How to File a Claim For VA Disability Compensation, Part III

Part III

In the last part, we read about what it takes to make a nexus statement, and how to get one. We also learned that it is very wise to review your C-file prior to filing your claim in order to be better prepared, and to make sure that the rater gets all the pertinent information. Now it's time to look at the forms that are necessary when filing a claim for disability compensation. This section went a little long. OK...this section went a LOT long, but there is a lot to cover here. I considered splitting this into two separate parts, but that seemed like it would only lead to more confusion. So, get a cup of coffee, a comfy chair, and settle in. You may be here a while.

The Correct VA Forms

Since we all know that the VA is a true blue government agency, then we all know that there is some kind of a form that has to be used for anything we need from them. What kind of forms are needed to file a claim for VA disability compensation, though? Well, that depends on a few things. First, we need to know if this is the first time that you have ever filed for any type of VA disability in the past. If you have not, then you need to use a VA Form 21-526, Veterans Application for Compensation and/or Pension.

If you have filed a claim in the past, then you will be filing a claim for increase. This is the case even if this claim is for a new condition that has never been filed for before. If this is the case, then you need to use a VA Form 21-4138, Statement in Support of Claim. If you are unemployed due to one or more of your service connected disabilities, but you are not rated at 100%, then you need to file a claim for Total Disability due to Individual Unemployability. To do this you will need to use a VA Form 21-8940, Veterans Application for Increased Compensation Based on Unemployability. All of these forms can be found in a PDF format on the VA.gov web site. The forms are set up so that you can enter your information from your computer, then print them off and mail them in.

The VA Form 21-526, including its instructions, is 23 pages long. This can be a little intimidating to a veteran filing for disability compensation for the very first time. Don't let the size of this form get the best of you, though. It's pretty straight forward, and since you have gathered all of the information from the previous section of this blog, the questions should be relatively easy to answer. The form is laid out into four parts; A, B, C, and D. You will have to fill out everything except Part D, which is used to apply for a pension.

Part A collects general information on you, such as name, date of birth, and contact information. It also seeks information about your active duty, reserve, or national guard service. They will ask questions regarding when and where entered and left the service, and mailing addresses of units that you served with. They will also want a list of military benefits that you currently receive along with the amount. This is also the section where you give your direct deposit banking information if you choose to.

Part B asks about the disabilities that you are claiming. Here is where you give the treatment dates while in service and names and locations of the medical facilities where you have been treated after your military service. They also ask about exposure to any environmental or chemical exposures in this section.

Part C is where information about marital status and dependants is given. You will also need information about any previous marriages that you and your spouse may have had. You will also have a chance to claim dependant parents in this section of the form. They will also want information on children or a spouse that does not live with you. Have everyone's social security numbers handy, as they will be needed. There are several documents listed in the instructions that should be turned in with this form. It is a good practice to include these documents any time that you file a claim, so I will discuss them in a few minutes, after I cover the other forms.

The VA Form 21-4138, or Statement in Support of Claim, is one that most disabled veterans will come to know intimately. Any time that we communicate with the VA by mail, in reference to our claim, it should be done on this form. They seem to recognize and address their own document a lot quicker than a hand-written or typed letter. This form is also used to file the majority of our claims. It is only two pages long, and is much less intimidating than the 21-526. It is simply for your remarks, and there is no list of questions that will need to be answered.

When filling out this form, it is best to keep it short and sweet. Your statement should be concise and to the point. You can actually pack a great deal of information into a single paragraph. A well-drawn picture of your claim should be saved for a addendum to this form. The way that I always like to approach this is to write something like this:

"I would like to submit a formal claim for increase in my service connected disability compensation for the condition XXXX. I am also seeking service connected compensation for the current medical conditions of XXXX, XXXX, and XXXX. I am providing you with my sworn statement in support of claim, which follows this VA Form 21-4138 as a addendum. I am also submitting all of the additional evidence in support of the total of my claims that I am currently in possession of. This evidence includes service medical records, civilian medical records, VA medical records, sworn statements of individuals, peer-reviewed medical journal articles, and internal VA training documents. There are a total of XXX pages in this correspondence, including this form.

Thank you for your timely attention to this matter."

Your addendum should be a typed letter of the standard business form. You should start out with your full name and claim number (typically your social security number) in bold letters at the top of the page. Follow this with your full street address, phone number and e-mail address. The current date comes next, then the person whom you are addressing the letter to. In this case it will be addressed to Triage, Department of Veterans Affairs, Regional Office, followed by the street or post office box address of the VARO that you use. Next, provide a regards line (RE:) letting the addressee know exactly what this document is; Addendum to Statement in Support of Claim (VA Form 21-4138). All of this should be left justified on the page.

You are now ready to begin the body of your letter. Start off with a simple address, like "To whom it may concern." In the first paragraph you will want to provide your identifying information. I would suggest starting off with your name, your period(s) of service, the branch(es) that you served in, your MOS (both number series and title) and where you served in combat, if applicable. In the second paragraph state why you are writing this letter. I use the line, "In this addendum, I seek to cover my current claims of..."

Next you want to begin to cover the issues you are claiming. Start from the beginning, and carry it through to the end. This is the only chance you'll have to tell your story up front. The next chance will be in a appeal, and you are trying to avoid letting it get that far. As we did with the 21-4138, you'll want to be as concise as possible. Keep your writing short and to the point. Try to use bullet statements where you can.

You'll want to do this in a standard outline format to cut down on the confusion. This is the same way we all did it in grade school; Roman numerals (I, II, III) followed by capitol letters (A,B,C) followed by Arabic numeral (1,2,3), and lastly lower-case letters (a,b,c). To keep things in line with the VA Form 21-4138 that you filled out, use the same order of the issues claimed. An example would look like this:

Issue I. Entitlement to service connected compensation for Intervertebral Disc Syndrome.

A. I was injured while on active duty on 1 January 1982 while making pancakes.
1. My service medical records state the following:
a. I visited the troop medical clinic at Ft. Bragg, NC for this injury
b. The physician stated that I had a severe muscle strain from the weight of the pancake.
2. I was assigned to the personnel section while my back recovered.

B. My back was no better by the summer of 1982, so my physician sent me to physical therapy.
1. My service medical records state the following:
a. The therapist stated the my lumbar ranges of motion were XXXX,
b. The therapist stated that I had severe muscle guarding in my lumbar region.
2. After three weeks of physical rehab, the therapists deemed me a poor candidate for therapy.

After you have covered all the issues, then you can close this addendum. I like to do this by stating, "I would like to request that any compensation and pension examinations necessary to the VA's development of these claims be completed at the XXXX Va Medical Center in (city, state). I also request that C&P exams deemed necessary be scheduled in a timely manner." This may not gain you any ground whatsoever, but it could possibly save you from being sent to a C&P exam provided by a QTC doctor who is outside of the VA system and is paid by the exam.

The last statement that you will want to make is, "All statements contained herein are true and correct, to the best of my knowledge." This makes the addendum a sworn statement. You may also want to include a statement something like this, "I hereby relinquish the remainder of any time that I may have. Please begin to schedule any pertinent exams and otherwise begin your work towards decisions on these claims." They will still want you to sign a VCAA Notice Response later on, but this will let them know that you are not interested in waiting the full amount of time that they have to offer you under the "Duty to Assist" laws.

If you are unemployed due to one or more of your service connected disabilities, but you are not rated at 100% for that disability, then you may be eligible for TDIU. This will allow you to be paid at the 100% rate, even though you do not meet the schedular criteria. The basic eligibility requirements is that you have a single service connected disability rated at 60%, or you have multiple service connected disabilities that provide a combined rating of 70%, with at least one of the disabilities being rated at 40%. If you don't meet these criteria, you could still possibly be granted TDIU, but it will be a hard fight.

To file a claim for TDIU, you have to use the VA Form 21-8940, Veteran's Application For Increased Compensation Based on Unemployability. This is also a two page form, but there are questions to be answered on this form. The form is laid out into four sections. The first section deals with disability and medical treatment. It asks which service connected disabilities prevent you from securing substantially gainful employment. It also asks if you've been under a doctor's care in the last twelve months, and the names, addresses, and dates of treatments.

The second section requires you to list all of your employment for the last five years. They want to know the name and address of the employers, and the dates you were employed there. They also want to know the type of work, the number of hours per week, the time you lost from illness, and your highest earnings per month. They will want to know you total earned income for the previous twelve months, and whether or not you left your last job due to your disabilities. If you have applied for any other jobs since your were last employed, they will want to know some information about those employers as well.

In the third section they ask about your schooling and other training. They want to know your highest year completed in school or college, and what type of education you received. They will also want to know if you have received any education or training since you became too disabled to work. There is also a remarks section for the veteran at the end of this section. If the disabilities that prevent you from working are static, or if you have had them form several years, I would suggest asking for "permanent and total/no future exams required" status in this remarks box. The last section simply asks for a signature and date.

I would suggest filling out and submitting a VA Form 21-4138 and a addendum along with this application. This will allow you to better describe the disabilities and circumstances that have caused you to become unemployable. Along with the application, and sworn statement, there are two other forms that should be addressed in a TDIU claim. It is not completely necessary for the veteran to complete these forms at this point in time, but if you do, you will be one step ahead of the game. You will also know that the VARO received as much information about your claim as you were able to control.

The first of these forms is VA Form 21-4140-1, Employment Questionnaire. This form is sent out to all TDIU veterans annually. It is supposed to be sent on the anniversary date of the TDIU award, and there is a strict timeline on returning it to the VARO. Recently, however, there have been many reports of veterans receiving this form too late to return on time, or not at all. While it should not be necessary to complete this form before the first anniversary of TDIU, not all VARO's seem to be on the same page, therefore it would be beneficial to go ahead and send it in with the rest of the application package.

This is a single page form, and there isn't much to it. Especially if you haven't worked in the last year. It requires the usual personal information, then there is a yes/no checkbox to answer whether or not you have been employed in the last year. If you check no, then you skip down to Section II, Unemployment Certification where you sign and date the form. If you check yes, then you go to Section I, Employment Certification. Here you will list the same basic work related information as on the 21-8940. After that, you simply sign and date the form.

The last form that needs to be completed is the VA Form 21-4192, Request For Employment Information in Connection With Claim for Disability Benefits. This form will actually be mailed to all the employers you listed on the 21-8940, but all too often employers are slow to return it to the VARO, or they simply never return it. This is usually due to a misplaced fear that the veteran is trying to come after the former employer for disability. Given this fact, I always suggest that you fill out one of these forms for each employer listed on the 21-8940, and then take it either to your former supervisor, or the human resources department at that former employer. This will guarantee that the form is filled out, and sent back in, because you are the one doing it.

This is another simple, one page form. The first couple of blocks deal with the names and addresses of the former employer and the VARO, followed by the veteran's personal information. Section II is for the employment information. They need your dates of employment and the amount earned in the last twelve months that you worked there. They will want to know your position title, and the number of hours per day and week that you worked. Along with other tidbits of information, they will need to know of any concessions the employer made for the veteran's disabilities and the reason the vet is no longer working there.

Section III deals with any benefits or payments that you are receiving from that employer. They will want to know if you are entitled to any benefits, such as short or long term disability or a pension, the type of benefit and the amount. Then they will need a signature from the employer. It is best to fill this out with the past employer so that all of the correct information can be listed, but offer to take down the information and fill out the form. This way all the employer has to do is review the form and sign it, which will save them time.

There is one last form that should be addressed here, and it deals with a claim for dependants. If you have a service connected disability that is rated at 30% or greater, your compensation will increase based upon the number of dependants you have. If you think that your compensation rating may go above 30%, then it will save you time in the long run to go ahead and submit a claim for dependency. If you have been rated above 30% in the past, and received benefits for dependants, but then had your rating lowered to below 30%, you will need to do this also. Once your dependants drop off of your compensation, apparently the VA has no way to retrieve the data.

The form used for this purpose is a VA Form 21-686c, Declaration of Status of Dependents. It is a short, two page document with only three sections, but it asks for a lot of information. As usual, the first thing that is required is the veteran's personal information, including the C-file number. Next is marital status and spouse's date of birth. I hope no one has to sneak a peek at his or her birth certificate to find the answer to this one.

The first section asks questions about the veterans marriages. You will need to know the date and place of any marriages that you've had, who you were married to, and their social security numbers. The best place to look for former spouse's social security numbers is on marriage certificates and divorce decrees. They also want to know how the marriage was terminated (i.e. divorce, or death), and the date and place that the marriage terminated.

In section two, they are seeking information about your spouse's previous marriages. You will need to know who your spouse was married to, and the date and place of their marriage. You will also need to know how, when, and where the marriage terminated. They also ask questions in this sections about the veteran status of your spouse, and whether or not you live with your spouse.

The last section is reserved for information on the veteran's unmarried children. They will need the name, date and place of birth, and social security number of all of your dependent children. They also want to know the status of your child, such as whether or not he is your biological child, or a adopted or step-child. They will need to know if the child is seriously disabled, or between the ages 18 and 23 and in school. Lastly they want to know if any of the children that you listed do not live with you. You will need their street address and the name of the person that they live with.