VA Form 21-686c – Fill Out and Use This PDF

The VA Form 21-686C is an essential document for veterans seeking to claim additional benefits for dependents or request the removal of a dependent from an award. This form helps veterans navigate the requirements for various types of dependents, such as spouses, children under 18, and disabled dependents. To ensure you have what you need to complete your application, consider filling out the form by clicking the button below.

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VA Form 21-686c PDF Details

The VA 21 686c form is a critical document for veterans and their families, serving as a means to adjust benefits in response to changes in their dependent status. This comprehensive form allows for the submission of claims for additional benefits for a dependent or the removal of a dependent from an award, catering to a broad spectrum of circumstances that reflect life's evolving nature. Applicable to veterans with a disability rating of at least 30 percent, those entitled to Veterans Pension or Survivors benefits, it covers dependents including spouses, children under 18, school-attending children between 18 and 23, children over 18 incapable of self-support, and dependent parents. Furthermore, it specifies the mandatory completion of sections for identification and certification, alongside additional documentation under various conditions such as school attendance, pension eligibility, or recognition of a common-law marriage. This form acts not only as a bridge for service members to claim rightful benefits but also outlines the procedural responsibilities involving marriage, divorce, death, and the unique cases of adopting or supporting stepchildren. With digital submission options and the recommendation for assistance from a veteran service officer (VSO), the VA 21 686c encapsulates the VA's effort to streamline the process while ensuring veterans can efficiently manage their benefits inline with changes in their personal lives.

Question	Answer
Form Name	VA Form 21-686c
Form Length	15 pages
Fillable?	Yes
Fillable fields	1
Avg. time to fill out	3 min 57 sec
Other names	va form 21 686c fillable, 21 686c, va dependents dependent, va 21 686c

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NOTICE TO BENEFICIARY/CLAIMANT REGARDING THE INFORMATION AND EVIDENCE NEEDED TO

SUPPORT A CLAIM FOR ADDITIONAL BENEFITS FOR A DEPENDENT OR TO REMOVE A

DEPENDENT FROM AN AWARD

Use this form and the attached application to:

•submit a claim for additional benefits for a dependent, or

•request removal of a dependent from your award.

The table below identifies the types of dependents for whom VA beneficiaries may be entitled to additional benefits.

If you are a …	Then you may be entitled to additional benefits for …

veteran entitled to disability compensation who has a	•	a spouse,
combined disability rating of at least 30 percent	•	children under age 18,
	• children that are between the ages of 18 and 23 who are attending school,
	• children over age 18 that are permanently incapable of self-support, and/or
	•	dependent parents.

veteran entitled to Veterans Pension	•	a spouse,
	• children under age 18,
	• children that are between the ages of 18 and 23 who are attending school, and/or
	• children over age 18 that are permanently incapable of self-support

surviving spouse entitled to survivors benefits	•	children under age 18,
	•	children that are between the ages of 18 and 23 who are attending school, and/or
	•	children over age 18 that are permanently incapable of self-support.
	Exception: A surviving spouse entitled to Dependency and Indemnity Compensation (DIC) is
	not entitled to additional benefits for children over age 18 that receive DIC in their own right.

TABLE OF CONTENTS

The table below provides a guide to the instructions and the application. The completion of certain sections of this application are required. Be aware that you must complete Section I - Veteran/Claimant's Identification Information and Section X - Beneficiary/ Claimant's Certification and Signature. If these sections are not complete, we will not be able to process your claim for additional benefits for dependents. Otherwise, complete the remaining sections that apply to you.

If you are …	Instructions	Application
claiming additional benefits for a spouse	Pages 3 and 4	Pages 8 and 9

claiming additional benefits for a child	Pages 4 - 5	Pages 10 and 11

reporting a divorce	Page 5	Page 12

reporting that a stepchild is no longer a member of your
household	Page 6	Page 12 and 13

reporting the death of a
• spouse	Page 5	Page 13
• child	Page 6
• child
• dependent parent	Page 6
• dependent parent

reporting the marriage of a child	Page 6	Page 13

reporting that a schoolchild over 18 has stopped attending school	Page 6	Page 13

claiming additional benefits for more than four children		Addendum - Page 15

CIRCUMSTANCES THAT REQUIRE ADDITIONAL FORMS

Under certain circumstances, other forms in addition to VA Form 21-686c, Application Request to Add and/or Remove Dependents, must be provided when claiming additional benefits for a dependent. The table below describes those circumstances. All VA forms are available at www.va.gov/vaforms.

VA FORM 21-686c, SEP 2018

Page 1

	If ...	Then submit ...

	• you are seeking additional benefits for a child or	VA Form 21-674, Request for Approval of School Attendance.
	children who are between the ages of 18 and 23	Note: Submit VA Form 21-686c in addition to VA Form 21-674 only if you
	who are attending school
	who are attending school	have never received additional benefits for the child or children.


	• you are entitled to Veterans Pension (instead of	VA Form 21P-0516-1, Improved Pension Eligibility Verification Report
	disability compensation based on service-	(Veteran With No Children), in addition to VA Form 21-686c.
	connected disabilities), and
	• you are seeking additional benefits for a spouse
	only

	• you are entitled to Veterans Pension	VA Form 21P-0517-1, Improved Pension Eligibility Verification Report

•you are seeking additional benefits for a child or (Veteran With Children), in addition to VA Form 21-686c. children (with or without a spouse), and

•the child or children are under the age of 23 or permanently incapable of self-support

• you are entitled to Survivors Pension,(instead of	VA Form 21P-0519s-1, Improved Pension Eligibility Verification Report
DIC based on a veteran's service-connected death) (Surviving Spouse With Children), in addition to VA Form 21-686c.
and
• you are seeking additional benefits for a child or
children that are either under the age of 23 or
incapable of self-support.

• you are a veteran entitled to disability	VA Form 21P-509, Statement of Dependency of Parent(s).
compensation (based on service-connected
disabilities), and	Note: There is no need to submit VA Form 21-686c when filing a claim for
• you are seeking additional benefits for a	additional benefits for a dependent parent or parents.
dependent parent or parents.

• you are a veteran entitled to disability	VA Form 21-2680, Examination for Housebound Status or Permanent Need
compensation, and	for Regular Aid and Attendance, or if your spouse resides in a nursing home,
• you are seeking additional benefits for a spouse	use VA Form 21-0779, Request for Nursing Home Information in
who requires aid and attendance	Connection with Claim for Aid and Attendance.
	Note: Submit VA Form 21-686c in addition to one of the forms referenced
	above only if you have never received additional benefits for your spouse.

• you are a veteran seeking additional benefits for	VA Form 21-4170, Statement of Marital Relationship, and
a spouse based on common-law marriage	VA Form 21P-4171, Supporting Statement Regarding Marriage.
a spouse based on common-law marriage
	Note: The above referenced forms must be submitted in addition to
	VA Form 21-686c.

HOW TO APPLY ELECTRONICALLY

Want to apply electronically? You can apply online at www.va.gov. If you sign in or create an account at www.va.gov, we can prefill parts of your application and save your work in progress.

NOTE: You may wish to contact an accredited veteran service officer (VSO) to assist you with your application. You may locate a list of VSO's at https://www.va.gov/vso/ .

WHERE TO SEND INFORMATION AND EVIDENCE

MAIL TO	SUBMIT ONLINE

Department of Veterans Affairs

Evidence Intake Center

VA gov: www.va.gov

PO Box 4444

Direct Upload via access.va.gov

Janesville, WI 53547-4444

VA FORM 21-686c, SEP 2018

Page 2

IMPORTANT: Applicants must provide their Social Security Number (SSN), and the SSN of their dependent(s) unless a SSN has not been assigned. Use Section IX, Item 25, Remarks, to explain why a SSN has not been assigned.

TO ADD A SPOUSE TO A VETERAN'S AWARD:

Marriage by Ceremony

VA will require additional evidence* to establish a spouse; if

•you do not reside within a state, territory, or other possession of the United States,

•your entries on the application conflict with other information you provided, and the discrepancies cannot be resolved through contact with you or a review of other information of record

•information of record raises questions regarding the validity of the marriage, or

•there is an indication of fraud or misrepresentation.

*Additional Evidence:

•Primary evidence of a marriage consists of a copy or abstract of the public record of a marriage, or a copy of the church record of a marriage, containing sufficient data to identify the

•parties involved,

•date (month, day, and year) and place (city and state, county and state, or city and country) of the marriage, and

•number of prior marriages for each spouse, if not shown on the official record.

•If primary evidence of a marriage is unavailable, a marriage may still be established by submission of the following

evidence in the order of preference shown below;

•an official report from your branch of service regarding a marriage that occurred while you were in service,

•an affidavit of the clergyman or magistrate who officiated in the marriage ceremony,

•a certified copy of the original certificate of marriage,

•affidavits or certified statements signed by two or more witnesses that attended the marriage ceremony, or

•any other secondary evidence that reasonably supports the assertion that a valid marriage occurred.

Note: The process to establish a same sex or transgender marriage is no different than the process to establish a marriage between the opposite sex.

Establishing a Common-Law Marriage

In some states it is possible to contract a marriage without a ceremony and without registration of the marriage. This type of marriage is referred to as a common-law marriage.

VA may recognize a common-law marriage that was considered valid in the state in which it took place. A common law marriage generally requires an agreement between the parties to be married, cohabitation, and holding themselves out to the public as married.

Evidence that must be submitted to claim a common-law marriage:

•VA Form 21-4170 completed by the veteran

•VA Form 21-4170 completed by the veteran's spouse in the common-law marriage

•Two VA Forms 21P-4171, each completed by two different persons that can provide their personal observations about the parties to the common-law marriage and the relationship that exists/existed between them, and

•Copies of the birth certificates of any children born of the common-law marriage.

Tribal Ceremony

VA may recognize marriages performed in accordance with tribal custom.

To establish a tribal marriage, a claimant must provide all of the following items:

•Affidavits from the parties married by tribal custom that include the name of the tribe, date (month, day, and year) of marriage, place (city and state, county and state, or city and country) where the marriage ceremony occurred, and name/mailing address of the person who performed the ceremony.

•Affidavits from at least two people who were present at the time the tribal marriage ceremony took place. The affidavits must include the name of the tribe, date (month, day, and year) of marriage, place (city and state, county and state, or city and country) where the marriage ceremony occurred, and name/mailing address of the person who performed the ceremony.

•Affidavit from the person who performed the ceremony, showing the date (month, day, and year) and place (city and state, county and state, or city and country) where the marriage ceremony occurred, and that person's authority for conducting the ceremony.

VA FORM 21-686c, SEP 2018

Page 3

Proxy Marriage

A proxy marriage is a wedding in which one or both of the individuals being united are not physically present, and are instead represented by other persons. If both partners are absent, a double proxy wedding occurs.

Marriage by proxy typically occurs when a couple wishes to marry, but one or both partners cannot attend for reasons such as military service, imprisonment, or travel restrictions; or when a couple lives in a jurisdiction in which they cannot legally marry.

All documents/certificates issued in connection with a claimed proxy marriage must be provided to establish a proxy marriage for VA purposes.

Note: The validity of a proxy marriage is dependent upon the law in effect at the location in which the proxy marriage was performed.

Spousal Aid & Attendance (A&A)

•VA may pay additional benefits to a Veteran for a spouse with severe medical need/disability (ies). To claim the additional benefits, a

•Veteran must complete a VA Form 21-2680 and submit medical evidence showing his or her spouse

•is blind or so nearly blind as to have corrected visual acuity of 5/200 or less in both eyes or concentric contraction of the visual field to 5 degrees or less; or

•is a patient in a nursing home because of mental or physical incapacity (by completing VA Form 21-0779); or

•requires the aid of another person in order to perform personal functions required in everyday living, such as bathing, feeding, dressing, attending to the wants of nature, adjusting prosthetic devices, or protecting him or her from the hazards of his or her daily environment.

TO ADD A CHILD TO A BENEFICIARY/CLAIMANT'S AWARD:

Unmarried Child

A person must be unmarried in order to be considered a child for VA purposes.

VA may continue paying additional benefits for an unmarried child

•until the child reaches age O 18, or

O 23, if the child is attending an approved school, or

•indefinitely if the child becomes permanently incapable of self-support before his/her 18th birthday.

VA will require a copy of the child's birth certificate; if

•you do not reside within a state, territory or other possession of the United States,

•your entries on the application conflict with other information you provided, and the discrepancies cannot be resolved through contact with you or a review of other information of record, or

•there is an indication of fraud or misrepresentation.

School-Age Child

You must complete and submit VA Form 21-674 to claim additional benefits for a child who is

•between the ages of 18 and 23, and

•attending school.

Note:

•Claimants with more than one school-age child must complete a separate VA Form 21-674 for each child.

•VA Form 21-674 is used to report

Oschool attendance,

Oa change in the educational facility a child is attending, and/or

Oa change in the date a school-age child plans to stop attending school.

Stepchild

VA will ask you to provide a copy of your stepchild's birth certificate, showing the names of both parents, before it will add the stepchild; if

•you do not reside within a state, territory, or other possession of the United States,

•your entries on the application conflict with other information you provided, and the discrepancies cannot be resolved through contact with you or a review of other information of record.

VA FORM 21-686c, SEP 2018

Page 4

•information of record raises questions regarding the validity of the marriage of the stepchild's biological or adoptive parent to the veteran, or

•there is an indication of fraud or misrepresentation.

Provide a copy of the decree of adoption or adoptive placement agreement if the veteran's spouse is the adoptive parent of the stepchild.

Note:

•VA may pay benefits to or for a stepchild only if the stepchild is (or was at the time of the veteran's death, if the veteran is deceased) a member of the veteran's household.

•If the veteran and stepchild do not reside together (or were not residing together when the veteran died, if the veteran is deceased), the stepchild remains a member of the veteran's household if

•they live (or lived, if the veteran is deceased) apart for medical reasons, to attend school, or to fulfill a military service obligation, or

•the veteran provides (or provided, if the veteran is deceased) at least half of the stepchild's support.

Adopted Child

A claim for additional benefits for an adopted child must include a copy of the

•final decree of adoption,

•adoptive placement agreement,

•interlocutory decree of adoptions, or

•revised birth certificate.

Note: VA cannot pay additional benefits for a grandchild or foster child unless the claimant submits evidence (referenced above) showing the veteran adopted the grand/foster child.

Child Incapable of Self-Support

VA may pay additional benefits for a child beyond his/her 23rd birthday if VA determines the child became permanently incapable of self-support before his/her 18th birthday.

A claim for additional benefits for a child who is incapable of self-support must include

•medical evidence showing a permanent mental or physical disability existed before his/her 18th birthday, and

•a statement from an attending physician showing the nature and extent of the child's physical or mental impairment.

REMOVAL OF A SPOUSE FROM A VETERAN'S AWARD:

Divorce or Death of a Spouse

VA must remove a spouse from a veteran's award when the spouse dies or divorces/annuls the marriage to the veteran.

Note:

•Veterans in receipt of disability compensation are not required to report to VA a separation or estrangement from their spouse, as it will have no effect on their award.

•Veterans remain entitled to additional benefits for a stepchild after divorcing the stepchild's biological or adoptive parent, as long as the veteran provides at least half of the stepchild's support.

VA FORM 21-686c, SEP 2018	Page 5

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As for the blanks of this particular document, here is what you should know:

1. When filling out the veterans administration forms 21 686c, be certain to incorporate all of the important blank fields within its associated section. This will help to expedite the process, allowing your information to be handled efficiently and properly.

va form 21 686c fillable completion process outlined (step 1)

2. After the last segment is completed, you're ready to include the essential particulars in MONTH, DAY, YEAR, C SPOUSES SOCIAL SECURITY NUMBER, MONTH, DAY, YEAR, E PLACE OF MARRIAGE City and State, City or County, StateProvince, Country, F HOW WERE YOU MARRIED Check one, CIVIL CEREMONY ie Justice of the, RELIGIOUS CEREMONY ie Minister, and TRIBAL so that you can progress further.

Best ways to prepare va form 21 686c fillable stage 2

3. In this specific stage, check out VETERANS SOCIAL SECURITY NO, NOTE You must provide complete, VETERANCLAIMANTS PREVIOUS MARITAL, If no prior marriages this section, A TO WHOM MARRIED First Middle, A DATE AND PLACE OF MARRIAGE, City or County, A REASON FOR TERMINATION, Death, Divorce, Annulment, Other Explain, A DATE AND PLACE MARRIAGE, StateProvince, and Country. These have to be taken care of with greatest accuracy.

Filling in section 3 in va form 21 686c fillable

4. The following subsection needs your attention in the following areas: Death, Divorce, Annulment, Other Explain, B DATE AND PLACE MARRIAGE, City or County, StateProvince, Country, C TO WHOM MARRIED First Middle, C DATE AND PLACE OF MARRIAGE, City or County, StateProvince, Country, C REASON FOR TERMINATION, and Death. Just remember to provide all needed details to move forward.

Filling in section 4 in va form 21 686c fillable

5. Lastly, the following last segment is what you'll want to complete prior to submitting the form. The blank fields in question are the following: D REASON FOR TERMINATION, Death, Divorce, Annulment, Other Explain, D DATE AND PLACE MARRIAGE, City or County, VA FORM c SEP, StateProvince, Country, and Page.

va form 21 686c fillable conclusion process explained (part 5)

Many people generally make errors when completing Other Explain in this area. Make sure you double-check what you enter here.

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