Va form 21 526c fill out and sign printable pdf template. Va form 21526 to apply for disability compensation andor pension. If desired you can call 1800827 to get information on where to send comments or suggestions about this form. Va form 21526c or va form 21526ez to apply for disability compensation only, and. This agreement supersedes any existing fiduciary agreement involving the beneficiaryies. Transform them into templates for numerous use insert fillable fields to collect recipients.
Complete and mail the va form 21526ez, application for disability compensation and related compensation benefits, and submit it with copies of your service treatment records to this address. Predischarge claim va form 21526c, predischarge compensation claim original, reopened, fully developed or supplemental claim va form 21526ez, application for disability compensation and related compensation benefits. If you wish to receive a copy of the confirmation pdf, enter your email address below. This short, onepage document is used to supplement other documents to aid the department in collecting information to determine a veterans eligibility of benefits. Good morning my fellow veterans welcome through the veterans advice hub my name is bill kelly and id like to talk to you this morning about submitting an application for a disability compensation claim thats va form two one five to six easy this is the third in a series of videos because i recommend every veteran start with an intent to file form that.
The va form 21527 is the application for nonservice connected combat pension. The va form 21526ez is the application for service connected disability compensation. You can fill out a paper form, or fill out an electronic form on. Do you have additional periods of active service va form jul 2009 21526c yr 14a. Required forms to file claim the following forms are required to apply for va disability compensation benefits. If claiming dependents,a completed va form 21686c,declaration of status of dependents. The va form 21534 is the application for certain survivor benefits. Va form 21526ez, application for disability compensation and related compensation benefits, and. Department of veterans affairs claims intake center po box 4444 janesville, wi 535474444. If you wish to file your claim under the process in which va traditionally processes claims, see standard claim process on page 2.
Submit your claim on a signed and completed va form 21527ez, application for pension attached. Service members with 6 months or less remaining on active duty can file a claim with the department of veterans affairs. Va form 21526 va form 21526b va form 21526c va form 21 8940 for individual unemployability and claims for increase va form 214502 for automobile and adaptive equipment claims va form 264555 for sahsha benefits. Submit va form 21526c, pre discharge compensation claim, or other applicable forms provide original or copy of strs provide known date of separation or retirement submit a permanent address, phone number, and email address. Say you are claiming a new issue, an increase, and a reconsiderationreopen, you must file the correct issues on both the 526ez and va form 200995 supplemental claim. The way to complete the online va form 21 526c on the internet. Va form 21 526c fill online, printable, fillable, blank. The advanced tools of the editor will lead you through the editable pdf template.
Benefits are payable to qualifying children, or on. Veterans benefits administration examples example 1. I see this form has seperate information blocks covering new claim, reopened claim, increase, and secondary claims. As the names of the forms imply, claimants may use. Federal register proposed information collection pre. If claiming a child in school between the ages of 18 and 23, you must also submit a completed va form 21674, request for approval of school attendance. The previous edition released in january 2015 is also being used. Entering your email address permits the virginia department of taxation to email you the confirmation pdf for this transaction, which contains return and payment details. The 21526b is a little more structured, but not as much of a burden as other versions. Va form 214169, supplement to va forms 21526, 21534, and 21535 for benefits for certain children with disabilities the required forms are. Also if you have any dependents, youll need to fill out vaf 21686c and attach a copy of any birth certificates, marriage certificates. Under the paperwork reduction act pra of 1995, federal agencies are required to publish notice in the. And all, if any, relevant, private medical treatment records and an identification of any relevant. Existing stock of va form 21 2680 may 2015 will be used.
The most recent version of the va form 21526c fillable version is available to download below or can be found through the va website. The veterans benefits administration vba, department of veterans affairs va, is announcing an opportunity for public comment on the proposed collection of certain information by the agency. The real reason the va is making form 21526ez mandatory. If youre a service member who meets the above criteria and would like to file a predischarge disability compensation claim before separation, youll need to fill out vaf 21526ez and attach a copy of all service treatment records for all periods of service. The intent to file a claim process allows applicants additional time to gather all of the information and evidence. Va form 21535 existing stock of va form 21535, sep 2000, general instructions page 1 apr 2005 will be used. Learn how to fill the va form 21 526 veterans application for compensation andor pension duration. Look at the table below to find out which parts of va form 21526 you should use to apply for different benefits. The latest edition of the form was released by the department of veterans affairs va in december 2017. But always, always, always, use va form 218940 anytime that you are seeking 100% total disability rating based on individual employability. Get and sign va gov vaforms va pdf va1100 pdf 19922020. Enter your official identification and contact details.
Va form 2122a appointment of individual as claimants representative. This form is used to notify va of your intent to file for the compensation, pension, survivors pension, and dic benefits. If you are making a claim for survivor benefits use va form 21p 534ez application for dic survivors pension andor accrued benefits. Fdc criteria claims for veterans non serviceconnected pension benefits 1. Use this stepbystep guide to complete the va form 21 526c fillable swiftly and with excellent accuracy. Va form 21526c, predischarge compensation claim va form 21526, veterans application for compensation or pension va form 21524, statement of person claiming to have stood in relation of parent va form 21509, statement of dependency of parents va form 214718a, certificate of balance on deposit and authorization to disclose financial records.
This is optional and is provided as a backup if you cannot opensave the pdf on the next page. Application for disability compensation and related compensation benefits fillable file type. This claim can be filed by the veteran or another person, such as a relative or a friend. Va form 214142 authorization and consent to release information to the department of veterans affairs va va form 218940 for total disability for individual unemployment. If claiming benefits for a seriously disabled helpless child, you must also submit all. Look at the table below to find out which parts of va form 21 526 you should use to apply for different benefits. Va form 21526c, predischarge compensation claim is a form used for filing a predischarged claim the latest version of the form was released by the department of veterans affairs va in june 2016 with all previous editions obsolete. Some parts of the form also contain notes or specific instructions for completing that part. Va form 2148, statement in support of claim is a form used to support a claim for benefits. A discussion of transition tools such as a substantially completed va form 21526ez application for disability compensation and related compensation benefits. Va form 210304, application for benefits for certain children with disabilities born of vietnam and certain korea service veterans. Home va commonly used forms va compensation and pension forms va form 21526c predischarge compensation claim.