Please rate Va Form 21 8940 Jul 2024
See mailing information on page 4 of this form.
By hand: if completed by hand, print the information requested in ink, neatly, and legibly, insert one letter per box, and completely fill each applicable checkbox.
Witnesses: a signature made by mark must be witnessed by two persons to whom the person making the statement is personally known.
Return to work: if you are granted service-connected total disability benefits based on your unemployability, you must immediately inform VA if you return to work.
Overpayment: total disability benefits paid to you after you begin work may be considered an overpayment requiring repayment to VA.
Social Security: individuals who have a disability and meet medical criteria may qualify for Social Security or Supplemental Security Income disability benefits.
| Question | Answer |
|---|---|
| Form Name | VA Form 21-8940 |
| Form Length | 4 pages |
| Fillable? | Yes |
| Fillable fields | 188 |
| Avg. time to fill out | 32 min |
| Edition | JUL 2024 |
| Where to send | Department of Veterans Affairs Evidence Intake Center, PO Box 4444, Janesville, WI 53547-4444 |
| Matches the agency's file | Yes, checked October 2, 2026 |
| Other names | VA 21-8940, VA Form 21-8940, 21-8940, Veteran's Application for Increased Compensation Based on Unemployability |
| Official source | VA Form 21-8940 (Rev JUL 2024), Department of Veterans Affairs |
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Please rate Va Form 21 8940 Jul 2024
