When adapting a paper form into an online application or tool on VA.gov, content writers and UX designers should consult our Form labels to see if a standardized label has already been created. Use the existing standardized labels when building a form rather than create new or custom labels with each new form.
The masterlist documents labels and questions that appear on our online forms. This list is continually updated as more forms are brought online and new field labels and form questions are documented.
Because form fields have a lot of visual design and formatting that can affect copy, this masterlist is also included in the Components > Form guidance.
A list of standardized form labels that appear on VA.gov forms. This list is a continued work in progress as each form is unique and has specific labels and questions. As we migrate more forms online, we’ll continue to add plain-language labels to this list.
Applicant information
Applicant information labels
Plain-language label or question |
Followup label or question |
Form notes |
Your first name |
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Your middle name |
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Your last name |
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Suffix |
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Mother's maiden name |
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appears on Health care app |
Your date of birth |
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Your place of birth |
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Social Security number |
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VA file number |
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Which categories best describe you? |
- Spanish
- Hispanic
- Latino
- American Indian or Alaskan Native
- Black or African American
- Native Hawaiian or other Pacific Islander
- Asian
- White
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Appears on Health care app |
What is your race, ethnicity, or origin? (Please check all that apply.) |
- American Indian or Alaskan Native
- Asian
- Black or African American
- Hispanic, Latino, or Spanish origin
- Native Hawaiian or other Pacific Islander
- White
- Another race or ethnicity
- Prefer not to answer
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Coronavirus research volunteer list |
Which of these best describe you? |
- Veteran
- Active-duty service member
- Member of the National Guard or Reserve
- VA employee
- Family member or caregiver of a Veteran or service member
- Enrolled in VA health care or CHAMPVA
- None of the above
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Coronavirus research volunteer list |
What is your gender? (Please check all that apply.) |
- Man
- Woman
- Transgender man
- Transgender woman
- Non-binary
- Prefer to self-describe
- Prefer not to answer
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Contact information
Contact information labels
Plain-language label or question |
Followup label or question |
Form notes |
Address |
Country, Street address, Street address line 2, Street address line 3, City, State, Postal code |
For forms, we use postal code to account for non-U.S addresses |
Home address |
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These are the labels used in VA.gov profile |
Mailing address |
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These are the labels used in VA.gov profile |
State or territory |
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Email address |
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Confirm email address |
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Appears as Re-enter email address on some forms |
Primary email address |
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appears on Pension app only |
Secondary email address |
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appears on Pension app only |
Home phone number |
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Mobile phone number |
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How should we get in touch with you? |
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How should we contact you if we have questions about your application? |
Mail, Email, Home phone, Mobile phone |
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To update your contact information for all of your VA accounts, please [go to your profile page]. |
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To update your address for all of your VA accounts, please [go to your profile page]. |
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I would like to receive text messages from VA about my [benefit type] benefits. |
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Military address
Plain-language label or question
Followup label or question
Form notes
I live on a U.S. military base outside of the country.
[Additional info component] U.S. military bases are considered a domestic address and a part of the United States.
Marriage information
Marriage information labels
Plain-language label or question |
Followup label or question |
Form notes |
What's your marital status? |
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Spouse's first name |
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Spouse's middle name |
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Spouse's last name |
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Spouse's suffix |
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Spouse's Social Security number |
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Where did you get married? |
City, State |
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When did you get married? |
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When did your marriage end? |
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Why did your marriage end? |
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Where did your marriage end? |
City, State |
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Type of marriage |
Ceremonial, Common-law, Proxy, Tribal, Other |
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How many times have you been married? |
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Caregiver information
Caregiver information labels
Plain-language label or question |
Followup label or question |
Form notes |
Primary Family Caregiver's first name |
label is same for Secondary Family Caregiver |
Caregiver form |
Primary Family Caregiver's middle name |
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Primary Family Caregiver's last name |
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Primary Family Caregiver's Social Security or tax identification number |
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Primary Family Caregiver's date of birth |
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Primary Family Caregiver's sex |
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Primary Family Caregiver's current street address |
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Primary Family Caregiver's primary phone number (including area code) |
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Primary Family Caregiver's alternate phone number (including area code) |
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What's the Primary Family Caregiver's relationship to the Veteran? |
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Does the Primary Family Caregiver applicant have health care coverage, such as Medicaid, Medicare, CHAMPVA, Tricare, or private insurance? |
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Service history
Service history labels
Plain-language label or question |
Followup label or question |
Form notes |
Last branch of service |
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appears on Health care app |
Branch of service |
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Sponsor's branch of service |
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Service start date |
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Service end date |
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Character of service |
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This could also be Character of discharge |
Service history |
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Type of service |
Active duty, drilling reservist, National Guard, IRR |
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Are you currently on active duty? |
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Did you serve under another name? |
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Place of last or anticipated separation from service |
City, State, or Foreign country |
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Are you currently on federal active duty in the National Guard? |
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Are you currently activated on federal orders? |
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Activation start date |
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Expected separation date |
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This could also be Anticipated separation date |
Obligation start date |
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Obligation end date |
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Most recent entry date |
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Are you a former POW? |
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Start of confinement? |
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End of confinement? |
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Have you received any type of severance or separation pay? |
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Do you have any periods of service that began before 1978? |
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Unit name |
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Military Service number |
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Dependent information
Dependent information labels
Plain-language label or question |
Followup label or question |
Form notes |
Do you have any dependents to report? |
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Do you have any dependent children? |
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What's your dependent's relationship to you? |
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Dependent's first name |
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Dependent's middle name |
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Dependent's last name |
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Dependent's suffix |
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Dependent's Social Security number |
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Dependent's date of birth |
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When did they become your dependent? |
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Does your child or dependent live with you? |
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Was your dependent permanently and totally disabled before the age of 18? |
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If your dependent is between 18 and 23 years old, did they attend school during the last calendar year? |
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Expenses your dependent paid for college, vocational rehabilitation, or training |
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Has your child ever been married? |
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Did your dependent live with you last year? |
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Do you have the same address as your spouse? |
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Do you have the same address as your dependent? |
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Income information
Income information labels
Plain-language label or question |
Followup label or question |
Form notes |
Annual income |
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What's your gross annual income from employment? |
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What's your net income from your farm, ranch, property, or business (if applicable) |
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Do you have any other income? |
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What's your spouse's gross annual income from employment? |
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What's your spouse's net income from your farm, ranch, property, or business? (if applicable) |
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Does your spouse have any other income? |
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Amount you or your spouse paid in non-reimbursable medical expenses this past year |
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Amount you paid in funeral or burial expenses for a deceased spouse or child this past year |
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Amount you paid for anything related to your own education (college or vocational) this past year. You don't
need to list your dependents’ educational expenses. |
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Account type |
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Bank account number |
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Bank routing number |
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Bank accounts, investments, and property |
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Social Security or other pensions (gross income) |
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Do you have any medical, legal, or other unreimbursed expenses? |
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Amount paid |
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Are you receiving military retired pay? |
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Expected income |
This is any income you didn't already report in this form that you expect to receive in the next 12 months. |
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Which type of VA compensation do you currently receive? |
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Health care information
Health care information labels
Plain-language label or question |
Followup label or question |
Form notes |
Are you eligible for Medicaid? |
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Are you enrolled in Medicare Part A (hospital insurance)? |
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Are you covered by health insurance? (Including coverage through a spouse or another person) |
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Provider's name |
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Policyholder's name |
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Policy number (This or the group code is required) |
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Group code (This or the policy number is required) |
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I'm enrolling to get minimum essential coverage under the Affordable Care Act |
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Please choose your preferred VA medical facility |
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Do you want VA to contact you to schedule your first appointment? |
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Education information
Education information labels
Plain-language label or question |
Followup label or question |
Form notes |
Which benefit have you used or are currently using? |
- Post-9/11 GI Bill (Chapter 33)
- Fry Scholarship (Chapter 33)
- Montgomery GI Bill (MGIB-AD, Chapter 30)
- Montgomery GI Bill Selected Reserve (MGIB-SR, Chapter 1606)
- Transfer of Entitlement Program (TOE)
- Post-Vietnam Era Veterans’ Educational Assistance Program (VEAP, Chapter 32)
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Are you applying for the Edith Nourse Rogers STEM Scholarship? |
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Are you enrolled in a STEM undergraduate degree program? |
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What's the name of your STEM degree? |
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Name of the school where you're planning on using the Rogers STEM Scholarship? |
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Name of school, university, or training facility you're attending |
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Type of education or training |
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Your school student ID number |
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Your school email address (This email address usually ends with .edu.) |
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Education or career goal |
(For example, “I want to get a bachelor’s degree in criminal justice” or “I want to get an HVAC technician
certificate” or “I want to become a police officer.”) |
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Are you getting, or do you expect to get any money (including, but not limited to, federal tuition assistance)
from the Armed Forces or public health services for any part of your coursework or training? |
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Are you getting benefits from the U.S. government as a civilian employee at the same time you’re requesting VA
benefits? |
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When did you stop taking classes or participating in the training program? (Future dates are ok.) |
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Why did you stop taking classes or participating in the training program? (For example, “I graduated” or “I
moved” or “The program wasn’t right for me.”) |
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When did you earn your high school diploma or equivalency certificate? |
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Hours completed |
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Type of hours |
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Degree, diploma, or certificate received |
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What did you study? |
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If you have any FAA flight certificates, please list them here |
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Have you ever held a license of journeyman rating (for example, as a contractor or plumber) to practice a
profession? |
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Main job |
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Number of months worked |
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Is student's tuition or education allowance being paid by the Survivors’ and Dependents’ Educational Assistance
(DEA), the Federal Compensation Act, or any U.S. government agency or program? |
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Burial information
Burial information labels
Plain-language label or question |
Followup label or question |
Form notes |
What expenses did you incur for the Veteran's burial? |
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Type of burial allowance requested |
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Date of death |
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Date of burial (includes cremation or interment) |
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Is there anyone currently buried in a VA national cemetery under your eligibility? |
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Disability information
Disability information labels
Plain-language label or question |
Followup label or question |
Form notes |
What type of disability claim are you filing? |
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Did you serve in a combat zone after Sept. 11, 2001? |
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Do you have any new conditions you want to add to your claim? |
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What caused this service-connected disability? |
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Do you need help buying or modifying your home? |
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Do you need help buying or modifying your car? |
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Are you confined to your home or need help with everyday activities? |
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Does your disability prevent you from holding down a job that you could otherwise do? (This doesn’t include
being retired.) |
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What is your work situation? |
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Please tell us where VA treated you for your disability |
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Name of VA medical facility |
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After we review your disability claim and supporting evidence, we may ask you to have a claim exam (also known
as a C&P exam) if we need more information to decide your claim. |
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We’ll use the results of this exam, in addition to your supporting evidence, to rate your disability. |
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Is there any evidence you’d like us to review as part of your claim? |
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What type of evidence do you want us to review as part of your claim? |
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Are you terminally ill? |
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Pension information
Pension information labels
Plain-language label or question |
Followup label or question |
Form notes |
Are you currently on federal active duty in the National Guard? |
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Have you had a job (including self-employment) from 1 year before you became disabled to now? |
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Employer's name |
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Employer's address |
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Job title |
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What disabilities prevent you from working? |
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Date your disability began |
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Have you been treated at a VA medical center for this disability? |
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How many days were lost due to your disability? |
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Housing information
Housing information labels
Plain-language label or question |
Followup label or question |
Form notes |
Are you currently homeless? |
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Disability compensation form |
Please describe your current living situation |
- I'm living in a homeless shelter
- I'm living somewhere other than a shelter (For example, I'm living in a car or a tent.)
- I'm living with another person
- I need to quickly leave where I currently live
- Other (Please describe)
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Please describe your current living situation |
- I'm losing my housing in 30 days
- I'm leaving a publicly funded homeless shelter soon
- Other (Please describe)
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Are you currently at risk of becoming homeless? |
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Please provide the name and number of a person we can call if we need to get in touch with you |
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Review and submit content
Review and submit content labels
Plain-language label or question |
Followup label or question |
Form notes |
Please review the information below to ensure that it's correct before you submit your application. This is
especially important if you worked on your application over several days. |
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Do you want to apply under the Fully Developed Claim program? |
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Last updated: 3/11/2021