Get Va 21-4192 2024-2025

The VA Form 21-4192 is a request for employment information related to a claim for disability benefits. This form is crucial for veterans seeking to substantiate their claims through employment history, and it is important to complete it accurately and thoroughly.

Follow the steps to fill out the VA 21-4192 online.

1. Click ‘Get Form’ button to obtain the form and open it for completion.
2. Begin by filling out Section I, which includes identification information. Complete the veteran's full name, social security number, date of birth, and VA file number if applicable. Ensure all details are accurate.
3. Proceed to Section II, which contains employment information. The employer will need to provide the beginning and ending dates of employment, type of work performed, amount earned during the last 12 months, and details about hours worked. Make sure to be precise.
4. Fill out Section III only if the veteran is currently serving in the Reserve or National Guard. Provide their current duty status and indicate any disabilities that may affect their military duties.
5. In Section IV, the employer needs to answer whether the veteran is receiving or entitled to any benefits as a result of their employment. Complete the necessary details about the type of benefits and gross monthly amounts.
6. Finally, ensure the employment representative signs and dates the form in Items 23A and 23B. This signature is crucial for validation.
7. After completing the form, carefully review all entries for accuracy. Users can then save changes, download, print, or share the completed form.

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