VA Form 21-526EZ is the application the U.S. Department of Veterans Affairs (VA), through the Veterans Benefits Administration, uses for claims for veterans' disability compensation and related compensation benefits. Veterans and active duty service members use it for a new claim or for an increased-evaluation claim on a decision made more than one year ago. On FillingPDF you can fill out the form online and download or print the completed PDF; the VA publishes the original at vba.va.gov, and the claim itself is sent through VA's own channels described below.
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What is 21-526EZ?
VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits, is the Department of Veterans Affairs form used to claim veterans' disability compensation and related benefits, such as service connection, increased compensation, individual unemployability and special monthly compensation.
The PDF has two parts. Pages 1 to 8 are the Notice to Veteran/Service Member of Evidence Necessary to Substantiate a Claim, which explains the Fully Developed Claim (FDC) Program, the Standard Claim Process, the evidence each type of claim needs, and how VA sets effective dates and disability ratings. Pages 9 to 15 are the application itself, with Sections I to XIII: identification, change of address, homeless information, exposure information, claim information, service information, service pay, direct deposit, certification and signatures, and an addendum for more claimed conditions.
The form covers claims such as disability service connection, presumptive and secondary service connection, increased compensation, temporary total disability ratings, compensation under 38 U.S.C. 1151, Specially Adapted Housing or Special Home Adaptation, auto allowance and benefits for a seriously disabled child. The printed revision is JAN 2026, which supersedes the NOV 2022 edition. It carries OMB Control No. 2900-0747.
It is not the form for every VA request. Supplemental claims use VA Form 20-0995, pension claims use VA Form 21P-527EZ, and survivor benefits use VA Form 21P-534EZ.
Who needs to file 21-526EZ?
Veterans and service members filing a new claim for VA disability compensation or related compensation benefits use this form. So do those filing a claim for increased disability compensation on an evaluation decided more than one year ago. Active duty service members can also file through the Benefits Delivery at Discharge (BDD) program, if they meet its criteria, by selecting the BDD option in Item 1.
Do not use this form in these cases:
- You disagree with an evaluation decided within the past year and have new and relevant evidence, or you are filing a supplemental claim: use VA Form 20-0995, Decision Review Request: Supplemental Claim.
- You are claiming veterans non service-connected pension: use VA Form 21P-527EZ, Application for Pension.
- You are claiming survivor benefits: use VA Form 21P-534EZ, Application for DIC, Death Pension, and/or Accrued Benefits.
If your claim is not an original claim, the form says only Section I, Section IV (if applicable), Section V and a signature are required.
Someone else may sign only in set cases. An alternate signer (for example a court-appointed representative or a person responsible for the claimant's care) signs in Section XI only if Item 33A is blank, and a valid VA Form 21-0972 must be of record or attached. A power of attorney signs in Section XII, cannot sign for an original claim, and needs a valid VA Form 21-22 or 21-22a on record.
When to file 21-526EZ
File VA Form 21-526EZ when you are making a new claim for disability compensation or related benefits, or a claim for increased compensation on an evaluation decided more than one year ago. The form prints no filing deadline of its own.
Active duty service members in the BDD program must be within 90 to 180 days of discharge and available to report for examinations for 45 days after submitting the claim. The form encourages filing as close to the 180-day mark as possible. Claims received with less than 90 days left on active duty are processed under the standard claim process, the FDC program or another qualifying program.
Under the Standard Claim Process you have up to one year from the date VA receives the claim to submit the evidence needed to support it. Under the FDC Program you send the evidence with the claim; evidence sent later moves the claim to the Standard Claim Process. For the effective date, if VA receives the claim before or within one year of your separation, entitlement runs from the day after separation, as long as the disability was present then.
Documents you need
- VA Form 21-4142 and VA Form 21-4142a: complete both under the Standard Claim Process if you want VA to request private medical records for you. VA Form 21-4142 is also required if you were treated at a Veterans Center.
- VA Form 21-686c: required if you are claiming dependents. Add VA Form 21-674 if you claim a child in school between the ages of 18 and 23.
- Relevant private medical treatment records for a seriously disabled (helpless) child: required if you are claiming benefits for that child.
- VA Form 21-8940 (and VA Form 21-4192, per the application's attachment list): required if you are claiming Individual Unemployability.
- VA Form 21-0781: required if you are claiming any mental health condition(s).
- VA Form 26-4555: required if you are claiming Specially Adapted Housing or Special Home Adaptation.
- VA Form 21-4502: required if you are claiming auto allowance.
- VA Form 21-2680, or VA Form 21-0779 if the claim is based on nursing home attendance: required if you or your spouse claim Aid and Attendance.
- FDC Program: all relevant private treatment records, if they exist, plus the location and information needed to obtain National Guard and Reserve personnel and service treatment records, if applicable.
- BDD claims: a completed Separation Health Assessment - Part A Self Assessment and copies of service treatment records for the current period of service.
- VA Form 21-0972, Alternate Signer Certification: required if an alternate signer signs in Section XI and none is already of record.
- VA Form 21-22 or VA Form 21-22a: must be of record for a power of attorney's signature in Section XII to be accepted.
How to fill out 21-526EZ
Choose the claim process
In Item 1, select FDC PROGRAM, STANDARD CLAIM PROCESS, IDES (only if your military service department referred you) or BDD Program Claim (only if you meet the BDD criteria).
Enter your identification
Section I: Item 2 name, Item 3 Social Security Number, Item 4 whether you have ever filed a claim with VA (with the VA file number in Item 5 if YES), Item 6 date of birth in MM-DD-YYYY, and Item 7 service number or DOD ID number if applicable. BDD claims also give the date or anticipated date of release from active duty in Item 8.
Add contact details
Enter your telephone number (Item 9, optional) and current mailing address (Item 10). Item 11 email is optional and includes your agreement to electronic correspondence from VA. Check Item 12 only if you are a VA employee.
Report any change of address
Complete Items 13A to 13C only if your address is changing: check TEMPORARY or PERMANENT, enter the new address, and give the beginning date (and ending date if temporary).
Answer homeless information if it applies
Complete Items 14A to 14F only if you are currently homeless or at risk of becoming homeless, including your living situation and a point of contact VA can use to reach you. Otherwise skip to Section IV.
Describe toxic exposures
Item 15A asks whether you claim conditions related to toxic exposures. If YES, complete 15B (Gulf War hazard locations), 15C (herbicide locations), 15D (other exposures) and 15E (additional dates and locations), giving dates as MM-YYYY.
List your claimed conditions
In Item 16, list each current disability or symptom, the exposure, event or injury involved, how the disability relates to service, and the approximate date it began or worsened. Use Section XIII, the addendum, if you need more space.
List treatment facilities
In Item 17, give the disability treated, the name and location of each VA medical center or DOD military treatment facility, and the treatment start date (MM-YYYY). Treatment beginning from 2005 to present does not need dates in Item 17B.
Complete service information
Section VI: Items 18A and 18B for other names served under, 19A and 19B branch and component, 20A to 20D service dates, combat zone service and separation place, 21A to 21F Reserve or National Guard details, 22A to 22C federal activation, and 23A and 23B prisoner of war confinement.
Report service pay
Section VII: Items 24A to 25 for military retired pay, Items 27A to 27D for separation or severance pay. Read the retired pay and training pay notices before checking Item 26 or Item 28.
Enter direct deposit information
Section VIII: skip it if you already signed up. Otherwise check Item 29 if you have no account, or give account number and type (Item 30), the financial institution (Item 31) and the routing number (Item 32).
Sign and date the form
Sign Item 33A and enter the date in Item 33B (MM-DD-YYYY). Witnesses sign Items 34 and 35 only if you signed with an "X"; an alternate signer uses Section XI and a power of attorney uses Section XII, when permitted.
Review and download the PDF
Check every item, including attached supporting forms and the Section XIII addendum. Download or print the completed PDF from FillingPDF and send it with your evidence as described under How to submit.
How to submit 21-526EZ
You can send VA Form 21-526EZ and your supporting evidence by mail or online.
- By mail: Department of Veterans Affairs, Evidence Intake Center, PO Box 4444, Janesville, WI 53547-4444.
- Online: through VA.gov at www.va.gov, or by Direct Upload through AccessVA. VA also offers an online application at https://www.va.gov/disability/how-to-file-claim/, where signing in lets VA prefill parts of the application, save your progress and accept uploaded documents.
Send the supporting forms the claim requires at the same time as the application (see the required documents). Make sure you sign the application in Section IX. An accredited veterans service organization or your state office of veterans affairs can help with the application. For questions or to request a hearing, use Ask VA at https://ask.va.gov or call 1-800-827-1000 (TTY: 711). No fee is printed on the form. Do not send the completed form to the VA Reports Clearance Officer email address on the page about respondent burden. FillingPDF lets you fill out and download the PDF; submission follows the channels above.
Common mistakes to avoid
- Submitting the application without the veteran's or service member's signature in Item 33A; it is marked required.
- Having a witness sign Items 34 and 35 when the veteran did not sign with an "X"; witnesses sign only in that case.
- Having an alternate signer or a power of attorney sign without a valid VA Form 21-0972, or VA Form 21-22 or 21-22a, of record or attached.
- Having a power of attorney sign for an original claim; the form says POAs cannot.
- Checking the box in Item 26 or Item 28 without understanding it: you will not receive VA compensation in lieu of retired pay or training pay.
- Sending additional evidence after filing in the FDC Program, which moves the claim to the Standard Claim Process.
- Selecting the BDD Program in Item 1 without meeting the criteria: being within 90 to 180 days of discharge and available for examinations for 45 days.
- Leaving out the supporting form for a claim type, such as VA Form 21-0781 for a mental health condition or VA Form 21-686c for dependents.
- Completing a handwritten form without printing in ink, neatly, one letter per box, and filling in each applicable check box completely.
- Entering a VA file number in Item 5 when you answered NO to Item 4, or leaving it blank when you have filed before.
Frequently asked questions
What is VA Form 21-526EZ used for?
VA Form 21-526EZ is the Department of Veterans Affairs application for veterans' disability compensation and related compensation benefits. It is used for new claims and for increased-evaluation claims on decisions made more than one year ago, among other claim types listed in the attached notice.
Can I fill out Form 21-526EZ online?
You can complete the PDF online on FillingPDF and download or print it. VA also offers its own online application at va.gov, where signing in prefills parts of the form. FillingPDF does not file your claim; send it through VA's channels.
Where do I mail VA Form 21-526EZ?
Mail it to Department of Veterans Affairs, Evidence Intake Center, PO Box 4444, Janesville, WI 53547-4444. You can also submit online through VA.gov or by Direct Upload through AccessVA.
What is the difference between the FDC Program and the Standard Claim Process?
In the FDC Program you send all your evidence with the claim, for expedited handling. In the Standard Claim Process you can ask VA to help get records and have up to one year from receipt to send evidence. FDC participation is optional and does not affect your entitlement.
Should I use Form 21-526EZ or VA Form 20-0995?
Use VA Form 21-526EZ for a new claim or an increased claim on an evaluation decided more than one year ago. Use VA Form 20-0995 if you disagree with an evaluation decided within the past year and have new and relevant evidence, or file a supplemental claim.
Can someone else sign Form 21-526EZ for me?
Yes, in limited cases. An alternate signer may sign in Section XI if Item 33A is blank, with a valid VA Form 21-0972 of record or attached. A power of attorney may sign in Section XII, but not for an original claim, and VA Form 21-22 or 21-22a must be of record.
What other forms do I attach to Form 21-526EZ?
It depends on the claim. Examples: VA Form 21-686c for dependents, VA Form 21-0781 for mental health conditions, VA Form 21-8940 for Individual Unemployability, VA Form 26-4555 for housing grants, and VA Form 21-4502 for auto allowance.
When can an active duty service member file a BDD claim?
Between 90 and 180 days before the anticipated separation date, and only if available to report for examinations for 45 days after submitting. Select the BDD Program option in Item 1 and enter the release date in Item 8.
What happens if I check Item 26 on Form 21-526EZ?
You will not receive VA compensation, if granted, because you choose not to receive it in lieu of military retired pay. If you already receive VA compensation and are also eligible for retired pay, checking it ends your compensation.
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