LexisNexis® Automated Veterans Benefits Forms

LexisNexis Automated Veterans Benefits Forms includes 245 forms and value-added instructions written by National Veteran's Legal Services Program (NVLSP) attorneys. New and revised forms are provided regularly.
Frequency: (2 issues)
CD :1 Year Subscription
$274.00
Quantity
In Stock
ISBN: 9780820552071
Frequency: (2 issues)
International Order Inquiry

Product details

LexisNexis® Automated Veterans Benefits Forms includes over 245 forms and value-added instructions written by National Veteran®s Legal Services Program (NVLSP) attorneys. New and revised forms are provided regularly.

The repetitive typing, cutting, and pasting, and the increased chance of error that plague traditional methods of document preparation all disappear with HotDocs® document-assembly software. Simply enter case- or client-specific information once and HotDocs will insert it where relevant throughout the form. You will produce a signature-ready document in minutes. You can also save the information you have entered and use the saved answers to complete related forms. HotDocs will also compute many of the tax calculations automatically.

Table of Contents

Veterans' Benefits Forms

Foreword by Ronald Abrams, National Veterans Legal Services Program

Veterans Benefits Manual Advocacy Checklist for Different Types of VA Claims (App17-A) (Word)

Veterans Benefits Manual Advocacy Checklist for Different Types of VA Claims (App17-A) (WordPerfect)

VA Compensation and Pension Forms

Fully Developed Claims Process

Application for DIC, Death Pension, and/or Accrued Benefits (21-534EZ)

Application for DIC, Death Pension, and/or Accrued Benefits (21-534EZ) (Instructions)

Fully Developed Claim Notice (Compensation) (21-526EZ)

Fully Developed Claim Notice (Compensation) (21-526EZ) (Instructions)

Fully Developed Claim Notice (Pension) (21-527EZ)

Fully Developed Claim Notice (Pension) (21-527EZ) (Instructions)

Application for Annual Clothing Allowance (Under 38 U.S.C. 1162) (10-8678)

Application for Automobile or Other Conveyance and Adaptive Equipment (21-4502)

Application for Automobile or Other Conveyance and Adaptive Equipment (21-4502) (Instructions)

Application for Benefits for Certain Children with Disability. Born of Vietnam Vets. (21-0304)

Application for Benefits for Certain Children with Disability. Born of Vietnam Vets. (21-0304) (Instructions)

Application for Burial Benefits (Under 38 U.S.C. Chapter 23) (21P-530)

Application for Burial Benefits (Under 38 U.S.C. Chapter 23) (21P-530) (Instructions)

Application for Dependency and Indemnity Compensation (21-534)

Application for Dependency and Indemnity Compensation (21-534) (Instructions)

Application for Dependency and Indemnity Compensation by a Surviving Spouse or Child (21-534a)

Application for Dependency and Indemnity Compensation by a Surviving Spouse or Child (Instructions)

Application for Dependency and Indemnity Compensation by Parent(s) (21-535)

Application for Dependency and Indemnity Compensation by Parent(s) (21-535) (Instructions)

Application for Exclusion of Children's Income (21-0571)

Application for Reimbursement from Accrued Amounts Due a Deceased Beneficiary (21-601)

Application for Reimbursement from Accrued Amounts Due a Deceased Beneficiary (21-601) (Inst.)

Application for Reimbursement of Headstone or Marker Expense (21-8834)

Application for United States Flag for Burial Purposes (27-2008)

Application for United States Flag for Burial Purposes (27-2008) (Instructions)

Declaration of Status of Dependents (21-686c)

Election of Comp in Lieu of Retired Pay or Waiver of Retirement Pay to Secure Comp from VA (21-651)

Eligibility Verification Report (21-0510) (Instructions)

Improved Pension Eligibility Verification Report (Child or Children) (21-0519c-1)

Improved Pension Eligibility Verification Report (Surviving Spouse with Children) (21-0519s-1)

Improved Pension Eligibility Verification Report (Surviving Spouse with No Children) (21-0518-1)

Improved Pension Eligibility Verification Report (Veteran with Children) (21-0517-1)

Improved Pension Eligibility Verification Report (Veteran with No Children) (21-0516-1)

Income-Net Worth and Employment Status Statement (21-527)

Income-Net Worth and Employment Status Statement (21-527) (Instructions)

Information Regarding Apportionment of Beneficiary's Award (21-0788)

Medical Expense Report (21P-8416)

Medical Expense Report (21P-8416) (Instructions)

Notice of Disagreement (21-0958)

Notice of Disagreement (21-0958) (Instructions)

Old Law and Section 306 Eligibility Verification Report (Children Only) (21-0513-1)

Old Law and Section 306 Eligibility Verification Report (Surviving Spouse) (21-0512s-1)

Old Law and Section 306 Eligibility Verification Report (Veteran) (21-0512v-1)

Old Law Eligibility Verification Report (Veteran) (21-0511v-1)

Parent's DIC Eligibility Verification Report (21-0514-1)

Pre-Discharge Compensation Claim (21-526c)

Report of Accidental Injury in Support of Claim for Compensation or Pension (21-4176)

Report of Accidental Injury in Support of Claim for Compensation or Pension (21-4176) (Instructions)

Report of Income from Property or Business (21-4185)

Request for Approval of School Attendance (21-674)

Request for Approval of School Attendance (21-674) (Instructions)

Request for Details of Expenses (21-8049)

Request for Employment Information in Connection with Claim for Disability Benefits (21-4192)

Request for Nursing Home Information in Connection with Claim for Aid and Attendance (21-0779)

School Attendance Report (21-674b)

Social Security Administration Application For Survivors Benefits (21-534b)

Social Security Administration Application For Survivors Benefits (21-534b) (Instructions)

Statement in Support of Claim (21-4138)

Statement in Support of Claim for Service Connection for Post-Traumatic Stress Disorder (21-0781)

Statement in Support of Claim for Service Connection for Post-Traumatic Stress Disorder (21-0781a)

Statement of Dependency of Parent(s) (21P-509)

Statement of Dependency of Parent(s) (21P-509) Instructions

Statement of Marital Relationship (21-4170)

Statement of Person Claiming to Have Stood in Relation of Parent (21P-524)

Supporting Statement Regarding Marriage (21-4171)

Veteran's Application for Compensation and/or Pension (21-526)

Veteran's Application for Compensation and/or Pension (21-526) (Instructions)

Veteran's Application for Increased Compensation Based on Unemployability (21-8940)

Veteran's Supplemental Claim (21-526b)

Department of Defense Forms

Application for Correction of Military Record (DD 149)

Application for Discharge of Member or Survivor of Member of Group... (DD 2168)

Application for the Review of Discharge or Dismissal from the Armed Forces (DD 293)

Application for the Review of Discharge or Dismissal from the Armed Forces (DD 293) (Instructions)

Claim for Combat-Related Special Compensation (CRSC) (DD 2860)

Claim for Combat-Related Special Compensation (CRSC) (DD 2860) (Instructions)

Pre-separation Counseling Checklist (AC), (AGR), (AR), (FTS), (RPA) (DD 2648)

Report of Medical Assessment (DD 2697)

Request for Medical/Dental Records From the National Personnel Records Center (NPRC)(DD 877-1)

Request for Medical/Dental Records or Information (DD 877)

Service Member's Individual Transition Plan Checklist (DD 2958)

Service Member's Individual Transition Plan Checklist (DD 2958) (Instructions)

Transition Assistance Program,(TAP) Checklist for Deactivating/Demobilizing NG/Reserve… (DD 2648-1)

Disability Benefits Questionnaires

Cardiovascular

(21-0960A-1) Ischemic Heart Disease (IHD)

(21-0960A-2) Artery and Vein Conditions (Vascular Diseases Including Varicose Veins)

(21-0960A-3) Hypertension Disability Benefits Questionnaire

(21-0960A-4) Heart Conditions (Including Ischemic and Non-Ischemic Heart Disease...)

Dental and Oral

(21-0960D-1) Oral and Dental Conditions Including Mouth, Lips and Tongue ...

(21-0960M-15) Temporomandibular Joint (TMJ) Conditions Disability Benefits Questionnaire

Dermatological

(21-0960F-1) Scars/Disfigurement Disability Benefits Questionnaire

(21-0960F-2) Skin Diseases Disability Benefits Questionnaire

Ear, Nose and Throat

(21-0960N-1) Ear Conditions (Including Vestibular and Infectious Conditions)

(21-0960N-3) Loss of Sense of Smell and/or Taste Disability Benefits Questionnaire

(21-0960N-4) Sinusitis/Rhinitis and Other Conditions of the Nose, Throat, Larynx and Pharynx ...

Endocrinological

(21-0960E-1) Diabetes Mellitus Disability Benefits Questionnaire

(21-0960E-2) Endocrine Diseases (Other than Thyroid, Parathyroid or Diabetes Mellitus)

(21-0960E-3) Thyroid and Parathyroid Conditions Disability Benefits Questionnaire

Gastrointestinal

(21-0960G-1) Esophageal Conditions (Including gastroesophageal reflux disease (GERD)...)

(21-0960G-2) Gallbladder and Pancreas Conditions Disability Benefits Questionnaire

(21-0960G-3) Intestinal Conditions (Other than Surgical or Infections)...

(21-0960G-4) Intestinal Surgery (Bowel Resection, Colostomy, Ileostomy) Disability Benefits...

(21-0960G-5) Hepatitis, Cirrhosis and Other Liver Conditions Disability Benefits Questionnaire

(21-0960G-6) Peritoneal Adhesions Disability Benefits Questionnaire

(21-0960G-7) Stomach and Duodenal Conditions (Not Including GERD or Esophageal Disorders)

(21-0960G-8) Infectious Intestinal Disorders, Including Bacterial and Parasitic Infections...

Genitourinary

(21-0960J-1) Kidney Conditions (Nephrology) Disability Benefits Questionnaire

(21-0960J-2) Male Reproductive Organ Conditions Disability Benefits Questionnaire

(21-0960J-3) Prostate Cancer Disability Benefits Questionnaire

(21-0960J-4) Urinary Tract (Including Bladder and Urethra) Conditions

Gynecological

(21-0960K-1) Breast Conditions and Disorders Disability Benefits Questionnaire

(21-0960K-2) Gynecological Conditions Disability Benefits Questionnaire

Hematologic and Lymphatic

(21-0960B-1) Disability Benefits Questionnaire Hairy Cell and Other B-Cell Leukemias

(21-0960B-2) Hematologic and Lymphatic Conditions, Including Leukemia Disability Benefits...

Infectious Diseases

(21-0960I-1) Persian Gulf and Afghanistan Infectious Diseases Disability Benefits Questionnaire

(21-0960I-2) HIV - Related Illnesses Disability Benefits Questionnaire

(21-0960I-3) Infectious Diseases (Other than HIV-Related Illness, Chronic Fatigue, Tuberculosis)...

(21-0960I-4) Systemic Lupus Erythematosus (SLE) and Other Autoimmune Diseases Disability Benefits

(21-0960I-5) Nutritional Deficiencies Disability Benefits Questionnaire

(21-0960I-6) Tuberculosis Disability Benefits Questionnaire

Musculoskeletal

(21-0960M-1) Amputations Disability Benefits Questionnaire

(21-0960M-2) Ankle Conditions Disability Benefits Questionnaire

(21-0960M-3) Non-Degenerative Arthritis...

(21-0960M-4) Elbow and Forearm Conditions Disability Benefits Questionnaire

(21-0960M-5) Flatfoot (Pes Planus) Disability Benefits Questionnaire

(21-0960M-6) Foot Miscellaneous (Other Than Flatfoot/PES Planus) Disability Benefits Questionnaire

(21-0960M-7) Hand and Finger Conditions Disability Benefits Questionnaire

(21-0960M-8) Hip and Thigh Conditions Disability Benefits Questionnaire

(21-0960M-9) Knee and Lower Leg Conditions Disability Benefits Questionnaire

(21-0960M-10) Muscle Injuries Disability Benefits Questionnaire

(21-0960M-11) Osteomyelitis Disability Benefits Questionnaire

(21-0960M-12) Shoulder and Arm Conditions Disability Benefits Questionnaire

(21-0960M-13) Neck (Cervical Spine) Disability Benefits Questionnaire

(21-0960M-14) Back (Thoracolumbar Spine) Conditions Disability Benefits Questionnaire

(21-0960M-16) Wrist Conditions Disability Benefits Questionnaire

Neurological

(21-0960C-1) Parkinson's Disease

(21-0960C-2) Amyotrophic Lateral Sclerosis (Lou Gehrig's Disease) Disability Benefits Questionnaire

(21-0960C-3) Cranial Nerve Conditions Disability Benefits Questionnaire

(21-0960C-4) Diabetic Sensory-Motor Peripheral Neuropathy Disability Benefits Questionnaire

(21-0960C-5) Central Nervous System and Neuromuscular Diseases (Except Trauma. Brain Injury, etc.)...

(21-0960C-6) Narcolepsy Disability Benefits Questionnaire

(21-0960C-7) Fibromyalgia Disability Benefits Questionnaire

(21-0960C-8) Headaches (Including Migraine Headaches) Disability Benefits Questionnaire

(21-0960C-9) Multiple Sclerosis (MS) Disability Benefits Questionnaire

(21-0960C-10) Peripheral Nerves Conditions

(21-0960C-11) Seizure Disorders (Epilepsy) Disability Benefits Questionnaire

Ophthalmological

(21-0960N-2) Eye Conditions Disability Benefits Questionnaire

Psychological

(21-0960P-1) Eating Disorders Disability Benefits Questionnaire

(21-0960P-2) Mental Disorders (Other Than PTSD and Eating Disorders) Disability Benefits

(21-0960P-3) Review Post Traumatic Stress Disorder (PTSD) Disability Benefits Questionnaire

Respiratory

(21-0960L-1) Respiratory Conditions (Other than Tuberculosis and Sleep Apnea) Disability Benefits

(21-0960L-2) Sleep Apnea Disability Benefits Questionnaire

Rheumatological

(21-0960Q-1) Chronic Fatigue Syndrome Disability Benefits Questionnaire

Surgery (General)

(21-0960H-1) Hernias (Including Abdominal, Inguinal and Femoral Hernias)...

(21-0960H-2) Rectum and Anus Conditions Including Hemorrhoids) Benefits Questionnaire

Educational Forms

Application and Enrollment Certification for Individualized Tutorial Assistance (22-1990t)

Application and Enrollment Certification for Individualized Tutorial Assistance (22-1990t) (Instructions)

Application for Family Member to use Transferred Benefits (22-1990E)

Application for Family Member to use Transferred Benefits (22-1990E) (Instructions)

Application for Refund of Educational Contributions (22-5281)

Application for Refund of Educational Contributions (22-5281) Instructions

Application for Survivors' and Dependents' Educational Assistance (22-5490)

Application for Survivors' and Dependents' Educational Assistance (22-5490) (Instructions)

Application for VA Education Benefits (22-1990)

Application for VA Education Benefits (22-1990) (Instructions)

Application for Work-Study Allowance (22-8691)

Application for Work-Study Allowance (22-8691) (Instructions)

Certificate of Affirmation of Enrollment Agreement--Correspondence Course (22-1999c)

Dependent’s Request for Change of Program or Place of Training (22-5495)

Dependent’s Request for Change of Program or Place of Training (22-5495) (Instructions)

Request for Change of VA Education Program or Place of Training (22-1995)

Request for Change of VA Education Program or Place of Training (22-1995) (Instructions)

Supplemental Information for Change of Program or Reenrollment (22-8873)

Time Record (Work-Study Program) (22-8690)


Finance Forms

Application for Assumption. Approval/Release from Personal Liability to Government on a Home Loan (26-6381)

Direct Deposit Enrollment (24-0296)


Home Loan Guaranty Forms

Request for a Certificate of Eligibility for VA Home Loan Benefits (26-1880)

Request for a Certificate of Eligibility for VA Home Loan Benefits (26-1880) (Instructions)

Request for Determination of Loan Guaranty Eligibility--Unmarried Surviving Spouses (26-1817)


Insurance Forms

Application for Cash Surrender Value/or Application for Policy Loan (29-1546)

Application for Service Disabled Insurance (29-4364)

Application for Supplemental Service Disabled Veterans (RH) Life Insurance (29-0189)

Application for Supplemental Service-Disabled Veterans Insurance (SRH) (29-0188)

Application for Veterans' Group Life Insurance (SGLV 8714)

Application for Veterans' Group Life Insurance (SGLV 8714) (Instructions)

Claim for Death Benefits (SGLV 8283)

Claim for Death Benefits (SGLV 8283) (Instructions)

Claim for Disability Insurance--Government Life (29-357)

Claim for One Sum Payment (29-4125)

Designation of Beneficiary Government Life Insurance (29-336)

Designation of Beneficiary Government Life Insurance (29-336) (Instructions)

Request for Change of Address/Cancellation of Direct Deposit (20-572)

Service-Disabled Veterans Insurance RH Information and Premium Rates


Miscellaneous Forms

Application for 10-Point Veteran Preference (To be Used by Veterans and Relatives of Veterans)(SF 15)

Application for Relief from Court-Martial Findings and/or Sentence... (DA Form 3499)

Presidential Memorial Certificate Request Form (40-0247)


National Archives Forms

Questionnaire about Military Service (NA 13075)

Request for Information Needed To Reconstruct Medical Data (NA 13055)


Other Department of Veterans Affairs Forms

Intent to File a Claim for Compensation or Pension, Survivors Pension, or Other Benefits (21-0966)

Appeal to Board of Veterans' Appeals (9)

Appeal to Board of Veterans' Appeals (9) (Instructions)

Application for Accreditation as a Claims Agent (VA-21A)

Application for Accreditation as a Veterans Organization Representative (VA Form 21)

Application for Adaptive Equipment Motor Vehicle (10-1394)

Application for CHAMPVA Benefits (10-10d)

Application for CHAMPVA Benefits (10-10d) (Instructions)

Application for Comprehensive Assistance for Family Caregivers Program (10-10CG)

Application for Comprehensive Assistance for Family Caregivers Program (10-10CG) (Instructions)

Application for Extended Care Services (10-10EC)

Application for Extended Care Services (10-10EC) (Instructions)

Application for Health Benefits (10-10EZ)

Application for Health Benefits (10-10EZ) (Instructions)

Application for Health Benefits (10-10EZ) (Old Copy)

Application for Health Benefits (10-10EZ) (Old Copy)(Instructions)

Application for Standard Government Headstone or Marker (40-1330)

Application for Standard Government Headstone or Marker (40-1330) (General Information Sheet)

Application for Survivors Benefits (SSA-24)

Application For Survivors Benefits (SSA-24) (Instructions)

Application of Surviving Spouse or Child for Reps Benefits (21-8924)

Appointment of Individual as Claimant's Representative (21-22a)

Appointment of Veterans Service Organization as Claimant's Representative (21-22)

Appointment of Veterans Service Organization as Claimant's Representative (21-22) (Instructions)

Authorization to Disclose a Record in the Presence of a Third Party (VA Form 5571)

Authorization to Disclose Information to the Department of Veterans Affairs (VA) (21-4142)

Authorization To Disclose Personal Information To a Third Party (21-0845)

Authorization To Disclose Personal Information To a Third Party (21-0845) Instructions

CHAMPVA Other Health Insurance (OHI) Certification (10-7959C)

CHAMPVA Other Health Insurance (OHI) Certification (10-7959C) (Instructions)

Claim for Government Medallion for Placement in a Private Cemetery (40-1330M)

Claim for Government Medallion for Placement in a Private Cemetery (40-1330M) Instructions

Claim for Payment of Cost of Unauthorized Medical Services (10-583)

Examination for Housebound Status or Permanent Need for Regular Aid and Attendance (21-2680)

Financial Status Report (5655)

Foreign Medical Program (FMP) Registration Form (10-7959f-1)

Health Benefits Renewal Form (10-10EZR)

Health Benefits Renewal Form (10-10EZR) (Instructions)

Individuals' Request for a Copy of Their Own Health Information (10-5345a)

Radiation Risk Activity Information Sheet

Rehabilitation Plan (28-8872)

Rehabilitation Plan--Continuation Sheet (28-8872a)

Request for and Consent to Release of Information from Claimant's Records (3288)

Request for and Consent to Release of Medical Records Protected by 38 U.S.C. 7332 (10-5345)

Request for Hardship Determination (10-10HS)

Request for Substitution of Claimant upon Death of Claimant (21-0847)

Request for Substitution of Claimant upon Death of Claimant (21-0847) Instructions

Statement of Accredited Representation in Appealed Case (1-646)

Veterans Application for Assistance in Acquiring Home Improvement and Structural Alterations

Veteran's Application in Acquiring Specially Adapted Housing or Special Home Adapt. Grant (26-4555)


Standard Forms

Claim for Damage, Injury, or Death Standard Form (SF 95)

Claim for Unpaid Compensation of Deceased member of the Uniformed Serviced (SF 1174)

Records Transmittal and Receipt (SF135)

Request Pertaining to Military Records (SF 180)

Request Pertaining to Military Records (SF 180) (Instructions)


Vocational Rehabilitation and Employment Forms

Counseling Record - Personal Information (28-1902)

Disabled Veterans Application for Vocational Rehabilitation (28-1900)

Disabled Veterans Application for Vocational Rehabilitation (28-1900) (Instructions)

Employment Questionnaire (21-4140-1)

Rehabilitation Needs Inventory (RNI) (28-1902W)


Additional Forms

Appeal Cancellation Form

Submission Cover Sheet


State Specific Forms

California

Calvet Home Loan Program - Prequalification Application Form

Civil Service Preference (SPB 1093)

Civil Service Preference (SPB 1093) (Instructions)

College Fee Waiver for Veteran's Dependents

Veterans Home Application

Veterans Home Application (Information)

Veterans' Special License Plate (Purple Heart, Medal of Honor) (Reg. 17A)

New York

Application for Alternative Veterans Exemption from Real Property Taxation (RP-458-a)

Application for Alternative Veterans' Exemption from Real Property Taxation (RP-458-a) (Instructions)

Application for New York State Civil Service Examination (Form CC-APP)

Application for New York State Civil Service Examination (Form CC-APP) (Instructions)

Application for Veterans Exemption from Real Property Taxation (RP-458)

Application for Veterans Exemption from Real Property Taxation (RP-458) (Instructions)

Form to Register a Vehicle with Former POW or Congressional Medal of Honor Plates (MV-1H)

Form to Register Motor Vehicle Obtained by Disabled Veteran under Title 38 U.S.C. (MV-1E)

Form to Renew Registration of Motor Vehicle for Disabled Veteran under Title 38 (MV-1G)

Texas

Application for "Disabled Veteran" License Plate (VTR-615)

Application for Military Veteran License Plates (VTR-420)

Claims Tracking Form (TVC 18)

Nursing Home Statement (TVC 15a)

Statement of Attending Physician (TVC 16)

Texas State Veterans Home Application for Admission

Texas Veterans Housing Assistance and Home Improvement Programs, Cert of Eligibility Application

Veteran Status / Veteran's Employment Preference Form