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Oct 27, 2023 · Last updated: October 27, 2023. Feedback. Get VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits. Use this VA claim form to apply for VA disability compensation (pay) or related benefits such as housing or compensation for your spouse.
You do not need to submit another application. If you are filing a new claim or a claim for increased disability compensation for an evaluation decided more than one year ago ... please complete and submit VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits.
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May 15, 2024 · File your claim by mail using an Application for Disability Compensation and Related Compensation Benefits (VA Form 21-526EZ). Get VA Form 21-526EZ to download. Print the form, fill it out, and send it to this address: Department of Veterans Affairs Claims Intake Center PO Box 4444 Janesville, WI 53547-4444.
- You must:
- Standard Claim Process
- You are strongly encouraged to:
- You must:
- 3. HOW VA WILL HELP YOU OBTAIN EVIDENCE FOR YOUR CLAIM
- VA will:
- 4. WHERE TO SEND INFORMATION AND EVIDENCE
- 5. WHAT THE EVIDENCE MUST SHOW TO SUPPORT YOUR CLAIM
- Disability Service Connection
- To support a claim for service connection based upon a period of active duty for training, the evidence must show:
- To support a claim for service connection based upon a period of inactive duty training, the evidence must show:
- Secondary Service Connection
- Increased Disability Compensation
- In order to support a claim for an extra-scheduler evaluation based on exceptional circumstances, the evidence must show:
- Specially Adapted Housing or Special Home Adaptation
- VETERAN/SERVICEMEMBER CERTIFICATION AND SIGNATURE
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Submit all relevant private treatment records, if they exist Identify any relevant treatment records available at a Federal Facility, such as a VA medical center Identify the location and sufficient information to obtain your National Guard and Reserve personnel and service treatment records (if applicable) If your claim involves a disability tha...
If you know of evidence not in your possession and want VA to try to get it for you;
• Send any information or evidence as soon as you can You have up to one year from the date we receive the claim to submit the information and evidence necessary to support your claim. If within 30 days, you do not provide any evidence or do not provide us with the information needed to assist you with obtaining evidence, we may decide your clai...
• Send the information and evidence identified in the "Special Circumstances" table below at the same time as your claim
The table below describes the information and evidence VA will assist you in obtaining based on whether you wish to have your claim considered in the FDC Program (Optional Expedited Process) or in the Standard Claim Process. FDC Program (Optional Expedited Process)
Retrieve relevant records from a Federal facility, such as a VA medical center, that you adequately identify and authorized VA to obtain Provide a medical examination for you, or get a medical opinion, if we determine it is necessary to decide your claim VA will: Retrieve relevant records from a Federal facility, such as a VA medical center, that...
You may send your application and any evidence in support of your claim by using any of the following methods shown in the table below.
The table below provides a guide to the evidence tables showing what evidence you must provide to support your claim.
To support a claim for service connection, the evidence must show: You had an injury in service, or a disease that began in or was made permanently worse during service, or there was an event in service that caused an injury or disease; AND You have a current physical or mental disability. This may be shown by medical evidence or by lay evidence ...
You were disabled during active duty for training due to disease or injury incurred or aggravated in the line of duty; AND You have a current physical or mental disability. This may be shown by medical evidence or by lay evidence of persistent and recurrent symptoms of disability that are visible or observable; AND There is a relationship between...
You were disabled during inactive duty training due to an injury incurred or aggravated in the line of duty or an acute myocardial infarction, cardiac arrest, or cerebrovascular accident during inactive duty training; AND You have a current physical or mental disability. This may be shown by medical evidence or by lay evidence of persistent and re...
To support a claim for compensation based upon an additional disability that was caused or aggravated by a service-connected disability, the evidence must show: You currently have a physical or mental disability shown by medical evidence or by lay evidence of persistent and recurrent symptoms of disability that are visible or observable, in additio...
If VA previously granted service connection for your disability and you are seeking an increased evaluation of your service-connected disability, we need medical or lay evidence to show a worsening or increase in severity and the effect that worsening or increase has on your ability to work. EVIDENCE TABLES (Continued)
• That your service-connected disability or disabilities present such an exceptional or unusual disability picture, due to such factors as marked interference with employment or frequent periods of hospitalization, that application of the regular schedular standards is impractical.
To support your claim for specially adapted housing (SAH), the evidence must show you are a: Veteran entitled to compensation under 38 U.S.C. Chapter 11 for a permanent and totally disabling qualifying condition; OR Servicemember on active duty who has a permanent and totally disabling qualifying condition incurred or aggravated in the line of duty...
certify and authorize the release of information. I certify that the statements in this document are true and complete to the best of my knowledge. I authorize any person or entity, including but not limited to any organization, service provider, employer, or government agency, to give the Department of Veterans Affairs any information about me. Fo...
SECTION XI: POWER OF ATTORNEY (POA) SIGNATURE (NOTE: POA'S CANNOT SIGN FOR AN ORIGINAL CLAIM ONLY)
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Apr 24, 2023 · Form 21-526EZ is used to initiate a claim for disability compensation and to provide information about the veteran’s medical conditions, military service history, and other relevant details. Some of the key purposes of Form 21-526EZ include:
Feb 28, 2024 · Steps for VA Form 21-526: Obtain the Form: The form can be downloaded from the VA website or obtained from a VA office. Complete the Form: Fill out the form with all the required information, including details about military service and the nature of the disability.
