VA Forms

http://www.va.gov/vaforms/form_detail.asp?FormNo=28-1900Microsoft Word timeline:

Microword chrono

Microword photo document for evidence submittal

VA claim PHOTO form (1) To insert photo, choose insert in upper left of M/S Word and click on picture. Leave cursor where you want the top left corner of photo to start on the page. We also suggest you download a ruler and print it in centimeters.  Print your name and SSN on the ruler and hold it in the photo to authenticate it. Here’s a free link:

https://www.teachervision.com/measurement/printable/44634.html

Click below for the PDF downloadable forms from VA that you may need:

http://www.va.gov/vaforms/form_detail.asp?FormNo=21-526c required as of 24 March 2015

Remember, regardless of what you download here, the new VBMS really wants to see the newer forms with the little boxes on them to capture the data more easily. Look at the VA Form 21-0958 facsimile and the small boxes. If you send anything new in from now on (after March 25th, 2015), you need to use the newest forms available or the VBMS will choke and puke on it.


UPDATE:  FROM February 19, 2019 ON: There are now only three forms you can present a claim on depending on your circumstances. To file a claim for the very first time for a disease or injury, you must use a VAF 21-526EZ with the most recent version.

To file a reopening of a previously denied claim, you must only use a VAF 20-0995 Supplemental Claim form and accompany it with new and relevant evidence. This requirement can be met very easily by submitting a VAF 21-4138 saying your ___________ got worse and give them some new records.

To disagree with a denial, you may do one of two things-but not both. You may file for a Higher Level of review (HLR) asking VA to review it for accuracy and have an informal telephone conversation explaining the error or a written brief. Or go to the BVA and ask for one of three things. You’ll get a new up or down HLR decision. From here, you again have two choices. Return to a new supplemental claim or go to the BVA.

If you get the HLR denial, you have a year to go to the BVA. You can ask for ta review of what happened at the Local Fort Fumble; you can submit new evidence and ask for a new decision; or you can ask for a hearing and submit new and relevant evidence and get a videoconference hearing with a BVA judge who probably will not be the one who decides it.

If you get denied at the BVA, you have two choices. Go to the Court of Appeals (Federal) in DC or go back to ground zero and reopen (supplemental) it again. Pretty soon, you’ll discover this is an endless Mobius Loop of denial. When you figure that out, give me a call.

I’m going to leave the rest of the documents as is  below which, for the most part are no longer valid info for historical Legacy perspective. Most documents still relevant, like the SF 180, have newer  versions with the little autofill blocks for OCR.

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Standard Form 180 – Request Pertaining to Military Records

VA Form 21-526 – Veteran’s Application For Compensation And/Or Pension

VA Form 526ez for new filings from now on. Mail to Intake Centers

VA form 527EZ  for Pensions based on NSC.

VA Form 10-5345 – Request for and Authorization to Release Medical Records or Health Information

VA Form 21-4138X – Statement in Support of Claim

VA Form 21-4142 – Authorization and Consent to Release Information to the Department of Veterans Affairs (VA)

 VA Form 21-8940 for Total Disability for Individual Unemployment

VA Form 21-22A – Appointment of Individual as Claimant’s Representative

VA Form 4597 – Board of Veterans’ Appeals Notice

VA Form 1-646 – Statement of Accredited Representation in Appealed Case

VA Form 9 – Appeal to Board of Veterans’ Appeals

VA Form 21-2680 Aid and Attendance /Housebound 

VA Form 10-0383  Catastrophic Disability determination request

Here’s the new Disability Benefits Questionnaire (DBQ) for hepatitis:

 HCV DBQ

Agent Orange Specific diseases

Diabetes Mellitus 2 DBQ

Ischemic Heart Disease DBQ

PTSD DBQ:

 PTSD DBQ

VA Stressors form VAF 21-0781

All DBQs

DBQs

DBQs by symptom

DBQ X SYMPTM

VA Travel Voucher forms–

VA Form 10-3542 Reimbursement for Travel 

Travel pay Vouchers

VCAA Form

Classified Missions that require information for substantiation of VA claims (FAST Letter 09-52). Attached is Microsoft Word attachment for SEALs, Rangers, Special Forces who have signed Nondisclosure agreements which prevent them from discussing  missions/actions in which they were injured.

fast-letter-09-52

Newest to the stable, the Form 21-0958 specifically for Notice of Disagreement

and here’s the .pdf fill out version. Now legally required as of 24 March 2015

21-0958

VA §5103 Waiver of Review in .pdf

VA 5103 VCAA Waiver of Review

Request form for C-files

C-file request form And the newer one-Form 3288 which came out in June 2014. The law dogs say this is the best one because the pukes up in Cheeseville, Wisconsin can even figure it out.

VA Form 21-2680 for request for medical exam for SMC-S/Aid and /Attendance

http://www.va.gov/vaforms/form_detail.asp?FormNo=21-2680

Application for starting Independent Living Program. VA Form 28-1900.

http://www.va.gov/vaforms/form_detail.asp?FormNo=28-1900

Proof of mailing USPS Form 3817 is here. The Common Law Mailbox Rules says we must prove we mailed something to the VA. This is the $1.30 repair order if you are too poor to use the “green card” showing certified mail return receipt requested ((CM-3R)

USPS Form 3817

P.S. No guarantees on all these links being operational. VA is renowned for 86ing them as soon as they create them.

4 Responses to VA Forms

  1. Danny W says:

    how you doing my brother. This is d y mean USMC I was looking for the website that I looked up claims in the past on. They were different dockets from all over the country of decisions that have already been rendered. How do I get back to that site. Thank you for the great work that you do

  2. Anne Go says:

    Thanks for sharing the links. BTW, if anyone needs to fill out a “ VA Form 21-8940”,I found a blank fillable form here:http://goo.gl/UJ4o02

  3. Leonard says:

    I was infected in 1976 through air gun, or one of the two Gama Globin shots I had, or in 1978 when I had surgery in Seoul Korea. I have never sniffed cocaine through a straw, or anything else. No other risk factors apply. The bottom line is; the Army killed my liver, and now my liver is killing me. My claim is filed, the VFW is my advocate, and the United States Government needs to take responsibility. They are asking me to file medical evidence that is under their nose. The VA diagnosed me last year, they sent me for a biopsy, and my service medical records (requested over a year ago) have still not arrived. I hope someone will grow a conscience, and do what is right.

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