Veterans Pension and Survivors Pension Application
Instructions
You will need the
following documents. Make sure you keep copies of everything you submit.
1.
Your DD214 discharge papers or standard form
180. If you no longer have them in your possession go to:
http://www.archives.gov/veterans/military-service-records
2. Copy of your marriage
certificate
3. Copy of death certificate
(surviving spouse only)
4. Social Security award letter
from January
5. Physician statement VDVA 10
required in Illinois
6. Net worth information - Bank
accounts, CDs, trusts, stocks, bonds, annuities, etc.
7. Proof of income - Pensions,
retirement, interest income from investments, annuities, etc.)
8. Proof of medical expenses –
Insurance premiums, medications, medical bills and any other medical expenses
that are not reimbursed by insurance, Medicare or Medicaid.
9. List of all doctors and
hospitals visited in the last year.
10. Banking information for
direct deposits of A&A monthly payments (include a voided check).
11. If you are a court-appointed
Guardian of the veteran or surviving spouse, a certified copy of the court
order of the appointment is required.
12. Employment history – Does
not apply if applicant is over 65.
Fill Out These Forms:
VDA-21P-527EZ Vet or Couple Only
VBA-21P-534EZ Spouse Only
VBA21-2680 Exam
for Housebound Status or Permanent Need
VDVA 10 Physician statement
VBA21P-84216 Medical Expense Report Form
VA21-4142 Consent Form
VBA21-0845 Authorization to Disclose Personal
Information
VDA21P-8416 Medical Expense Form
VBA21-0779 Nursing
Home Information Form (for those living in a facility)
*VA21-22 Appoint Veterans Service Organization as
Rep
*VA21-22A Appoint Representative (Non-Service
Organization)
*Fill out either VB21-22 or VA21-22A depending on who your advocate is. APPLY through an advocate to get the VA
Aid and Attendance Benefit. Do not apply directly to the VA. Call 855-462-0100 for
an advocate referral in your area. The forms are available at
http://www.elderwerks.org/resources/guides/veterans-area-14-1.aspx