How To Complete VA Form 21-0966: Intent To File

Why Submit An Intent To File?

When a veteran has decided to pursue a claim within the VA disability system, but does not yet have enough evidence to yield a favorable result for their claim, they can file an intent to file via VA Form 21-0966 to preserve the effective date of their claim. By filing an intent to file, the veteran has one additional year to gather evidence before they must submit their initial disability claim. When that initial claim is decided, the effective date for any compensation awarded will be the date the intent to file was submitted. An intent to file can also protect the veteran’s earliest possible effective date because it allows the VA to extend the effective date back to the veteran’s date of diagnosis of their condition if the VA Form 21-0966 is filed within one year of the diagnosis date.  

Filling Out VA Form 21-0966

Section I: Claimant/Veteran Identification

In this section you will provide some personal information. You will need to include your name, Social Security Number, VA file number, veteran’s date of birth, veteran’s name (if different from claimant), veterans Social Security Number, veteran’s biological sex, veteran’s service number, current mailing address, telephone number, email address, and mark if you have ever filed a claim with the VA.

Section II: General Benefit Election

In this section, you will include information on the general benefits you intend to file for by selecting one or more of the following selections: 

  • Compensation
  • Pension
  • Survivors pension and/or Dependency and Indemnity Compensation (DIC)
    • You should only check this option if you are the surviving dependent of the veteran.

Section III: Declaration Of Intent

In this section, you will sign and date the form to authorize it. Your intent to file is now ready to submit to the VA.

Help With Your Initial VA Claim

For first time applicants, the VA disability claims system can be overwhelming. If you are a veteran seeking assistance with your initial VA claim, please contact our office today. We help veterans file initial claims pro-bono and are ready to help you get the compensation you are entitled to.