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Va Form 21-4138 - Statement In Support Of Claim - National: What You Should Know
The statement must include: (1) the name and address of the veteran; (2) the service-connected disability rating; (3) the duration and disability rating; (4) the date of disability; and (5) the basis for claimant's claim. The form must also contain supporting medical data, including a copy of the Veteran's Medical Record Sheet (MR), and the service record summary for each month of the disability, excluding the period for which the veteran has the service-connected disability. If a veteran is self-pay, the veteran has 10 days after receiving the Statement to complete and submit the VA Form 21-4138 (Service-Paid Agent) in support of their claim. Veterans can use VA Form 21-4138 when supporting other veterans in a claim. These veterans include: spouses and dependent citizens or legally permanent residents (including legal immigrants); members on active duty of the military forces of the United States or deemed members of the Selected Reserve or National Guard and covered by a service support contract; veterans in receipt of compensation other than the Veterans Health Administration Disability Benefit (which includes veterans receiving disability pension from the Veterans Health Administration or VA or covered veterans under VA and VA's health system). As a general rule, VA Form 21-4138 can be used to submit VA Form 5800-7, Petition for Correction of Military Records, to DS POA for an opinion concerning the veteran's claim. For more information, you can call them at. Also check with your local VA office. About the Form 21-4138 — Veterans Affairs Sep 29, 2023 — VA 21-4138, Statement in Support of Claim: Use this form to submit supporting medical data, including the service record summary for a given month. The statement must include: (1) the name and address of the veteran and the claimant; (2) the service-connected disability rating for each month of the disability and its duration and duration ratings; and (3) the date of disability.
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