Form VA 21-526 Veteran’s Application for Compensation and/or Pension

Form VA 21-526 Veteran’s Application for Compensation and/or Pension

November 30
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A VA Form 21-626 is the Veteran Affairs Application for Compensation or Pension form that is used to make a claim for benefits.  This form is used to claims for benefits that arise from disability or injuries sustained during military service or for benefits for qualifying retired military members.  

The VA Form 21-526 is available on the United States Department of Veteran Affairs website.    

Boxes 1 and 2 require that you identify the compensation you are applying for and any previous applications for compensation.

1. In box 1, you should seek compensation if you have suffered an injury or illness while in the military.

2. You should seek a pension claim if you are over 65 years old with a disability, served on active duty during at least one day of a period of war, and your income and net worth does not exceed the limits outline by the Veterans Affairs office.

Next, boxes 3 through 9 require your basic identification information. 

Boxes 10 through 18 require information about past benefits applications, a history of your injuries, and your medical treatment history. 

3. You should provide a detailed history of all medical events that occurred during your military service.  

4. Ensure that you give as much specific information as possible in box 11.  You can add additional information in the blank box at the end of the form if you need more space. 

Parts III through V require that you supply your service information.  

5. Part V requires that you supply your military retired and severance pay.  

Part VI requires your marital status and dependency information, which will be used to determine the type of benefits you are entitled.

6. Ensure that you include all of your marriage history and all dependents for which you support in the appropriate boxes.  

Parts VII through X require your financial information for evaluation of your benefits. 

7. In Parts VII, VIII and IV, do not leave any boxes blank, even if they do not apply to you or your spouse.  Fill in a zero if you do not receive the benefit.  

Complete the form by certifying all of the information in Part XII and consent to the release form that allows Veterans Affairs to review your information.  

8. Send in the VA Form 21-526 to the address supplied by the VA. 

Download the PDF file .


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