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  • Note: Please Read The Privacy Act And Respondent Burden Below Before Completing The Form

Get Note: Please Read The Privacy Act And Respondent Burden Below Before Completing The Form

NSION AND/OR DIC (This Form Is Used to Notify VA of Your Intent to File for the General Benefit(s) Checked Below) NOTE: Please read the Privacy Act and Respondent Burden below before completing the form. SECTION I: CLAIMANT/VETERAN IDENTIFICATION NOTE: You can either complete the form online or by hand. If completed by hand, print the information requested in ink, neatly and legibly to expedite processing of the form. 1. CLAIMANT'S NAME (First, Middle Initial, Last) 2. CLAIMANT'S SOCIAL SECU.

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How to use or fill out the NOTE: Please read the Privacy Act and Respondent Burden below before completing the form online

Filling out the Intent to File a Claim for Compensation and/or Pension form can be a straightforward process when approached with clear guidance. This guide provides step-by-step instructions tailored to help you navigate the online version of the form effectively.

Follow the steps to fill out your form online.

  1. Click the ‘Get Form’ button to access the form and open it in your browser.
  2. Begin by filling out Section I, which requires you to provide identifying information for the claimant and veteran, such as names, social security numbers, and contact information. Ensure that the details are accurate and legible.
  3. In Section II, select one or more general benefits you intend to file for by checking the appropriate boxes. Make sure to choose all that apply, as this allows for an efficient application process.
  4. Proceed to Section III, where you will declare your intent to apply for the chosen benefits. Remember to read the acknowledgment statements carefully and provide your signature and date.
  5. Once all sections are completed, review the form thoroughly to ensure all information is correct. If necessary, make adjustments before finalizing your submission.
  6. Finally, save your changes, and you may choose to download, print, or share the form, ensuring you keep a copy for your records.

Start completing your documents online today to expedite the claims process.

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Use VA Form 21-22 when you want to have a Veterans Service Organization (VSO) help you with VA benefits or claims.

Fill out the Decision Review Request: Higher-Level Review (VA Form 20-0996). Bring your completed form to a VA regional office near you. You can also ask a regional benefit office for a copy of this form. Or call us at 800-827-1000 (TTY: 711) to request a form.

One status that may signify approval of an appeal is “We are correcting an error.” This is a good sign for a Veteran because it means that mistakes were made on the VA's part and not on the Veteran's part.

IMPORTANT: This form is ONLY used to request military records or a veteran's benefit records. INSTRUCTIONS: Read the Privacy Act and Respondent Burden information on Page 4 before completing the form.

USE THIS FORM TO REQUEST A HIGHER-LEVEL REVIEW OF A DECISION YOU RECEIVED. A Higher-Level Review is a new review of an issue(s) previously decided by the Department of Veterans Affairs (VA) based on the evidence of record at the time VA issued notice of the prior decision.

The VA Evidence Intake Center functions as a centralized mail processing center for all veteran disability claims. Instead of sending any of your important documents to a regional office, you'll send them to the EIC. The VA established the EIC to make the disability claims process much more efficient.

Use this form to request a Higher-Level review of the decision you received by the Department of Veterans Affairs based on the evidence of record at the time VA issued of the prior decision.

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