution for Claimant
- Adjudication Manual Marriage Rules
- Adjudication Manual Rules for Evaluating Evidence and Decision-Making
Case Studies (Coming Soon)
- Compensation Case Study
- DIC Case Study
- VA Pension Case Study
- Survivor Pension Case Study