VA Form 21-526EZ Application for Disability Compensation and Related Compensation Benefits

What Is VA Form 21-526EZ Used For?

The VA Application for Disability Compensation can be used to claim one of the following benefits:

• Disability service connection;
• Compensation claims submitted prior to discharge;
• Compensation under 38 U.S.C. 1151;
• Automobile allowance or adaptive equipment;
• Secondary service compensation;
• Temporary total disability rating;
• Special monthly compensation;
• Benefits for a veteran's seriously disabled child;
• Increased disability compensation;
• Individual unemployability ("Adapted Housing" and "Special Home Adaptation").

How to Fill Out VA Form 21-526EZ?

VA Form 21-526EZ instructions are as follows:

1. Start with selecting the claim program type.
2. Include your name, Social Security Number (SSN), VA number if any, date of birth, veteran service number, and gender, as well as your contact details in Section I ("Identification Information"). If the form is used for Benefits Delivery at Discharge (BDD), this section should include the date or anticipated date of release from active duty. Indicate your employment if you are a current VA employee.
3. If you anticipate a change of address, mention it in Section II ("Change of Address Information").
4. Section III ("Homeless Information") is filled out if you are homeless or at risk of being homeless. Otherwise, leave it blank.
5. List all your current disabilities and treatment facilities where you received treatment in Section IV ("Claim Information").
6. Include the branch and component of service, the most recent active service dates, whether you served in reserves or national guard, or are on active duty in Section V ("Service Data"). If you have served in a combat zone since 9/11/2001 or have ever been a prisoner of war, indicate it in this section.
7. Provide data about all military payments you receive, and whether you want to receive the VA compensation in lieu of military retired pay or training pay or not in Section VI ("Service Pay Information").
8. Section VII, Section VIII, Section IX, Section X, and Section XI are self-explanatory.

Not what you were looking for? Check out these related forms:

• VA Form 21-526, Veteran's Application for Compensation and/or Pension;
• VA Form 21-526B, Veteran's Supplemental Claim for Compensation;
• VA Form 21-526C, Pre-Discharge Compensation Claim.