Get Va Form 21-4192 - Veterans Benefits Network

Completing the VA Form 21-4192 is a crucial step in the process of claiming veterans disability benefits. This guide will provide you with a comprehensive walkthrough of the form, helping you understand each section and fill it out accurately online.

Follow the steps to complete the form accurately and efficiently.

1. Select the ‘Get Form’ button to access the VA Form 21-4192 and open it for filling out.
2. Begin with Section I, which is pre-filled by the VA. Check that the employer details and veteran’s identification information are complete and accurate.
3. In Section II, ask the employer to fill out the employment information. This includes the employment start date, end date, and earnings details.
4. Request details about time lost due to disability and the type of work performed. Have them accurately indicate the hours worked both daily and weekly.
5. Inquire about any concessions made to the veteran by reason of age or disability. Ensure they provide reasons and dates related to termination of employment if applicable.
6. Fill out Section III regarding benefits. Confirm whether the veteran is entitled to any sick, retirement, or other employment-related benefits. If yes, gather information on the type and gross monthly amount of these benefits.
7. Have the employer or supervisor sign and date the form in Items 21A and 21B, ensuring that all responses are truthful and complete.
8. After completing the form, review all sections for accuracy. Save your changes, then you can download, print, or share the completed form as needed.

Start filling out the VA Form 21-4192 online today to expedite your veterans benefits application.