To submit this form, ensure all sections are completed and additional required forms are attached. You can submit the form online through the Department of Veterans Affairs website, or mail it to the VA Claims Intake Center, P.O. Box 4444, Janesville, WI 53547-4444. Alternatively, you can fax your completed form to (844) 531-7818. It is advised to keep a copy of the completed form and any supplementary documents for your records.

Expiration Date: This form remains valid until 09/30/2022 at the time of document extraction. Stay updated with the Department of Veterans Affairs for any extensions or new revisions of this form in 2024 and 2025.

The purpose of the VA Disability Compensation Application form is to provide a standardized method for veterans and service members to apply for disability compensation and related benefits. This form collects essential information such as personal identification details, service history, and specifics about any military service-connected disabilities. Additionally, it outlines procedures for attaching required documents and provides guidelines for claim submission processes.

• 1. Form Type Selection: Select the type of claim program or process, including Fully Developed Claim, Standard Claim Process, IDES, or BDD Program Claim.
• 2. Personal Information: Provide your full name, Social Security Number, date of birth, service number, sex, and contact details.
• 3. Change of Address: Indicate any temporary or permanent address changes, along with the effective dates of the changes.
• 4. Homeless Information: Answer questions about your current living situation and whether you are homeless or at risk of being homeless.
• 5. Claim Information: List the disabilities or symptoms related to your military service and provide details such as exposure type, how the disability relates to service, and approximate dates.
• 6. Medical Treatment History: Enter information about VA Medical Centers or Department of Defense facilities where you received treatment for your claimed disabilities.
• 7. Additional Required Forms: Attach additional forms for specific claims, such as supplemental claims, individual unemployability, PTSD, auto allowance, etc.
• 8. Service Information: Provide details about your military service, including branch, component, service dates, combat zone involvement, and periods of reserve or National Guard service.
• 9. Previous Prisoner of War Status: Indicate whether you have ever been a prisoner of war and provide dates of confinement if applicable.

Failing to submit the VA Disability Compensation Application form may result in delays or ineligibility for compensation and benefits.

• Delays in Processing: Your disability claim may be delayed due to incomplete information.
• Ineligibility for Benefits: You may not be considered for the compensation you are entitled to.
• Loss of Benefits: Potential loss of crucial veteran benefits if the submission is not done timely.

• 1. Disability Compensation Claims: Complete this form for initial or additional disability compensation claims.
• 2. Change of Address: Update your address information using the designated section.
• 3. Homeless Information: Provide information if you are currently homeless or at risk of becoming homeless.
• 4. Medical Treatment History: Use this form to document treatment received at VA or DoD medical facilities post-discharge.
• 5. Service Information: Detail your military service history for processing and verification.