Redirecting to our new, updated website ...
VA Form | Description | Claimant |
---|---|---|
Non-Service-Connected Disability Pension Benefits | ||
21-22 | Appointment of Veterans Service Organization as Claimant's Representative | Veteran & Spouse |
21-4138 | Statement in Support of Claim (Housebound) | Veteran |
21-4138 | Statement in Support of Claim (Housebound) | Surviving Spouse |
21-4138 | Statement in Support of Claim (Nursing Home or Assisted Living) | Veteran |
21-4138 | Statement in Support of Claim (Nursing Home or Assisted Living) | Surviving Spouse |
21-526 | Veteran's Application for Compensation and/or Pension | Veteran |
21-534 | Dependency and Idemnity Compensation and Death Pension | Surviving Spouse |
21-8416 | Medical Expense Report | Veteran & Spouse |
21-4142 | Authorization and Consent to Release Information to the VA | Veteran & Spouse |
21-2680 | Examination For Housebound Status or Permanent Need for Regular A&A | Veteran & Spouse |
21-0779 | Request for Nursing Home Information in Connection with A&A | Veteran & Spouse |
Military Medals Request | ||
Records | Request for Military Medals & Awards | Veteran/Next of Kin |
Note: A veteran or surviving spouse filing for VA pension benefits should provide medical evidence and proof of income. Additionally, the VA requires a certified copy of the veteran's Report of Separation, a copy of the marriage license and death certificate. The Erie County Veterans Service Agency can assist veterans and their family in obtaining any military records. | ||
Service-Connected Disability Compensation Benefits | ||
21-22 | Appointment of Veterans Service Organization as Claimant's Representative | Veteran |
21-4138 | Statement in Support of Claim | Veteran |
21-0781 | Statement in Support of Claim for Service Connection for PTSD | Veteran |
21-0781a | Statement in Support of Claim for PTSD Secondary to Personal Trauma | Veteran |
21-526 | Veteran's Application for Compensation and/or Pension | Veteran |
21-4142 | Authorization and Consent to Release Information to the VA | Veteran & Spouse |
Note: Additionally, a veteran filing for a service-connected disability compensation with the VA should provide a copy of the Report of Separation (DD Form 214) and military medical evidence which supports the claim. | ||
Other VA Forms | ||
10-10EZ | VA Form 10-10EZ - Application for Medical Benefits (Enroll) | Veteran |
10-10EZR | VA Form 10-10EZR - Update Your Information | Veteran |
21-0792 | Fiduciary Statement in Support of Appointment | Veteran & Spouse |
ECVSA-1 | Mark/Witness Form - For Pension and Compensation Benefits | Veteran & Spouse |
SF 180 | Request for dd-214/discharge paperwork | |
80-11-01 | Federal Benefits Guidebook |
All documents listed above are in pdf format and require Adobe Acrobat/Reader to view and print.