VA Form 10-3542 Printable, Fillable in PDF

Table of Contents

VA Form 10-3542 Printable, Fillable in PDF – Veteran or beneficiary claims for reimbursement of travel expenses are submitted to the Department of Veterans Affairs (VA) on VA Form 10-3542, Veteran/Beneficiary Claim for Reimbursement of Travel Expenses, by the veteran or beneficiary to cover trip expenses for receiving professional medical care in another state or country. The most recent version of the form, which was issued on November 1, 2013, rendered all earlier versions of the form obsolete. For your convenience, we have included a fillable version of VA Form 10-3542 that is up to date and can be accessed on the VA website.

If you are a veteran or beneficiary receiving a VA pension, or if your income is less than the pension, you may be eligible for travel reimbursement. To be qualified for reimbursement, the trip’s objective must be directly related to your medical condition, treatment, or service. The costs of the trip are refunded within thirty days of the trip’s completion.

The applicant must fall into one of the following categories to be deemed eligible:

Veterans with a disability rating of 30 percent or higher may be eligible for reimbursement for travel expenses incurred in connection with any healthcare condition.
The Department of Veterans Affairs may compensate veterans for travel due to their service-connected ailment if their disability rating is less than 30%;
Veterans receiving VA pension benefits may be paid for travel expenses incurred as a result of their medical condition.
Veterans having an annual income that is less than the maximum authorized yearly rate of pension may be eligible for reimbursement for travel connected to any medical condition.
Veterans who are unable to defray the costs of travel (as defined in the current Beneficiary Travel regulations); Veterans who are unable to defray the costs of travel (as defined in the current Beneficiary Travel regulations); Veterans who are unable to defray the costs of travel (as defined in the current Beneficiary Travel regulations); Veterans who are unable to defray the costs of travel (as defined in the current Beneficiary Travel regulations);
Veterans who are traveling in connection with an examination for Compensation and Pension (C&P) benefits;
Beneficiaries of other Federal Agencies that have been approved by the agency in question
When permitted by the proper foreign government agency, allied beneficiaries may be eligible;
Non-veterans who have served in the military (caregivers to veterans under the National Caregivers Program, medically required attendants, VA transplant care donor and support person, or other claimants subject to current regulatory guidelines).

Instructions For Completing VA Form 10-3542

The form is filled out by the veteran who is claiming benefits or their agent. Allied beneficiaries and beneficiaries of other federal agencies are exempt from completing Section A, Questions 3a-c, which asks for the veteran’s full name, social security number, and date of birth, since they are related to the veteran.
You must keep track of all of your non-mileage costs, which include tolls on roads or bridges, parking fees, ferry fares, meals and accommodation charges, as well as transit expenses such as by bus, train, taxi, or other public transportation. Prior clearance is required for all meals and lodging.
The claim will be assessed to establish whether or not the claimant is eligible for travel benefits and services. If it is judged to be eligible, the claim will be processed for payment at the presently permitted rate, less any applicable deductibles, at the time of submission.
Instructions for completing VA Form 10-3542 are included on the second page of the form, which is also available online. Instructions on how to complete each stage are provided below.

Detailed Instructions For Completing VA Form 10-3542

The VA Form 10-3542 must be filled out completely and include the following information:

Section A of the application asks for information on the traveling party. It is necessary to supply the claimant’s complete name, date of birth, social security number, and immigration status. It is advised that you use a passport or ID card to ensure that you submit the proper information as it appears on official papers. The veteran’s name, social security number, and date of birth are required on the application form.
Section B is responsible for giving information regarding the journey. It is necessary to give the day and time of the journey, as well as the departure and arrival addresses. Preparing the tickets and other papers containing this information ahead of time can help the claimant avoid making errors.
To be eligible for further reimbursement, a person must specify all of the expenses they want to be reimbursed for, such as tolls, parking, hotel accommodations, meals, and so on. A claimant must be prepared to present the receipt for each item for which they want to be paid when submitting a claim. It is necessary to indicate the name and location of the treating institution, which may be a VA- or non-VA-affiliated clinic.
Section C is where the certification will be completed. In addition, the claimant asserts that they have provided accurate and up-to-date information and that they have incurred a cost in connection with the travel claimed; they have not obtained transportation at the expense of the government, whether through the use of government-owned conveyance, or the purchase of government-purchased tickets or tokens or received other transportation resources at no cost to them; and they have not obtained transportation at the expense of the government. In addition, the claimant must confirm that they have never received any kind of veteran trip compensation previously and that they are the only one who is claiming for the travel that is indicated on the application. When signing the form, the claimant must be fully aware of the fact that they are fully responsible for the information they have submitted. False, fake, or fraudulent information may result in significant criminal and civil consequences, including a fine or jail, or both, depending on the circumstances.

What Address Should I Use To Send My VA Form 10-3542?

Alternatively, the form may be delivered in person or sent to the VA health care institution where the treatment was received. With the use of an up-to-date VA facility finder tool, a person may search for the closest VA medical center, as well as other health care facilities, VA benefits offices, cemeteries, and Veteran Service Centers among the VA’s 1925 institutions. In VA institutions, this repository of the facility and critical personnel information is updated regularly across the VA network. It is intended for simplicity of use, and information is organized by state and administration for browsing convenience. On the VA website, you can see the locations of all of the VA healthcare institutions throughout the country.

Where Can I Send My VA Form 10-3542 Via Fax?

One of the procedures for applying for travel reimbursement is to send the VA travel VA Form 10-3542 to the local Beneficiary Travel Office through secure fax or postal mail. Detailed contact information for VA health care institutions, including phone numbers and fax numbers, is available on the VA’s official website.