Applying For VA Disability Compensation: VA Form 21-526ez

VA Form 21-526ez: Application For Disability Compensation And Related Compensation Benefits

Any veterans interested in receiving VA disability benefits first need to complete a VA Form 21-526ez to begin their claim. On this form, veterans will provide information regarding their service, what disability they are claiming service connection for, how the condition is related to their military service, and more. VA Form 21-526ez can be completed on paper or online through the veteran’s account.

Given the volume of information required on this form, having a step by step guide for filling it out can be extremely helpful. For that reason, we have put together the information below for any veteran interested in applying for VA disability benefits. Additional help can be found at the VA website here. If you have any questions regarding this guide or your claim, feel free to contact us.

Completing VA Form 21-526ez

Section 1 – Identification And Claim Information

In this section, veterans will provide their personal information and any existing information about their claim (if they are not completing an original application). The information requested will include their name, Social Security Number, VA file number, date of birth, veteran’s service number (if applicable), biological sex, anticipated date of release from active duty (BDD claims only), phone number, current mailing address, and email.

Section 2 – Change Of Address

If the applicant is temporarily or permanently changing his or her address, he or she needs to include details about the new address and the dates he or she will be living there.

Section 3 – Homeless Information

In this section, veterans will provide information on their housing status, specifically regarding whether or not they are homeless. If they are homeless, veterans need to provide the type of accommodations in which they are currently living, such as a shelter or living with a friend. If they are not homeless but are at risk of becoming homeless, veterans should check Yes to the question in box 15C. In box 15D, they should then indicate the status of their living situation, i.e. why they are at risk of homelessness. In boxes 15E and 15F, the veteran will need to provide contact information for his or her point of contact, a person the VA can contact to get in touch with the veteran in the absence of a formal mailing address.

Section 4 – Claim Information

In this section, veterans will list the current disability(ies) or symptoms that they claim are related to their military service and/or their service-connected disability. In row 1 of table 16, the veteran will name the disability/symptom. Moving to the right from that box, he or she will input the exposure type, how the disability relates to the in-service event/exposure/injury, and the approximate date the disability began or worsened in each box in that row. The veteran will then continue down the table and complete each row as necessary depending on the number of disabilities the veteran is claiming. 

In table 17, veterans will need to list the VA Medical Centers (VAMC) and Department Of Defense (DOD) military treatment facilities where they received treatment after discharge for their claimed disability(ies) listed in table 16. In column 17A, they will need to enter the disability treated and name/location of the treatment facility. In the adjacent box of column 17B, they will need to provide the approximate dates of treatment, or check the box in column 17C if they do not know the approximate dates of their treatment.

Section 5: Service Information

For section five, veterans will need to provide information about their military service.

  • Boxes 18A-B both regard the veteran’s name. In the event the veteran served under a different name than the one he or she currently has, the veteran will need to provide that name.
  • Boxes 19A-B ask for information about the veteran’s branch of service (army/navy/marine corps/air force/coast guard/space force) and component of service (active/reserves/national guard). 
  • Boxes 20A-D require information regarding dates of service and whether or not the veteran served in a combat zone post 9/11. 
  • Boxes 21A-F ask for information regarding the veteran’s reserves or national guard service. If the veteran did not serve in the reserves or national guard, he or she can skip to item 22A. 
  • Boxes 22A-C ask if the veteran is currently on active orders with the national guard or reserves, and for the dates of that activation. 
  • Boxes 23A-B ask for information about the veteran’s status as a prisoner of war, and if he or she was a prisoner of war, the dates of that confinement.

Section 6 – Service Pay (Retired Pay, Separation Pay, and Disability Severance Pay)

  • Boxes 24A-D of this section require that the veteran provide information regarding whether he or she receives(ed) military retirement pay, if they will receive it in the future, what branch of service they will receive it from, and the monthly amount of that pay. 
  • Box 25 asks for the veteran’s retired status, with the options of retired, permanent disability retired list, and temporary disability retired list. If the veteran is not retired, he or she need not fill out this box. 
  • Box 26 will ask the veteran if he or she would like to forego receiving VA disability compensation because it could reduce his or her retired pay. It should be noted that the retired pay will only be reduced by an amount equal to the VA compensation awarded. 
  • Boxes 27A-D request information on separation/severance pay the veteran may have received from his or her branch of service upon discharge.
  • Box 28 discusses inactive duty training pay. If the veteran checks the box in item 28, the VA will retroactively adjust their VA award to withhold benefits equal to the total number of training days waived at the monthly rate in effect for the fiscal year period for which the veteran received training pay. 

Section 7 – Direct Deposit Information

In this section, the veteran will enter his or her direct deposit information so the VA can pay benefits directly to his or her account. This information includes the veterans account number, name of the financial institution, and the routing number. If the veteran does not have an account with a formal financial institution or certified payment agent, he or she should check item 29 at the top of the section.

Sections 8 through 11 – Claim Certification And Signature

Here, the veteran will sign and date the document to authorize it for review by the VA. If the veteran is required to have witnesses to his or her signature, or must have his or her alternate signer or power of attorney sign the document, those signatures must be collected in sections 9 through 11, respectively.

Help With Your Initial Veterans Disability Benefits Claim

If you are seeking assistance in applying for VA disability benefits, please contact our office today. Our experienced veterans disability attorneys are ready to assist you in getting the compensation you are entitled to.