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va form 21 4138

VA 21-4138 2021-2024 free printable template

OMB Control No. 29000075 Respondent Burden: 15 minutes Expiration Date: 06/30/2024VA DATE STAMP (DO NOT WRITE IN THIS SPACE)STATEMENT IN SUPPORT OF CLAIM INSTRUCTIONS: Before completing this form,
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How to fill out va form 21 4138


How to fill out VA Form 21-4138:

Begin by downloading VA Form 21-4138 from the official Department of Veterans Affairs website or obtaining a physical copy from your local VA office.
Fill out the top section of the form, including your name, social security number, and contact information.
Provide details about the purpose of the form by explaining the issue or claim you are addressing. Be specific and concise in describing your concerns or requests.
Use additional pages if necessary to provide extra information. Clearly label each page with your name, social security number, and the page number.
Attach any supporting documents or evidence that may be relevant to your claim or issue. This can include medical records, letters, or other documents that support your case.
Sign and date the form. Ensure your signature matches the name provided at the top of the form.
Keep a copy of the completed form and supporting documents for your records.
Submit the form to the appropriate VA office, whether by mail or electronically, as indicated on the form's instructions.

Who needs VA Form 21-4138:

Veterans who wish to communicate specific concerns, claims, or requests to the Department of Veterans Affairs may need to fill out VA Form 21-4138.
Family members or representatives of veterans may also use this form to address issues on behalf of the veteran.
The form is utilized by individuals seeking to navigate the VA system, provide information, appeal decisions, or submit evidence related to their VA benefits or claims.
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What is the Statement in Support of Claim?

The Statement in Support of Claim (also known as form VA 21-4138) is used to support a claim for benefits from the Veterans Affairs department. It provides necessary personal claim to the department while they are evaluated your claim. This personal claim statement supports the veteran’s story, and gives the department an idea of any special case situations.

In one sentence, what is the purpose of submitting this form?

Veterans submit form VA 21-4138 to support their claim for veteran’s benefits.

What information do you need in order to complete this form?

Form VA 21-4138 is very straightforward -- it almost looks like a blank piece of paper. All you need to fill out the form is…

  • The first, middle, and last name of the veteran applying for benefits
  • The veteran’s social security number
  • The veteran’s VA file number
  • A handwritten statement in support of the particular claim the veteran is making
  • The veteran’s signature, and the date the document was signed
  • The veteran’s full address and daytime/evening phone numbers

The statement section is the most important part of your VA Form 21-4138. It must include a well written and thought out statement that supports ALL your claims. It’s a good idea to write a draft of your statement, and then go back to ensure that it includes a very detailed explanation, that it addresses all the required additional information the Department of Veteran's Affairs requires, and that it covers all of your claims. Once you’ve completed a first draft on scratch paper, you can either handwrite your explanation in the box or fill it out online.

Who is the intended recipient of this form?

This form is intended to be received by the Department of Veteran’s Affairs.

Video instructions and help with filling out and completing va form 21 4138
Instructions and Help about veterans disability claim form
When the va receives a claim for monthly tax-free disability benefits they need to evaluate this claim and give the applicant a disability rating that will define the amount of monthly compensation in order to collect more evidence the department of veterans affairs may request that you complete va form 21-4138 pdf filler provides you with an up-to-date fillable template that you can easily complete sign and submit online the 21-4138-va form includes just two pages a significant portion is allocated for your remarks so you won't spend much time filling it out start preparing the va form 21-4138 statement in support of claim by entering your name and date of birth indicating your veteran's social security number is optional according to the privacy act information at the bottom of the second page providing a social security number helps to ensure that this form is properly associated with your claim and refusal to provide it or any other person who knows about the veteran's disability to prove that the current conditions are connected with the military service once every field has been completed and checked off date and sign the va form 21-4138 statement in support of claim directly in the pdf filler editor then click done to save the changes you've made choose what you would like to do with your 21-4138 va form next print out the resulting document share it with anybody via email fax sms usps or shareable link send it out for signature save it to your device convert it into a template or continue editing your document online give pdf filler a try and start saving your time and resources today.


  • What is va form 21 4138?
    VA Form 21-4138, Statement in Support of Claim, is used by veterans to provide additional evidence and information in support of their claim for benefits from the U.S. Department of Veterans Affairs (VA). The form is used to provide details related to the veteran's claim, such as the dates of service, type of injury or illness, and any evidence or documents that support the claim.
  • Who is required to file va form 21 4138?
    VA Form 21-4138 is used to provide evidence in support of a benefit claim. It is most commonly filed by veterans or their surviving spouses.
  • How to fill out va form 21 4138?
    To fill out VA Form 21-4138, start by entering your name and service number at the top of the form. Then, describe the issue you're appealing in the first section. You will need to provide details about the issue and why you're appealing the decision. In the second section, you'll need to provide information about any supporting documents you're submitting with your appeal. This may include medical records, witness statements, or other evidence that supports your appeal. In the third section, you'll need to describe why you believe the decision should be overturned. This section should include detailed information about why the decision is incorrect and how it should be changed based on the evidence you have provided. Finally, you'll need to sign and date the form. Once you have completed the form, you can submit it to the VA.
  • What is the purpose of va form 21 4138?
    VA Form 21-4138 is used to provide information to a Veteran's claim for service-connected disability compensation or pension benefits. It is used to provide evidence of a current disability or illness that is related to military service. The form must be completed by a doctor or other healthcare provider and must include a diagnosis, prognosis, treatment, and any other relevant information.
  • What information must be reported on va form 21 4138?
    VA Form 21-4138 is used to provide evidence of a claimant's service-connected disability status and is used for various purposes, including filing for disability benefits and appealing a denial of benefits. The information required on the form includes the veteran's name, Social Security number, branch of service, dates of service, and a description of the claimed disability or disabilities. Additionally, the form may require additional information, such as medical records, to support the claim.
  • When is the deadline to file va form 21 4138 in 2023?
    The deadline to file VA Form 21-4138 in 2023 is December 31, 2023.
  • What is the penalty for the late filing of va form 21 4138?
    The penalty for late filing of VA Form 21-4138 is a monetary fine, which is determined by the amount of time the form is late. The fine can range from $1 to $100 per day, depending on the amount of the claim.
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