Facing a service-connected disability and its impact on your daily life can be incredibly challenging, but you’re not alone. The Department of Veterans Affairs (VA) offers disability compensation and other benefits to help.
One important step in claiming these benefits is understanding and completing VA Form 21-526EZ. This guide walks you through everything you need to know about this form so you can confidently pursue the support you deserve.
What is VA Form 21-526EZ for?
VA Form 21-526EZ, titled “Application for Disability Compensation and Related Compensation Benefits,” is how veterans like you can apply for disability compensation benefits from the VA. These benefits can provide much-needed financial assistance if your service-connected disability affects your day-to-day activities and quality of life.
Here’s a breakdown of some of the benefits you can apply for using VA Form 21-526EZ:
- Disability compensation: This provides monthly payments to veterans with service-connected disabilities.
- Additional benefits for Veterans with certain disabilities: VA Form 21-526EZ can also help you qualify for additional benefits beyond disability compensation, such as aid and attendance or housebound allowances, depending on your specific disability.
Why else would you use VA Form 21-526EZ?
In addition to applying for disability compensation benefits, VA Form 21-526EZ can be used to:
- Request an increase in your current disability rating: If your condition has worsened since your last rating decision, you can use VA Form 21-526EZ to request an increase in your disability rating.
- Provide updated information or evidence: If your condition has worsened, you can use VA Form 21-526EZ to submit evidence to support your claim.
- Apply for Special Monthly Compensation (SMC): Veterans and surviving spouses or parents who require aid and attendance of another person for everyday living activities due to a service-related disability can use VA Form 21-526EZ to apply for Special Monthly Compensation (SMC).
Who should use VA Form 21-526EZ?
Not sure if you qualify to use VA Form 21-526EZ? To be eligible, you must have served on active duty, active duty for training, or inactive duty training and have an illness or injury that impacts your ability to function in daily life and is related to your military service.
You must also be able to say one of the following statements:
- I got sick or injured while serving in the military, and I can prove that my illness or injury is connected to my military service.
- I had an existing condition that was worsened by my military service.
- I have a service-connected disability that developed after I left the military.
If you have a presumptive condition, you do not need to prove a direct connection between your disability and military service.
How to Fill Out VA Form 21-526EZ
Filling out VA Form 21-526EZ accurately is crucial for a successful claim. The form has 13 sections and requires detailed information about your personal details, military service, disability or medical condition, employment history, and supporting documentation or evidence.
Here’s some information on how to fill out VA Form 21-526EZ:
Sections I-III: Identification and Background
- Section I (Veteran’s Identification Information): Fill in your full name, date of birth, Social Security number, and contact information.
- Section II (Change of Address): Update your mailing address if it differs from your service records.
- Section III (Homeless Information): Only complete this section if you are homeless or at risk of homelessness.
Section IV: Exposure Information
This section focuses on potential exposure to toxins during your service.
- Carefully review the listed exposures and check any that apply based on your service records.
- Having service records detailing your deployment locations and dates is an important part of filling out this section accurately.
Section V: Claim Information
This is the core section where you detail your current disability and its connection to your military service.
- Describe your disability: Explain the nature of your disability and how it impacts your daily life.
- Establish service connection: Explain how your disability relates to your military service. Be specific and mention any relevant events, injuries, or exposures.
- Provide key dates: Indicate the approximate date your disability began or worsened, and any relevant exposure dates.
- Treatment history: If you’ve received treatment, list the facilities and dates. If you haven’t, check the appropriate box.
Sections VI & VII: Service Information and Pay
- Section VI (Service Information): Provide details about your military service, including branch, service number, enlistment and discharge dates, and POW status if applicable.
- Section VII (Service Pay): Complete this section only if you receive military retired, separation, or severance pay.
Section VIII: Direct Deposit (Optional)
- This section allows you to set up direct deposit for your benefits if your claim is approved. You’ll need your bank account number, routing number, and bank name.
Sections IX-XI: Signing and Representation
- Section IX (Claim Certification and Signature): Review the information carefully. Sign and date the form with ink to certify its accuracy.
- Section X (Witness to Signature): If you cannot sign yourself, have two witnesses observe you making an “X” and sign this section with their contact information.
- Section XI (Alternate Signer Certification and Signature) This section is only needed if you cannot sign and don’t have witnesses. You must submit a separate VA Form 21-0972 designating an authorized alternate signer (e.g., legal representative, guardian) who will sign this section.
Section XII: Power of Attorney (Optional)
- If you have legal representation assisting you with your claim, your attorney will complete this section with their signature. A designated representative can sign the form on the your behalf, but only if the VA has been properly notified of this designation beforehand through the designated forms.
Section XIII: Claim Information (Addendum)
- Use this section if you have additional disabilities not listed in Section V. Briefly describe them and their impact on your life.
Important Tips:
- Read each section thoroughly before filling it out.
- Be clear, concise, and truthful in your explanations.
- Use an addendum if you need more space for details.
Submitting VA Form 21-526EZ
Once you’ve completed the form and gathered your documentation, you have a few options for submitting your application to the VA:
- Online: Submit your completed application and supporting documents via VA.gov.
- Mail: Send your completed application and supporting documents to the appropriate VA regional office.
- In-Person: Certain VA regional offices accept applications in person. Check with your local office for specific details.
