Writing a Statement in Support of Claim

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.

As always, number each page of this letter with 1 of X, 2 of X, etc. Also be sure to put your name and C-file number at the bottom of every page. When you are finished, attach it to the VA Form 21-4138 and any other evidence that you may have (being sure to number the form and each page of the evidence, as well as adding your name and C-file number). I like to use a three-hole folder, with a clear front. I always add a cover page as well, that has my name, C-file Number, the purpose of the documents (Claim for compensation, NOD, etc.) and the date. Anything we can do to make it easier for a rater may actually play out in our favor. Then, send this package to the VARO via certified mail, return receipt requested.