Fill VA Form 21-526EZ online
Application for Disability Compensation and Related Compensation Benefits
or choose your own copy:
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VA Form 21-526EZ in short
VA Form 21-526EZ is the application veterans and service members use to claim VA disability compensation and related benefits. It covers new claims, claims for an increased rating, and supplemental claims with new and relevant evidence. You can file it online on VA.gov or fill in the PDF and send it by mail, fax or in person.
| Issued by | U.S. Department of Veterans Affairs (VA), Veterans Benefits Administration |
|---|---|
| Current version | Rev. January 2026 (checked 2026-10-25) |
| Who fills it in | Veterans, and service members within 90 to 180 days of separation under the Benefits Delivery at Discharge (BDD) program. The form says a court-appointed representative, a person acting under a durable power of attorney, or a caregiver may sign as an alternate signer in some cases, with VA Form 21-0972 on file. A representative with VA Form 21-22 or 21-22a on record may sign, but the form says a POA cannot sign for an original claim only. |
| Who receives it | VA, through its intake center in Janesville, Wisconsin, which scans the claim into the veteran's file for a decision. |
| Where to send it | Online at VA.gov. By mail, VA's how to file page gives: Department of Veterans Affairs, Claims Intake Center, PO Box 4444, Janesville, WI 53547-4444 (the form itself names the Evidence Intake Center at the same PO box). You can also bring it to a VA regional office, fax it, or file with help from an accredited representative. |
| Deadline | There is no fixed deadline to file a disability claim. VA says that if you file on paper you may want to submit an intent to file first, which can protect an earlier effective date while you gather evidence. After VA receives the claim you have up to one year to send supporting evidence. BDD claims must be filed 90 to 180 days before your separation date. |
| Official links | Official page · Official PDF |
What changed
The JAN 2026 edition replaced the NOV 2022 edition, which the form marks as superseded. VA did not publish a list of changes on the form page.
How to fill out VA Form 21-526EZ, line by line
| Item 1 | Claim program or process Choose the Fully Developed Claim (FDC) program, the Standard Claim Process, IDES (only if your service department referred you) or a BDD claim. FDC means you send all your evidence with the claim. If you add evidence later, VA moves the claim to the standard process. |
| Section I, items 2 to 12 | Veteran identification Name, Social Security number, VA file number if you filed before, date of birth, service number, phone, mailing address and optional email. Item 8 is only for BDD claims and asks for your release date from active duty. |
| Section II, item 13 | Change of address Fill this in only if your address is changing. Mark it temporary or permanent and give the start date, and an end date for a temporary address. |
| Section III, items 14A to 14F | Homeless information Answer only if you are homeless or at risk of becoming homeless. Give a point of contact VA can use to reach you. |
| Section IV, items 15A to 15E | Toxic exposure Say whether you claim conditions linked to toxic exposures, such as Gulf War hazard locations, herbicide locations like Vietnam, burn pits, asbestos or Camp Lejeune water. Give approximate month and year ranges. |
| Section V, item 16 | Current disabilities List each condition or symptom you claim, whether it is linked to an exposure, event or injury, how it relates to service, and roughly when it began or got worse. Use Section XIII on page 15 for more space. |
| Section V, item 17 | VA and military treatment facilities List VA medical centers and military treatment facilities where you were treated after discharge for the claimed conditions. If treatment began in 2005 or later, you do not need to give dates. |
| Section VI, items 18 to 23 | Service information Branch, component, most recent active service dates, other names you served under, Reserve or National Guard details, current federal activation and any prisoner of war confinement. |
| Section VII, items 24 to 28 | Service pay Tell VA about military retired pay, separation or severance pay, and training pay. The form explains that VA compensation can be offset against some of these payments. Item 26 and item 28 are only for people who do not want VA compensation. |
| Section VIII, items 29 to 32 | Direct deposit Bank name, routing number, account number and account type. Skip it if you already have direct deposit set up with VA. |
| Section IX, item 33 | Signature and date The veteran or service member signs and dates the claim. The form marks this signature as required. If you sign with an X, two witnesses sign in Section X. |
Common mistakes to avoid
- Leaving item 33A unsigned. The form marks the veteran's signature as required.
- Choosing the FDC program and then sending more evidence later. VA moves the claim to the standard process when that happens.
- Using this form to appeal a decision made in the past year. The form points to VA Form 10182, 20-0995 or 20-0996 for decision reviews.
- Using this form for non-service-connected pension or survivor benefits. The form says to use VA Form 21P-527EZ or 21P-534EZ instead.
- Not attaching the extra forms listed on page 11, such as VA Form 21-8940 for Individual Unemployability or VA Form 21-0781 for mental health conditions.
- Describing conditions vaguely. List each condition and explain how it relates to an event, exposure or injury in service.
- Filing a paper claim without considering an intent to file first, which VA says can help avoid a later effective date.
Questions about VA Form 21-526EZ
Can I file VA Form 21-526EZ online?
Yes. VA's form page says you can apply online instead of filling out and sending the paper form. VA says that when you file online, your effective date is set when you start the online form.
Where do I mail VA Form 21-526EZ?
VA's how to file page gives Department of Veterans Affairs, Claims Intake Center, PO Box 4444, Janesville, WI 53547-4444.
Do I have to send evidence with the claim?
No. VA says you do not have to submit evidence, but it may schedule a claim exam. You have up to one year from when VA receives the claim to send evidence.
What is the Fully Developed Claim program?
It is an optional faster process. You send all relevant private records with the claim and tell VA about federal records. If VA finds it needs other records, it moves the claim to the standard process. The form says this does not affect the benefits you are entitled to.
Can I file before I leave the military?
Yes, under the Benefits Delivery at Discharge program, if you are 90 to 180 days from separation and can attend exams for 45 days after filing.
Who can help me fill out the form?
The form suggests an accredited veterans service officer or your state office of veterans affairs. You can also contact VA at ask.va.gov or 1-800-827-1000 (TTY: 711).
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Sources
Checked against the official sources on 2026-10-25. PDF Editor Hub is not affiliated with the U.S. Department of Veterans Affairs or any government agency. This page is general information, not legal or tax advice.