NOTICE TO VETERAN/CLAIMANT OF VA FORMS THAT MAY ACCOMPANY AN ALTERNATE SIGNER CERTIFICATION FORMIMPORTANT: The form(s) shown below will be accepted along with the attached VA Form 210972, Alternate.
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How to fill out the 21-0972. Alternate signer certification online
Filling out the 21-0972, Alternate Signer Certification, is an essential step for individuals signing benefit applications on behalf of veterans or claimants. This guide provides clear, concise steps to ensure accurate completion of the form online, helping facilitate the claims process.
Follow the steps to successfully complete the form online.
- Click ‘Get Form’ button to access the form and open it in your preferred editor.
- Begin by filling in the veteran's identification information in Section I. Provide the veteran's name, social security number, date of birth, VA file number (if applicable), and service number (if applicable). Ensure all entries are legible and complete.
- In Section II, enter the claimant's identification information if the claimant is other than the veteran. This includes the claimant's name, social security number, mailing address, relationship to the veteran, preferred telephone number, and email address.
- Continue to Section III, where you will fill in the alternate signer’s identification information. Input the signer’s name, mailing address, preferred telephone number, email address, and relationship to the veteran or claimant. Ensure to check at least one box to indicate the relationship.
- In Section IV, indicate whether the veteran or claimant falls under specific categories, such as being under 18 years of age or mentally incompetent. Check all that apply.
- Proceed to Section V to complete the alternate signer’s declaration of intent. The alternate signer must signature and date the form at the designated areas.
- Review the entire form for accuracy and completeness before submitting it. Ensure all necessary supporting documents are attached that correspond to the claim being made.
- Finally, save your changes. You can download, print, or share the completed form as needed.
Complete your documents online to ensure a smooth application process.
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What is the VA Form 21 0172 certification of permanent and total disability?
If the Department of Veterans Affairs (VA) certifies that you are permanently and totally disabled, you can use VA Form 21-0172 instead of the physician's statement. VA Form 21-0172 must be signed by a person authorized by the VA to do so. You can get this form from your local VA regional office.
What is VA Form 21 0172?
Under an agreement with the IRS, the IRS will accept a VA certification on VA Form 21-0172, Certification of Permanent and Total Disability, based solely on an existing rating of permanent and total disability in place of the required private physician's statement, if the form is completed and signed by a member of the ...
Is the third signature required for VA back pay?
The third signature is required only if the award grants initial, increased or resumed benefits for a retroactive period of more than two years.
What is VA Form 21 0972?
VA Form 21-0972 will be used to collect the alternate signer information necessary for VA to accept benefit application forms signed by individuals on behalf of Veterans and claimants. The information collected will be used to contact the alternate signer for verification purposes.
How do I get 100% VA disability total and permanent?
To be eligible for permanent and total disability (P&T) compensation, a veteran must be affected by a service-connected disability that is both “total” and “permanent.” To warrant a permanent and total disability rating, the veteran must have a condition that is fully disabling and does not show signs of improvement.
What is the VA form for total and permanent disability?
Use VA Form 21-526EZ when you want to apply for VA disability compensation (pay) and related benefits.
What is an alternate signer?
Note: For purposes of this form, the individual signing the form on behalf of the veteran/claimant is referred to as the "alternate signer." Your accurate and complete answers to the questions on this form are important to help VA complete the veteran/claimant's claim.
What is the difference between TDIU and permanent and total disability?
The main difference between the two is that with TDIU, a Veteran has been deemed unemployable even though their service-connected disabilities do not add up to 100% overall. Being rated at 100% overall, however, does not necessarily restrict a Veteran from obtaining and securing substantially gainful employment.
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