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Effective date: July 2015
Veterans and Service Member should use this form to submit a claim for veterans disability compensation and related compensation benefits.
Use this form to expedite the process under the Fully Developed Claim Program (FDC)
Effective date: Mar 2018
Service Members with 6 months or less remaining on active duty can file a claim with the Department of Veterans Affairs
Form effective June 2016
Want your pension claim processed faster? Use this form to expedite the process under the Fully Developed Claim Program (FDC)
Date effective: October 2018
VA will pay a burial allowance up to $2000 if a veteran's death is service related. VA will also pay a burial and funeral allowance for nonservice-connected injuries. The person who paid the Veteran's burial expenses may apply for reimbursement from VA.
Effective: April 2017
Application used for surviving spouses and children to submit a claim for DIC. Death Pension, and/or Accrued benefits under the Fully Developed Claim Program (FDC)
Form effective: June 2018
To apply for accrued benefits due the beneficiary but not paid prior to death
Effective date: September 2016
Declaration of Status of Dependents used to add eligible family members to a veteran's VA running award.
Effective date: June 2017
This Notice of Disagreement is used to initiate an appeal from a VA decision for disability benefits you receive.
Effective: September 2018
This Form Is Used to Notify VA of Your Intent to File for the Compensation, Pension, Survivors Pension, and DIC Benefit(s). The Intent to File a claim process allows applicants additional time to gather all of the information and evidence needed to support their claim(s).
Intent to File replaces an informal claim.
38 CFR §3.155
Effective- Aug 2018
Veterans and Spouses would require assistance in performing their daily activities of living (ADLs), must have their primary care physician complete this form indicating the need for either Aid and Attendance (A&A) or Housebound status.
Effective May 2015
Statement in support of claim.
Effective date: Jan 2018
Authorization for Release of Information
Effective date: Mar 2018
Veteran's Application for Increased Compensation Based on Unemployability
Effective date: October 2017
Use this form to apply for educational assistance under the following benefit programs:
- Post- 9/11 GI Bill chapter 33 of title 38, U.S. Code
- Montgomery GI Bill (MGIB) chapter 30 of title 38, U.S.Code
- Montgomery GI Bill - Selected Reserve (MGIB-SR) chapter 1606 of title 10, U.S. Code
- Reserve Educational Assistance Program (REAP) chapter 1607 of title 10, U.S. Code
- Post-Vietnam Era Veterans' Educational Assistance Program (VEAP) chapter 32 of title 38, U.S. Code, or section 901 or section 903 of Public Law 96-342
Do not use this form to apply for Vocational Rehabilitation and Employment benefits (chapter 31 of title 38, U.S. Code), Dependents Educational Assistance benefits (chapter 35 of title 38, U.S. Code), Transfer of Entitlement, or National Call to Service (section 510 of title 10, U.S. Code). These benefits require different application forms.
Effective: December 2016
Do not use this form to apply for Veterans' education assistance based on your own service (chapters 30, 32, 33, 1606, or 1607) or vocational rehabilitation benefits (chapter 31). To apply for veterans' education assistance based on your own service, use VA Form 22-1990. To apply for vocational rehabilitation benefits, use VA Form 28-1900.
To qualify for Survivors' and Dependents' Educational Assistance (DEA) you must be either:
(1) The spouse or child of a veteran who is permanently and totally disabled as a result of a service-connected disability.
(2) The spouse or child of an individual on active duty who has been listed as missing in action, captured in the line of duty by hostile force, forcibly detained or interned in the line of duty by hostile force, or forcibly detained or interned in the line of duty by foreign government or power for more than 90 days.
(3) The surviving spouse or child of a veteran who died of a service-connected disability or who dies while a service-connected disability was rated permanent and total in nature.
(4) The surviving spouse or child of an individual on active duty for which the evidence shows that the individual is hospitalized for receiving outpatient medical care services or treatment; has a total disability permanent in nature incurred or aggravated in the line of duty in the active military, naval, or air service; and the serviceperson is likely to be discharged or released from such service for such disability.
Effective date: June 2017
Used to apply for vocational rehabilitation benefits. Vocational Rehabilitation provides services and assistance to certain veterans with disabilities to get and keep a suitable job. If employment is not reasonably feasible, vocational rehabilitation may be able to provide services to support veterans with disabilities to achieve maximum independence in their daily living activities.
Effective date: September 2014
Disability Benefits Questionnaires (DBQs) are medical examination forms used to obtain important information for evaluating disability compensation and/or pension claims.
The following DBQ can be obtained by visiting: http://www.benefits.va.gov/COMPENSATION/dbq_ListByDBQFormName.asp
Cardiovascular
Form # |
Form Name |
21-0960A-2 |
Artery and Vein Conditions (Vascular Diseases including Varicose Veins) |
21-0960A-3 |
|
21-0960A-4 |
Heart Conditions (including IHD, Non-IHD, Arrhythmias, Valvular Disease and Cardiac Surgery) |
Dental and Oral
Form # |
Form Name |
21-0960M-15 |
|
21-0960D-1 |
Dermatological
Form # |
Form Name |
21-0960F-1 |
|
21-0960F-2 |
Ear, Nose and Throat
Form # |
Form Name |
21-0960N-1 |
Ear Conditions (including Vestibular and Infectious Conditions) |
21-0960N-3 |
|
21-0960N-4 |
Sinusitis, Rhinitis, and Other Conditions of the Nose, Throat, Larynx, and Pharynx |
Endocrinological
Form # |
Form Name |
21-0960E-1 |
|
21-0960E-2 |
Endocrine Diseases (other than Thyroid and Parathyroid, or Diabetes Mellitus) |
21-0960E-3 |
Gastrointestinal
Form # |
Form Name |
21-0960G-1 |
Esophageal Conditions (Including GERD, Hiatal Hernia and Other Esophageal Disorders) |
21-0960G-2 |
|
21-0960G-3 |
|
21-0960G-4 |
|
21-0960G-5 |
|
21-0960G-6 |
|
21-0960G-7 |
Stomach and Duodenal Conditions (not including GERD or Esophageal Disorders) |
21-0960G-8 |
Infectious Intestinal Disorders (including Bacterial and Parasitic Infections) |
Genitourinary
Form # |
Form Name |
21-0960J-1 |
|
21-0960J-2 |
|
21-0960J-3 |
|
21-0960J-4 |
Urinary Tract (including Bladder and Urethra) Conditions (excluding Male Reproductive System) |
Gynecological
Form # |
Form Name |
21-0960K-1 |
|
21-0960K-2 |
Hematologic and Lymphatic
Form # |
Form Name |
21-0960B-1 |
|
21-0960B-2 |
Infectious Diseases
Form # |
Form Name |
21-0960I-1 |
|
21-0960I-2 |
|
21-0960I-3 |
Infectious Diseases (other than HIV-Related Illness, Chronic Fatigue Syndrome, or Tuberculosis) |
21-0960I-4 |
Systemic Lupus Erythematosus (SLE) and Other Autoimmune Diseases |
21-0960I-5 |
|
21-0960I-6 |
Musculoskeletal
Form # |
Form Name |
21-0960M-1 |
|
21-0960M-2 |
|
21-0960M-3 |
|
21-0960M-4 |
|
21-0960M-6 |
|
21-0960M-7 |
|
21-0960M-8 |
|
21-0960M-9 |
|
21-0960M-10 |
|
21-0960M-11 |
|
21-0960M-12 |
|
21-0960M-13 |
|
21-0960M-14 |
|
21-0960M-16 |
Neurological
Form # |
Form Name |
21-0960C-1 |
|
21-0960C-2 |
|
21-0960C-3 |
|
21-0960C-4 |
|
21-0960C-5 |
|
21-0960C-6 |
|
21-0960C-7 |
|
21-0960C-8 |
|
21-0960C-9 |
|
21-0960C-10 |
Peripheral Nerve Conditions (Not Including Diabetic Sensory-Motor Peripheral Neuropathy) |
21-0960C-11 |
Ophthalmological
Form # |
Form Name |
21-0960N-2 |
Psychological
Form # |
Form Name |
21-0960P-1 |
|
21-0960P-2 |
|
21-0960P-3 |
Respiratory
Form # |
Form Name |
21-0960L-1 |
Respiratory Conditions (other than Tuberculosis and Sleep Apnea) |
21-0960L-2 |
Rheumatological
Form # |
Form Name |
21-0960Q-1 |
General Surgery
Form # |
Form Name |
21-0960H-1 |
Hernias (including Abdominal, Inguinal, and Femoral Hernias) |
21-0960H-2 |