Applications: VA Forms 21-527,21-4142,21-8416,21-4138
Posted by James Jett on October 31, 2007
Well, I finally mailed all the forms in my application for compensation benefits for eye injury. In addition I am claiming additional condition, since I applied for benefits on February 11, 1955 and the appeal period has expired and the decision was final. If I want the issues reconsider, I need to provide new and material evidence. To qualify as new, the material must be submitted to the VA for the first time. If the material is going to be considered “material evidence” it must relate to an unestablished fact. The new and material evidence, considered with the evidence of record must raise a reasonable possibility that the conclusion will change.
With this information, I gather doctor reports about my medical conditions and the treatments provided for those conditions. It seems to me, my doctor visits clearly points out the facts that I went in the Naval Reserve, and the Army Airborne a healthy man and came out with slowly declining health. Because I had the best medical insurance at my places of employment, I received the proper treatments for my sicknesses. Now my insurance cost has skyrocketed and my income declined because a pension that should pay $500. Per month, now pay $12.40 per month! For this reason I enrolled in the VA Health Care Programs, enabling me to get treatment and medicine I need without going deeper in debt.
With my health condition, I applied for everything that health and income needs dictated, and will await the decision. To claim a non service-connected pensions I completed VA Form 21-527, most of that information is readily available on your 1099R, SSA-1099 and your current income tax statements. VA Form 21-4142 is where you list each visit to the doctor, hospital or clinic, using a form for each treatment. On VA Form 21-8416, I recorded all medical expenses all the way back to (in my case April 16, 2006) because that is the date I made my first application. These expenses must be medical and drug bills’ insurance did not pay. Example: health insurance, including Medicare; in addition private medical insurance, co-pay and deductibles. Once all these are completed, write a good statement supporting your claims. Make sure you sign everything requiring a signature. The last thing I had to complete was the Direct Deposit Information: Things like: Checking or Saving Account, Account Number, Name of financial institution and (last but important) Routing or Transit Number
juan c rivera said
mail to me the form 21-4138
James Jett said
Juan C. Rivera, Form 21-4138 is the Statement In Support Of Claim; you use this form to support your claim or claims for benefits. I received my copy with my name and VA file No. already printed on the form. You can download a copy here (http://www.vba.va.gov/pubs/forms/21-4138x.pdf) and complete it using as many pages as you require. You could do as I did type the first page with enough information to cover the space provided for text, leaving the last line clear where it say (continue on reverse) paste the first page in place and make a copy then copy your second page on the back, in other words print the second page on the reverse side. You are welcome to complete all parts by hand if you prefer. I had to use this procedure because I have no software that will make a copied page active.