Search results
12 paź 2024 · Form name: Request for Employment Information in Connection with Claim for Disability Benefits. Use VA Form 21-4192 if you’re a Veteran and you need your most recent employer to send us information so you can apply for Individual Unemployability disability benefits.
- Veterans Affairs
Use VA Form 21-8940 if you want to apply for Individual...
- VA Form 21-8940
You can locate the address of the nearest SSA office at...
- Veterans Affairs
20 wrz 2024 · Use VA Form 21-8940 if you want to apply for Individual Unemployability disability benefits for a service-connected condition that prevents you from keeping a steady job. Download VA Form 21-8940 (PDF)
You can locate the address of the nearest SSA office at https://secure.ssa.gov/ICON/main.jsp or call 1-800-772-1213 (Hearing Impaired TDD line 1-800-325-0778). You may also contact SSA by Internet at http://www.ssa.gov/. SECTION I - VETERAN IDENTIFICATION INFORMATION.
3 maj 2024 · You’ll need to submit both of the forms listed here. A Veteran’s Application for Increased Compensation Based on Unemployability (VA Form 21-8940) Get VA Form 21-8940 to download; and. A Request for Employment Information in Connection with Claim for Disability Benefits (VA Form 21-4192) Get VA Form 21-4192 to download
For free help in completing this form, call VA toll-free at 1-800-827-1000. If you use a Telecommunications Device for the Deaf (TDD), the Federal number is 711.
13 kwi 2023 · The VA Form 21-4192 is a VA request for employment information from your most recent employer. It’s typically submitted alongside a few other forms when a veteran wants to file a VA unemployability claim, also known as Total Disability Individual Unemployability (TDIU).
25 maj 2019 · Once a veteran submits VA Form 21-8940, VA will send a notice indicating they have received the TDIU application. VA will then send out VA Form 21-4192 , the Request for Employment Information in Connection with Claim for Disability Benefits, to each former employer listed on the TDIU Form 21-8940.
