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  • Va Form 21-4192 - Veterans Benefits Network

Get Va Form 21-4192 - Veterans Benefits Network

Whitehouse. gov/omb/library/OMBINV. html VA. If desired you can call 1-800-827-1000 to get information on where to send comments or suggestions about this form. VA FORM JUL 2004 21-4192 SUPERSEDES VA FORM 21-4192 DEC 1994 WHICH WILL NOT BE USED. U.S. DOD Form dod-va-21-4192 OMB Approved No. 2900-0065 Respondent Burden 15 minutes REQUEST FOR EMPLOYMENT INFORMATION IN CONNECTION WITH CLAIM FOR DISABILITY BENEFITS SECTION I - IDENTIFICATION INFORMAT.

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What Is the Benefit Amount of Individual Unemployability? Individual Unemployability benefits are paid at a rate equivalent to a 100 percent disability rating, which is $3,621.95 per month for a single veteran as of December 2022. Veterans may receive additional monthly compensation for a spouse or dependent children.

To receive the resulting supplemental compensation, termed Individual Unemployability (IU) payments, disabled veterans must apply for the benefit and meet two criteria. First, they generally must be rated between 60 percent and 90 percent disabled.

For free help in completing this form, call VA toll-free at 1-800-827-1000. If you use a Telecommunications Device for the Deaf (TDD), the Federal number is 711. SUPERSEDES VA FORM 21-4192, SEP 2017.

Use VA Form 21-4192 if you're a Veteran and you need your most recent employer to send us information so you can apply for Individual Unemployability disability benefits. Your most recent employer must complete and submit this form.

When to use this form. Use VA Form 21-8940 if you want to apply for Individual Unemployability disability benefits for a service-connected condition that prevents you from keeping a steady job.

A 100% disability rating is the highest rating that the VA can assign and indicates that the veteran is totally disabled as a result of their service-connected disability. An individual unemployability designation means that the VA has determined that the veteran cannot work due to their service-connected disability.

What is the VA Form 21-4192? VA Form 21-4192: Request for Employment Information In Connection With Claim For Disability Benefits. Whenever a veteran decides to apply for a Total Disability Rating Based on Individual Unemployability (TDIU), they will need to complete a VA Form 21-8940.

If you can't work because of a disability related to your service in the military (a service-connected disability), you may qualify for what's called “Individual Unemployability.” This means you may be able to get disability compensation or benefits at the same level as a Veteran who has a 100% disability rating.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232