VA Form 21-2680 Printable, Fillable in PDF

VA Form 21-2680 Printable, Fillable in PDF – Examining for Housebound Status or Permanent Need for Regular Aid and Attendance (VA Form 21-2680) is a form that is used to evaluate if a veteran or their beneficiary is in need of any further support or monetary compensation. On September 1, 2018, the Department of Veterans Affairs (VA) in the United States issued the most recent version of the form available. A fillable VA Form 21-2680 is available for digital filing and download at the link provided below.

VA Form 21-2680 Printable, Fillable in PDF

Veterans aged 65 and over with little or no income, as well as recipients under the age of 65 who are permanently or fully incapacitated, are eligible for payments from the Veterans Administration. It is possible for a veteran or benefit to fill the form on their own, or for a claimant who is linked to the veteran or beneficiary, or for other relatives of the application; nevertheless, the document must be signed by an examiner.

VA Form 21-2680 (Virginia) The claimant’s physical and mental characteristics are detailed in the form, including how agile they are, what ailment they have, what tasks they can undertake throughout the day, and if they are able to leave home. The VA makes a judgment on whether or not to offer the requested assistance or compensation based on the information given.

What is the Purpose of VA Form 21-2680?

The VA Form 21-2680 is used to describe the health concerns that a veteran or recipient is experiencing, as well as their physical condition and ability to perform simple motions. It enables people to seek help and support, as well as additional monetary contributions on top of their pension income. Financial support or other essential assistance is determined in accordance with the information that has been submitted.

Vets or beneficiaries will be supplied with aid and assistance if they need the support of another person to do basic daily activities like washing, clothing, feeding oneself, and so on. A need to be in bed owing to a disability, or a requirement to be in a nursing facility due to a mental or physical condition, is also regarded significant enough to qualify for assistance.

How Do I Fill Out VA Form 21-2680 (Veterans Affairs)?

The following are the instructions for completing VA Form 21-2680:

  • For Section, I, “Veteran’s Identification Information,” the veteran must provide their complete name, Social Security Number (SSN), date of birth, service number (if applicable), gender, phone number (with area code), email address, and mailing address.
  • Section II (“Claim Information”) necessitates the submission of extensive information on the claimant (the veteran and the claimant can be the same person). Boxes 10 and 11 should include the claimant’s name as well as his or her social security number. Identify the claimant’s connection to the veteran or beneficiary in Box 12 by providing the following information: When filling out Box 13, the claimant must pick between two alternatives in order to specify the sort of benefit they are requesting for (for example, either “Special Monthly Compensation (SMC)” or “Special Monthly Pension (SMP)”).
  • Section III requests information such as the date of the examination, the veteran’s or beneficiary’s home address, and whether or not the claimant is presently hospitalized.
  • A detailed description of the claimant’s diagnosis is required in Box 17. The information supplied in Box 17 must not be in conflict with the information provided in Boxes 25 through 39. Boxes 18A through 18C provide a record of the claimant’s physical attributes, which are detailed below. It is necessary to include information regarding nutrition in boxes 19 through 20. The findings of the blood pressure, pulse, and respiratory assessments will be included in boxes 21 through 23 of the report. On page 24, you will see a list of the limitations that prohibit the claimant from doing the tasks described on pages 26 through 28.
  • If the claimant is required to remain in bed, the number of hours spent in bed should be recorded in Box 25. Filling out Boxes 26 through 28 will need basic information on activities such as feeding and preparing meals as well as whether or not the claimant is able to execute these tasks. If Boxes 26 and 27 include negative responses while Box 28 is answered positively, an explanation is requested. A separate piece of paper might be used for this. Information concerning the claimant’s vision and whether or not they are blind should be included in boxes 29A and 29B of the application.
  • Boxes 30 through 32 detail the kind of assistance the claimant needs, as well as whether or not they will be able to handle the payments themselves. Arguments should be used to back up the responses given. Box 33 contains a description of the claimant’s posture and physical appearance. Sections 34 through 36 describe the limitations on the ability to perform fundamental activities and motions. Box 37 contains a list of all of the diseases that impede the claimant from doing these duties.
  • In Box 38, the claimant specifies when and under what conditions he or she will be entitled to leave home. Providing information regarding whether or not the claimant needs help with mobility is required in Box 39. In order for the examining physician to complete boxes 40 through 41, they must include their name and signature on the form.

Where Should VA Form 21-2680 Be Sent?

The completed paperwork should be sent to a regional VA office in your area.

  • The Inyo, Kern, Los Angeles, San Luis Obispo, Santa Barbara, San Bernardino, and Ventura counties are all under the jurisdiction of the Los Angeles Regional Office, which is located in the city of Los Angeles. This office’s postal address is 11000 Wilshire Boulevard at the Federal Building in Los Angeles, CA 90024.
  • This office serves the counties of Imperial, Orange, Riverside, and San Diego under the jurisdiction of the San Diego Regional Office. The postal address is 8810 Rio San Diego Drive, San Diego, California 92108, and the fax number is (858) 92108.
  • The Alpine, Lassen, Modoc, and Mono areas are under the jurisdiction of the Reno Regional Office, which is based in Reno. This is the postal address for the Reno Regional Office, which is located at 5460 Reno Corporate Drive in Reno, Nevada 89511.
  • The Oakland Regional Office is responsible for all of the other counties in the region. If you want to send anything, the Oakland Regional Office is located at 1301 Clay Street, Room 1400 North in Oakland, California 94612.

VA Form 21-2680 Printable, Fillable in PDF

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