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VA Form 21-4138

Form name: Statement in Support of Claim
Form revision date: July 2024
Related to: Careers and employment, Disability, Education and training, Health care, Housing assistance, Life insurance, Pension

When to use this form

Use VA Form 21-4138 to share more information as instructed by another VA form or process. Here are a few examples of when you may need to use this form:

  • To share more details about your family situation or finances for applications or claims related to pension, Dependency and Indemnity Compensation, or accrued benefits
  • To tell us about reimbursement you received after you submitted a medical expense report
  • To share more details about claimed disabilities or other issues in support of your claim that can’t fit on the original claim form

Downloadable PDF

Online tool

You can submit your statement in support of claim online instead of filling out and sending us the paper form.

  • VA Form 21-10210

    Form name: Lay/Witness Statement

    Use VA Form 21-10210 to submit a formal statement to support your VA claim—or the claim of another Veteran or eligible family member. People also sometimes call this statement a “buddy statement.”

  • VA Form 20-10206

    Form name: Freedom of Information Act (FOIA) or Privacy Act (PA) Request

    Use VA Form 20-10206 to access your compensation, pension, benefit, or military records.

  • VA Form 20-10207

    Form name: Priority Processing Request

    Use VA Form 20-10207 to request priority processing for your claim due to certain qualifying circumstances or status.

Helpful links related to VA Form 21-4138

  • Find out how to apply for VA health care as a Veteran or service member.

  • Find out how to file a claim for disability compensation or increased disability compensation.

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