VA Form 10-7959d CHAMPVA Potential Liability Claim

What Is VA Form 10-7959d?

This is a legal form that was released by the U.S. Department of Veterans Affairs on March 1, 2004 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is VA Form 10-7959d?
A: VA Form 10-7959d is known as the CHAMPVA Potential Liability Claim form.

Q: What does CHAMPVA stand for?
A: CHAMPVA stands for Civilian Health and Medical Program of the Department of Veterans Affairs.

Q: What is the purpose of VA Form 10-7959d?
A: The purpose of VA Form 10-7959d is to file a potential liability claim with CHAMPVA for reimbursement of medical expenses.

Q: Who should use VA Form 10-7959d?
A: This form should be used by individuals who are covered by CHAMPVA and wish to file a potential liability claim.

Q: What types of expenses can be claimed through VA Form 10-7959d?
A: Expenses related to medical care and services that are not covered by CHAMPVA can be claimed through this form.

Q: How should VA Form 10-7959d be submitted?
A: The completed form should be submitted to the CHAMPVA Claims Processing Center.

Q: Are there any deadlines for submitting VA Form 10-7959d?
A: Yes, claims must be submitted within one year from the date of service.

Q: Is there a fee for submitting VA Form 10-7959d?
A: No, there is no fee for submitting this form.

Q: Is VA Form 10-7959d only for residents of the United States?
A: No, this form can also be used by residents of Canada who are covered by CHAMPVA.