Forms & Applications

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Request Military Service Records & DD214

Veterans can obtain missing military records (and awards) through National Archives website. Many requests can be filed electronically or submitting SF Form 180; be sure to have Veteran’s Date of Birth, Social Security number, service number, and dates of service. 
 
FYI: The DD Form 214 was issued to Veterans who served between 1950-present day. Veterans serving between 1941-1949 were issued either WD AGO (War Department General’s office) Forms or the NAVPERS (Navy Personnel Command).
 
 
Standard Form 180 (REQUEST PERTAINING TO MILITARY RECORDS) https://www.archives.gov/files/research/order/standard-form-180.pdf
 

Request Military Awards (Medals) and Decorations: https://www.archives.gov/veterans/replace-medals

Order Veteran’s Records (and Awards) Online: https://vetrecs.archives.gov/VeteranRequest/home.html
 

Discharge Upgrade or Correction Process

A discharge upgrade changes the “character of service” shown on your DD-214 discharge certificate. Today, most certificates show the “character of service” as either Honorable, General (Under Honorable Conditions), Other Than Honorable, Bad Conduct or Dishonorable.

NOTE: Even with a less than honorable discharge, you may be able to access some VA benefits through the Character of Discharge review process. When you apply for VA benefits, the VA will review your record to determine if your service was “honorable for VA purposes.” This review can take up to a year. Please provide the VA documents supporting your case, similar to the evidence you’d send with an application to upgrade your discharge.

Request for Upgrade (Online): https://www.va.gov/resources/request-a-discharge-upgrade-or-correction/

DD Form 293 (APPLICATION FOR REVIEW OF DISCHARGE FROM THE ARMED FORCES) https://www.esd.whs.mil/Portals/54/Documents/DD/forms/dd/dd0293.pdf

Upgrade Instructions: https://www.va.gov/discharge-upgrade-instructions/

DoD Release Article: https://www.defense.gov/Newsroom/Releases/Release/Article/1424248/dod-and-va-release-online-tool-to-assist-veterans-with-discharge-upgrade-process/

Apply or Update For VA Health Benefits

VA form 1010EZ is for enrollment into the VA VA health care system. The information provided on this form will be used by VA to determine your eligibility for medical benefits and on average will take 30 minutes to complete. This includes the time it will take to read instructions, gather the necessary facts and fill out the form.
 
VA Form 10-10EZ (ENROLLMENT APPLICATION FOR HEALTH BENEFITS) https://www.va.gov/vaforms/medical/pdf/1010ez-fillable.pdf
 
If already enrolled in the VA, use the VA Form 10-10EZR (when needed) to update your personal, insurance, or financial information AFTER you are enrolled. NOTE: Its important to complete/submit VA Form 10-10EZR when a Veteran is receiving Social Security or becomes unemployed for any reason.
 
VA Form 10-10EZR (HEALTH BENEFITS UPDATE FORM)
Submit Intent to File
 
The VA Form 21-0966 (Intent to File) is used to notify the VA of your intent to File for compensation and/or pension, or survivor’s pension and/or Dependency and Indemnity Compensation (DIC). 
 
NOTE: Submit your Intent to File BEFORE you gather documents for a claim. You have one year from the date of submission to gather supporting documents for your claim. Payment is retro active to the month the Intent to File was originally submitted.
 
 
VA Form 21-0966 (INTENT TO FILE A CLAIM FOR COMPENSATION AND/OR PENSION, OR SURVIVORS PENSION AND/OR DIC ) https://www.vba.va.gov/pubs/forms/VBA-21-0966-ARE.pdf

File a VA Disability Claim

  • Submit Intent to File (see above).
  • Gather any evidence (supporting documents) you’ll submit yourself when you file your VA disability claim.
  • Be sure your claim is filled out completely and you have all the supporting documents ready to send in along with your claim. This will help the VA process your claim quickly.

After submitting your Intent to File, you have one year to complete your VA claim using VA Form 21–526EZ. Importantly, the date that VA received your Intent to File will be the effective date of your claim.

Types of VA disability claims and when to file: https://www.va.gov/disability/how-to-file-claim/when-to-file/

 
Fully Developed Claims Checklist: https://www.benefits.va.gov/FDC/checklist.asp
 
Private Medical Evidence. The Department of Veterans Affairs encourages all Veterans to submit their private medical records for consideration during the processing of their benefits claim. VA values evidence from your private treatment providers because they are familiar with your medical history, often over a long period of time. If required, complete your healthcare provider’s release of information form, obtain your records, and submit with your claim, OR Complete the VA Form 21-4142. 
 
 
VA Form 21-4142 (Authorization to Disclose Information to the VA) https://www.vba.va.gov/pubs/forms/VBA-21-4142-ARE.pdf
 
VA Form VBA-21-526EZ (Application for Disability Compensation and Related Compensation Benefits) https://www.vba.va.gov/pubs/forms/VBA-21-526EZ-ARE.pdf
 
VA Form 21-4138 (Statement in Support of a Claim (Buddy Statement): https://www.va.gov/find-forms/about-form-21-4138/
 
VA Form 21-10210 (Lay/Witness Statement) https://www.vba.va.gov/pubs/forms/VBA-21-10210-ARE.pdf
 
Once your claim is submitted, you can track the progress of your claim by using eBenefits. The eBenefits Portal is an online resource for tools and benefits-related information for Wounded Warriors, Veterans, Active Duty Servicemembers, their Families, and those who care for them.
 

Apply for Veterans Pension Benefits

The Veterans Pension program provides monthly payments to wartime period Veterans who meet certain age or disability requirements, and who have income and net worth within certain limits. Find out if you’re eligible for this benefit.

  • Do NOT have a Dishonorable Discharge
  • Your yearly family income and net worth meet certain limits set by Congress. Your net worth includes all personal property you own (except your house, your car, and most home furnishings), minus any debt you owe. Your net worth includes the net worth of your spouse.
  • Served in a Wartime Period (see below)
  • Are at least 65 years old, or
  • Have a permanent and total disability, or
  • Are a patient in a nursing home for long-term care because of a disability, or
  • Are getting Social Security Disability Insurance or Supplemental Security Income

Under current law, we recognize the following wartime periods to decide eligibility for VA pension benefits:

  • Mexican Border period (May 9, 1916, to April 5, 1917, for Veterans who served in Mexico, on its borders, or in adjacent waters)
  • World War I (April 6, 1917, to November 11, 1918)
  • World War II (December 7, 1941, to December 31, 1946)
  • Korean conflict (June 27, 1950, to January 31, 1955)
  • Vietnam War era (February 28, 1961, to May 7, 1975, for Veterans who served in the Republic of Vietnam during that period. August 5, 1964, to May 7, 1975, for Veterans who served outside the Republic of Vietnam.)
  • Gulf War (August 2, 1990, through a future date to be set by law or presidential proclamation)

Veterans Pension Eligibility: https://www.va.gov/pension/eligibility/

Pension FAQ: https://www.benefits.va.gov/BENEFITS/factsheets/limitedincome/pensionprogram-and-representation.pdf

To apply for Veteran Pension, use VA Form 21P-527EZ or apply online.

https://www.va.gov/pension/application/527EZ/introduction

How to Apply (online): https://www.va.gov/pension/how-to-apply/

VA Form 21P-527EZ (APPLICATION FOR VETERANS PENSION) https://www.vba.va.gov/pubs/forms/VBA-21P-527EZ-ARE.pdf

Aid & Attendance and Housebound Request

The VBA Form 21-2680 is the examination form for housebound status or permanent need for regular aid and attendance. Your Primary Care Physician (PCP) will complete sections II and III of this form when he/she evaluates your medical assistance needs.
 
Activities of Daily Living (ADL) are routine activities people do every day without assistance. There are six basic ADLs: eating, bathing, getting dressed, toileting, transferring and continence.
 
VA Form 21-2680 (EXAMINATION FOR HOUSEBOUND STATUS OR PERM NEED FOR REGULAR AID AND ATTENDANCE) https://www.vba.va.gov/pubs/forms/VBA-21-2680-ARE.pdf
 
If you’re in a nursing home, you’ll also need to fill out a Request for Nursing Home Information in Connection with Claim for Aid and Attendance (VA Form 21-0779).
 
VA Form 21-0779 (REQUEST FOR NURSING HOME INFORMATION IN CONNECTION WITH CLAIM FOR AID AND ATTENDANCE) https://www.vba.va.gov/pubs/forms/VBA-21-0779-ARE.pdf

Add Dependents to VA Compensation Benefits

You may be eligible for additional disability compensation for a spouse, child and/or parent if you are eligible for disability compensation AND have combined 30% or higher disability rating from VA.
 
Filing an Online Dependency Claim FAQ: https://benefits.va.gov/COMPENSATION/docs/bas-dependency-faq-final-508.pdf
 
Add Dependents to your VA disability benefits: https://www.va.gov/disability/add-remove-dependent/
 
How to Add a Dependent Online through eBenefits: https://benefits.va.gov/COMPENSATION/docs/dependency-infographic-final-508.pdf
 
Complete VA Form 21-674  when Veteran’s child is at least 18 but under 23 and attending high school, college, or vocational school.
 
VA Form 21-674 (REQUEST FOR APPROVAL OF SCHOOL ATTENDANCE) https://www.vba.va.gov/pubs/forms/vba-21-674-are.pdf

Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)

If you’re the spouse or child of a Veteran with disabilities, or the surviving spouse or child of a Veteran who has died, complete VA Form 10-10d to apply for health insurance through CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs) and VA Form 10-7959C (Other Health Insurance).  If over 65, also provide a copy of your Medicare card.

CHAMPVA Benefits: https://www.va.gov/health-care/family-caregiver-benefits/champva/

VA Form 10-10D (Application for CHAMPVA Benefits) https://www.va.gov/vaforms/medical/pdf/vha-10-10d-fill.pdf

VA Form 10-7959C (Other Health Insurance (OHI) Certification) https://www.va.gov/vaforms/medical/pdf/VA%20Form%2010-7959c.pdf

Apply for Education Benefits as an Eligible Dependent

VA’s Survivors’ and Dependents’ Educational Assistance (Chapter 35) program provides education and training opportunities to eligible dependents and survivors of certain Veterans.
 
VA Education Benefits for Dependents and Survivors (also called Chapter 35 benefits):
 
 
  
VA Form 22-5490 (DEPENDENTS’ APPLICATION FOR VA EDUCATION BENEFITS) 

Apply for VA Individual Unemployability

If you can’t work because of a disability related to your service in the military (a service-connected disability), you may qualify for what’s called “Individual Unemployability.” This means you may be able to get disability compensation or benefits at the same level as a Veteran who has a 100% disability rating.
 
 
 
VA Form 21-8940 (VETERAN’S APPLICATION FOR INCREASED COMPENSATION BASED ON UNEMPLOYABILITY) https://www.vba.va.gov/pubs/forms/vba-21-8940-are.pdf
 
VA Form 21-4192 (REQUEST FOR EMPLOYMENT INFORMATION IN CONNECTION WITH CLAIM FOR DISABILITY BENEFITS) https://www.vba.va.gov/pubs/forms/VBA-21-4192-ARE.pdf

Apply for Caregivers Assistance for Family Caregivers

The intent of the VA’s Program of Comprehensive Assistance for Family Caregivers (PCAFC) is to support family members who support the health and wellness of their Veteran family member. 
 
 
 
VA Caregiver Support: https://www.caregiver.va.gov/
 
VA Form 10-10CG (Application for Comprehensive Assistance for Family Caregivers Program) https://www.va.gov/health-care/forms/vha-10-10CG.pdf

Apply for Disability Housing Grants for Veterans

The VA offers housing grants for Veterans and service members with certain service-connected disabilities so they can buy or change a home to meet their needs and live more independently. Changing a home might involve installing ramps or widening doorways. Find out if you’re eligible for a disability housing grant—and how to apply.

Disability Housing Grants for Veterans:  https://www.va.gov/housing-assistance/disability-housing-grants/

How to Apply: https://www.va.gov/housing-assistance/disability-housing-grants/how-to-apply/

VA Form 26-4555 (APPLICATION IN ACQUIRING SPECIALLY ADAPTED HOUSING OR
SPECIAL HOME ADAPTATION GRANT) https://www.vba.va.gov/pubs/forms/VBA-26-4555-ARE.pdf

Apply for VA Home Improvements (HISA) Grant

Home Improvements and Structural Alterations (HISA)
HISA Grant Amounts:
This grant provides medically necessary improvements and structural alterations to Veterans/Servicemembers’ primary residence.
1. $6800 for service connected condition or have a non-service connected condition rated 50% or more service connected.
2. $2000 for non-service connected condition.
 
VA Form VHA-10-0103 (VETERANS APPLICATION FOR ASSISTANCE) 
 

Submit Durable Power of Attorney (POA) for Health Care and Living Will

Use VA Form 10-0137 to give specific people permission to make health care decisions for you, and to let VA health care providers know your wishes for medical, mental health, long-term, and other types of care.  

A durable Power of Attorney (POA) usually must be signed and notarized, as well as specified as being durable; it will continue to be in effect in the event the principal becomes incapacitated.
 
VA Form 10-0137 (VA ADVANCE DIRECTIVE DURABLE POWER OF ATTORNEY FOR HEALTH CARE AND LIVING WILL) https://www.va.gov/geriatrics/docs/vha-10-0137-fill-2-26-20.pdf

Submit Fiduciary

VA’s Fiduciary Program was established to protect Veterans and other beneficiaries who, due to injury, disease, or due to age, are unable to manage their financial affairs. VA will only determine an individual to be unable to manage his or her financial affairs after receipt of medical documentation or if a court of competent jurisdiction has already made the determination.

Fiduciary Fact Sheet: https://benefits.va.gov/BENEFITS/factsheets/fiduciary/FiduciaryFactSheet.pdf

Fiduciary References: https://www.benefits.va.gov/fiduciary/references.asp

VA Form 21P-4706B (VA FIDUCIARY ACCOUNT) https://www.vba.va.gov/pubs/forms/VBA-21P-4706b-ARE.pdf

Apply for Pre-Need Burial in VA Cemetery

Pre-Need means before death. Only complete this form if you are applying (and planning) for a Pre-Need determination of eligibility for burial in a VA national cemetery. Time of Need means time of death. DO NOT complete this form if the individual is already deceased; instead, contact a local funeral home or the National Cemetery Scheduling Office at 800-535-1117 to expedite processing.
 
Pre-Need Eligibility: https://www.cem.va.gov/pre-need/
 
VA Planning Legacy Booklet: https://www.cem.va.gov/cem/docs/factsheets/Planning_Legacy_Booklet.pdf
 
VA Form 40-10007 (APPLICATION FOR PRE-NEED DETERMINATION OF ELIGIBILITY FOR BURIAL IN VA CEMETERY)  https://www.va.gov/vaforms/va/pdf/VA40-10007.pdf

Reporting a Veteran’s Death

  • Locate or order Veteran’s DD214
  • If the Veteran was receiving disability compensation or a pension, call the Veterans Benefits Administration at 800-827-1000.
  • If the Veteran is also a retiree, contact the Defense Finance and Accounting Service (DFAS) by calling the Retiree Casualty Section of the DFAS at 800-321-1080 .
  • Notify Social Security by calling 800-772-1213.

Burial Registration and Benefits

 Veterans, Service Members, and some Family Members may be eligible for burial in a VA National Cemetery. 
 
 
 
Schedule a Burial: To start, you may want to choose a funeral director to help you plan the burial. Then either you or the funeral director can call the National Cemetery Scheduling Office at 800-535-1117 to request a burial. 

National Cemetery Administration: https://www.cem.va.gov/burial_benefits/

 
VA Form 21P-530 (APPLICATION FOR BURIAL BENEFITS) https://www.vba.va.gov/pubs/forms/VBA-21P-530-ARE.pdf
 
Helpful Resources:
Reporting a Veteran’s Death: https://va.org/reporting-a-veterans-death/
Office of Survivors Assistance: https://www.va.gov/survivors/contact_us.asp

Apply for Survivor’s (Widow) Benefits

Dependency and Indemnity Compensation (DIC) is a tax free monthly benefit paid to eligible survivors of military Servicemembers who died in the line of duty or eligible survivors of Veterans whose death resulted from a service-related injury or disease.
 
Survivors’ Dependency and Indemnity Compensation (DIC) https://www.benefits.gov/benefit/290
 
Office of Survivors Assistance: https://www.va.gov/survivors/contact_us.asp
 
 
VA Form 21P-534EZ (APPLICATION FOR DIC, SURVIVORS PENSION, AND/OR ACCRUED BENEFITS) https://www.vba.va.gov/pubs/forms/VBA-21P-534EZ-ARE.pdf
 
Honoring Gold Star Families. In the military, a blue star comes from the symbol on the service flag used to denote a family member who is serving. As such, those with active duty relatives are called “blue star families.” But in the event of a death, that blue star is replaced with a gold variant — the highest honor. 
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