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  • Va Form 10 10163

Get Va Form 10 10163

REQUEST FOR AND PERMISSION TO PARTICIPATE IN SHARING PROTECTED HEALTH INFORMATION THROUGH HEALTH INFORMATION EXCHANGES By completing this form, you are authorizing VA to share your protected health.

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When you're an active, Guard and Reserve service member, and you leave military service, the Department of Defense (DoD) sends some information to the Department of Veterans' Affairs (VA). Depending on your health history and dates of service, the VA may access your DoD electronic health record.

The Veterans Benefits Administration (VBA) uses VA Form 21-4142, Authorization to Disclose Information to the Department of Veterans Affairs (VA), to request private medical records and information regarding the source of records in support of claims for compensation and/or pension benefits.

Use VA Form 21-526EZ when you want to apply for VA disability compensation (pay) and related benefits.

Use VA Form 10-5345 to authorize us to share your health information with a non-VA (or third-party) individual or organization.

VA disability pay for 2023 increased by 8.7%. The new disability compensation rates took effect on December 1, 2022. See the current VA disability pay chart, and calculate your monthly compensation.

Use VA Form 21-2680 to apply for Aid and Attendance benefits that will be added to your monthly compensation or pension benefits.

If you need help filing a disability claim, you can contact a VA regional office and ask to speak to a counselor. To find the nearest regional office, please call 800-827-1000 . An accredited representative, like a Veterans Service Officer (VSO), can help you fill out your claim.

When to use this form. Use VA Form 21-4138 when you want to submit a VA “buddy statement” or other statement from someone with firsthand knowledge of information you believe will help support your request for VA benefits.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
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