Department of veterans affairs evidence intake center phone number

Find a VA form. About VA Form 21-8951-2. About VA Form 21-8951-2. Form name: Notice of Waiver of VA Compensation or Pension to Receive Military Pay and Allowances. Related to: VBA. Form last updated: June 2023.

Department of veterans affairs evidence intake center phone number. Department of Veterans Affairs Freedom of Information Act Services (005R1C) 811 Vermont Avenue, NW Washington, DC 20420 ... Phone: 202-738-2974 Email: FOIAHelp@va.gov.

Administered by the U.S. Department of Veterans Affairs through the National Cemetery Administration, the PMC program ensures that the memory of these veterans lives on in the collective consciousness of the nation they served. ... NCA Memorial Products Service Presidential Memorial Certificate Program NCA FP Evidence Intake Center P.O. Box ...

Providing Health Care for Veterans. The Veterans Health Administration is America's largest integrated health care system, providing care at 1,321 health care facilities, including 172 medical centers and 1,138 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled Veterans each year.You can call the VA's main information line at 800-698-2411 (TTY: 711) or use one of the other contact methods available. Use Ask VA to send us your questions, updates, and documents online. Contact us online through Ask VA. Media inquiries should be directed to the Office of Media Relations at [email protected] of Veterans Affairs Evidence Intake Center PO Box 4444 Janesville, WI 53547-4444: 844-531-7818 (toll free) ... cannot be resolved through contact with you or a review of other information of record ... • number of prior marriages for each spouse, if not shown on the official record. ...Veterans benefits help Veterans and their families buy homes, earn degrees, start careers, stay healthy, and more. Join an event for conversation and information. SHOW ALL VA EVENTS. External Link Disclaimer: This site contains links that may take you outside of the Department of Veterans Affairs website.As a leading healthcare provider for our nation’s veterans, Hines VA Medical Center offers a wide range of innovative technologies and treatments to ensure the best possible care. ...Use VA Form 21P-534EZ if you want to submit evidence along with your claim, using the Fully Developed Claim (FDC) program to get a decision on your claim faster. You can use this form if you're: A surviving spouse or child of a Veteran who has died. Applying for VA benefits and/or the money that we owe the Veteran but didn't pay prior to ...Select the appropriate User Type button on the User Identification screen: Veteran, Veteran Family Member, or VSO/VA Business Partner (e.g., officer, attorney, or claims agent). Once your registration is complete, you will be able to upload your documents electronically online using QuickSubmit. Once logged into QuickSubmit, when submitting ...

Department of Veterans Affairs Pension Intake Center PO Box 5365 Janesville, WI 53547-5365. In person. Bring your application to a VA regional office near you. Find a VA regional office near you. Learn about the evidence you'll need to support your claimDepartment of Veterans Affairs Board of Veterans' Appeals P.O. Box 27063 Washington, DC 20038 Fiduciary Fiduciary Intake Center P.O. Box 95211 Lakeland, FL 33804-5211 The fastest way to respond to VA is to contact us at 1-800-827-1000.SOCIAL SECURITY NUMBER. SECTION I: IDENTIFICATION INFORMATION. 4. VA FILE NUMBER 5. VETERAN'S DATE OF BIRTH ... Department of Veterans Affairs Evidence Intake Center ... Pension Intake Center PO Box 5365 Janesville, WI 53547-5365 FIDUCIARY Department of Veterans Affairs Fiduciary Intake PO Box 95211 Lakeland, FL 33804-5211The Evidence Intake Center (EIC) operates under the US Department of Veterans Affairs through an office in Wisconsin. This subsector of the VA processes disability compensation documents, and as a veteran, you are required to send your documents (such as evidence) to this office. After applying for a disability claim, you can expect letters ...U.S. Department of Veterans Affairs | 810 Vermont Avenue, NW Washington DC 20420. Last updated January 17, 2024Elizabeth Marrone, CTRS Recreation Therapist 1 VA Ctr Augusta ME 04330 (207)623-8411 x5371 [email protected]. Rehabilitation and extended care. We provide medical care and rehabilitation services to Veterans in our …Veterans will receive up to 12 months of tuition and fees and a monthly housing allowance based on Post-9/11 GI Bill rates. To learn more about VRRAP, Veterans can visit www.va.gov . Veterans can also contact the Education Call Center at 888-442-4551 between 7 a.m. - 6 p.m. EST, Monday-Friday to speak with a VA education representative.

In Nov. 2021, the VA started mailing out notices to hundreds of thousands of disabled veterans. The groundbreaking April 2021 Beaudette v. McDonough decision means vets can now appeal VA decisions on the Caregiver Program to the Board of Veterans' Appeals. Learn more. | Veterans Disability Info 888.878.9350Contact Us. Please reach us toll-free at (888) 407-0144 and select the appropriate Fiduciary hub below. For general evidence or information related to your fiduciary records you may mail or fax information to: VA Fiduciary Intake Center P.O. Box 5211 Janesville, WI 53547-5211 Fax 888-581-6826Veterans will receive up to 12 months of tuition and fees and a monthly housing allowance based on Post-9/11 GI Bill rates. To learn more about VRRAP and how to apply for the program, Veterans can visit www.va.gov. Veterans can also contact the Education Call Center at 888-442-4551 between 7 a.m. - 6 p.m. EST, Monday-Friday to speak with a VA ...Please be sure to put your name and claim number or social security number on every page of documentation you mail or fax to VA and keep a copy of everything for your records. When submitting claims: U.S. Department of Veterans Affairs Claims Intake Center PO Box 5235 Newnan, GA 30271-0020

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Attention: Milwaukee Pension Center PO BOX 5365 Janesville, WI 53547-5365 Fax: 1-844-655-1604. Service Area: Alabama, Arkansas, Illinois, Indiana, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Ohio, Tennessee, Wisconsin. St. Paul VA Regional Office. Department of Veterans Affairs Claims Intake Center Attention: St. …Intake Site At Fort Bragg. Soldier Support Center/VA Outbase office Fort Bragg, NC 28307. 318. Intake Site At New River MCAS. Camp Lejeune Dept of VA - Benefits Delivery at Discharge Camp Lejeune, NC 28547. 318. Intake Site At Pope Air Force Base. Family Support Center Seymour-Johnson AFB, NC 28307. 318.U.S. Department of Veterans Affairs | 810 Vermont Avenue, NW Washington DC 20420. Last updated May 02, 2024.Evidence Requirements. Evidence Needed; Private Medical Evidence; ... submit a request with the beneficiary's name and VA file number, and your name and contact information to the Fiduciary Hub of jurisdiction. To identify the correct Fiduciary Hub review the Contact Us page. ... U.S. Department of Veterans Affairs | 810 Vermont Avenue, NW ...Evidence Requirements. Evidence Needed; Private Medical Evidence; ... submit a request with the beneficiary's name and VA file number, and your name and contact information to the Fiduciary Hub of jurisdiction. To identify the correct Fiduciary Hub review the Contact Us page. ... U.S. Department of Veterans Affairs | 810 Vermont Avenue, NW ...

If you want to notify us by submitting the form, download and fill out an Intent to File a Claim for Compensation and/or Pension, or Survivors Pension and/or DIC (VA Form 21-0966). Download VA Form 21-0966 (PDF) Mail your completed form to this address: Department of Veterans Affairs Claims Intake Center PO Box 4444 Janesville, WI 53547-4444.Contact Us. 1-800-562-2308. [email protected] (360)725-2182 - King County ... Washington State Department of Veterans Affairs Homeless Veterans' Reintegration Program is supported by the U.S. Department of Labor. A total of $500,000, or 100 percent, of the program is financed with federal funds. ... credible evidence indicating that the ...Vocational rehabilitation and employment help. Please contact us at 1-800-827-1000 for assistance. Visitor Engagement Reporting Application-VERA. Visitors seeking assistance from the Regional Office Public Contact Team are encouraged to schedule a virtual or in-person appointment on the Visitor Engagement Reporting Application (VERA).Internet technology has made the quest for cell phone information as easy as logging on to a website, and clicking a few buttons. Here are a few tips to show you how to tell if a n...Contacting VA Outside of Togus: By Phone: Please note Veterans can access information or ask questions about their benefits by calling: Phone: 1-800-827-1000 or 1-800-MYVA411 (1-800-698-2411) Online: Veterans also have the option to check the status of a claim or appeal, view payment history, upload evidence to support a claim or appeal, file ...Apply for VA health care, find out how to access services, and manage your health and benefits online. File a claim for disability compensation for conditions related to your military service, and manage your benefits over time. Apply for and manage your GI Bill and other education benefits to help pay for college and training programs.Do not send original documents; they will not be returned. ELECTRONICALLY submit your claim and If you prefer, you may FAX VA Form 40-1330 claims and supporting documents supporting documents by using Quick Submit MAIL claims to: NCA FP Evidence Intake Center to 1-800-455-7143. at access.va.gov.Enter International Phone Number (If applicable) YES (If "Yes," complete Item 6B) NO . ... Department of Veterans Affairs Evidence Intake Center ... WI 53547-4444 Pension Intake Center PO Box 5365 Janesville, WI 53547-5365. Where to Send Your Correspondence - After completing this form, please use the related mailing address: SECTION VII: REMARKSAfter completing the form, mail to: Department of Veterans Affairs, Evidence Intake Center, P.O. Box 4444, Janesville, WI 53547-4444. SECTION I: VETERAN'S IDENTIFICATION INFORMATION. NOTE: You may complete the form online or by hand. If completed by hand, print the information requested in ink, neatly and legibly, insert one letter per box, and ...Veterans will receive up to 12 months of tuition and fees and a monthly housing allowance based on Post-9/11 GI Bill rates. To learn more about VRRAP, Veterans can visit www.va.gov . Veterans can also contact the Education Call Center at 888-442-4551 between 7 a.m. - 6 p.m. EST, Monday-Friday to speak with a VA education representative.

Support. We have a number of ways to answer your questions and provide the forms and other information you need to ensure you receive the best possible customer service. To find a VA location or in-network community care provider, use the VA Facility Locator Tool. 855-673-4357.

Enter International Phone Number (If applicable) 15. EMAIL ADDRESS (Optional) ... Department of Veterans Affairs Evidence Intake Center ... Department of Veterans Affairs Pension Intake Center PO Box 5365 Janesville, WI 53547-5365 FIDUCIARY Department of Veterans Affairs Fiduciary Intake PO Box 95211 Lakeland, FL 33804-5211Address. 1 Jefferson Barracks Drive. St. Louis, MO 63125-4199. Get directions on Google Maps to St. Louis VA Medical Center-Jefferson Barracks.Facility Address Phone; 328: Chicago Regional Office: 2122 W Taylor Street Chicago, IL 60612 Mailing Address: Department of Veterans Affairs / Claims Intake Center / PO Box 5235 Janesville, WI 53547-5235 800-827-1000 328: Intake Site At Great Lakes Naval StationYou can call the VA's main information line at 800-698-2411 (TTY: 711) or use one of the other contact methods available. Use Ask VA to send us your questions, updates, and documents online. Contact us online through Ask VA. Media inquiries should be directed to the Office of Media Relations at [email protected] Veterans Benefits Administration (VBA) uses VA Form 21-4142, Authorization to Disclose Information to the Department of Veterans Affairs (VA), to request private medical records and information regarding the source of records in support of claims for compensation and/or pension benefits.The response helps VA determine whether a source identified by the claimant has pertinent information or ...VA benefits; however, if medical evidence indicates they cannot manage their benefits, VA can appoint a ... Fax to Claims Intake Center, PO Box 95211, Lakeland, FL 33804-5211, Fax 888-581-6826 . Create ... It is the policy of the Department of Veterans Affairs (VA) to makeIf you prefer to mail your correspondence, please use the related mailing address below. Compensation Benefits. Pension & Survivors Benefits. Department of Veterans Affairs Compensation Intake Center PO Box 4444 Janesville, WI 53547 Toll Free Phone: 1-800-827-1000 Toll Free Fax: (844) 531-7818.The local MST Coordinators for the Indianapolis Regional Office are Ms. Tamika Shelton and Mrs. Kimberlyn (Kim) Tutt. If you are an MST survivor and need assistance with a benefits-related question or assistance in filing a claim for benefits, please contact one of our MST Coordinators at 317-916-3022. External Link Disclaimer: By clicking on ...What if I have trouble downloading a VA letter? Call our MyVA411 main information line at 800-698-2411 (TTY: 711). Check the status of debt related to VA disability compensation, non-service-connected pension, or education benefits. You can also make payments or request help. Last updated: January 26, 2024.Are you in need of assistance with your Xfinity Center experience? Whether you have questions about ticketing, event information, or any other concerns, contacting the right custom...

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Since 2007, the VA Evidence Synthesis Program (ESP) has helped VA function as a continuously learning health care system. We provide timely, rigorous, independent syntheses of published evidence for the VA to translate into evidence-based clinical practice, policy, and research. We adapt traditional systematic review approaches to meet our ...Line 1: Type of Document (Notice of Disagreement, Substantive Appeal, Evidence Submission etc) Line 2: Include the date of the Submission. Line 3: Write the name of the VA Regional Office. Line 4: Your Name. Line 5: Claim Number. Line 6: Page Numbering (I recommend using Page # of # type references) If this header appears at the top of EVERY ...You can find out where your claim, decision review, or appeal is in our review process. You can also check these details: Any evidence you’ve filed online to support your initial claim. Any additional evidence we’ve requested from you. Your claim, decision review, or appeal type. What you’ve claimed.Department of Veterans Affairs, Evidence Intake Center, P.O. Box 4444, Janesville, WI 53547-4444. INSTRUCTIONS: NOTE: 10A. PROVIDER OR FACILITY NAME . 10D. PROVIDER/FACILITY STREET ADDRESS (Number and street or rural route, P.O. Box, City, State, ZIP Code and Country) From: 10C. DATE(S) OF TREATMENT: (Include the time period (MM/DD/YYYY)number on each page. Send your application and any evidence in support of your claim to the following address: Department of Veterans Affairs Evidence Intake Center P. O. Box 4444 Janesville, WI 53547-4444 . If you are unable to mail your application or evidence, please use the following Fax Lines: • (844) 531-7818 (Toll Free) •Centralized Intake Coversheet . To: Department of Veterans Affairs Claims Intake Center . PO BOX 4444, Janesville, WI 53547-4444. Fax: 844-531-7818 . Claimant Last Name: Claimant First Name: Claimant C-File #: Claimant Zip Code: VSO Contact Email: Fax Date (MM/DD/YYYY – if applicable): # of Pages to Include Coversheet: Emergent Claim ...Filing a claim. In order to file a claim for benefits call our office at 303-284-6077 and make an appointment. When making an appointment, be prepared to provide the last two numbers of your Social Security number as this will assist us in booking an appointment for you with the corresponding State Service Officer.For assistance or to ask questions about your claim status please call the Veterans Benefits Administration National Call Center at 1-800-827-1000 . Report the passing of a Veteran or beneficiary. Check on the status of your claim. Obtain financial documentation. Request information on burial and mortuary benefits.At the Prescott Vet Center, we can connect you with the VA HUD-VASH program or other community resources. Call our Veterans Crisis Line at 988 and press 1 to get support anytime day or night. This service is private, free, and available 24/7. Our Vet Center can also connect you with ongoing counseling and services. ….

Please be sure to put your name and claim number or social security number on every page of documentation you mail or fax to VA and keep a copy of everything for your records. When submitting claims: U.S. Department of Veterans Affairs Claims Intake Center PO Box 5235 Newnan, GA 30271-0020You may apply for Aid and Attendance or Housebound benefits by submitting the prescribed VA form (s) to the Pension Management Center (PMC) that serves your state. You may also visit your local regional benefit office to file your request. You can locate your local regional benefit office using the VA Facility Locator. Include this information:r/VeteransBenefits. r/VeteransBenefits. Join. Everything you need to get the Veteran's Benefits you earned and are entitled to. We're here to help. Let's get started! 133K Members 106 Online.The Department of Housing and Urban Development (HUD) offers a rental assistance program called the Veterans Affairs Supportive Housing (VASH) program. This program provides rental...They may be contacting you for information about your claim. The CPC will only be processing: Claims for increase. Original claims for compensation. Original claims for pension. Dependency claims. Contact Info: VA Claims Processing Center PO Box 6513 London, KY 40742 859-389-4895.Phone Number Email; Hawaii: 1-800-827-1000 1-800-MyVA411: [email protected] ... [email protected]: You may mail or fax claims and evidence to: Department of Veterans Affairs Claims Intake Center PO Box 4444 Janesville, WI 53547-4444. Fax Toll Free: 844-531-7818. 1-800-MyVA411. The Department of Veterans Affairs established …Phone. Call 1-800-827-1000 and tell them you would like to initiate an intent to file. In person. Complete VA-Form 21-0966 and submit it to your nearest VA Regional Office. Fax. 844-531-7818; By mail. Submit VA-Form 21-0966 to: Department of Veterans Affairs Claims Intake Center PO Box 4444 Janesville, WI 53547-4444 IMPORTANT NOTE:ü Phone/Video Interview. ü Document Drop-off. ü In-Person Interview (limited slots) ... Department of Veterans Affairs. Evidence Intake Center. P.O. Box 4444. Janesville, WI, 53547-4444 Department of Veterans Affairs. Pension Intake Center. P.O. Box 5365. Janesville, WI 53547-5365. To fax your documents without …Find phone numbers for many of the administrative and program offices at VA Salt Lake City health care. Mailing address. George E. Wahlen Department of VA Medical Center 500 Foothill Drive Salt Lake City, UT 84148. Main phone numbers. Local: 801-582-1565 Toll-free: 800-613-4012, select 0. To use TeleType for the Deaf (TTY) services: dial … Department of veterans affairs evidence intake center phone number, Evidence Requirements. Evidence Needed; Private Medical Evidence; ... submit a request with the beneficiary's name and VA file number, and your name and contact information to the Fiduciary Hub of jurisdiction. To identify the correct Fiduciary Hub review the Contact Us page. ... U.S. Department of Veterans Affairs | 810 Vermont Avenue, NW ..., For assistance or to ask questions about your claim status please call the Veterans Benefits Administration National Call Center at 1-800-827-1000 . Report the passing of a Veteran or beneficiary. Check on the status of your claim. Obtain financial documentation. Request information on burial and mortuary benefits., telephone at 1-800-827-1000 or contact VA online at ASK VA: https://ask.va.gov. ... social security number, VA ... Department of Veterans Affairs Evidence Intake Center , To request the status of an open compensation claim, pension claim, or appeal, please call VBA at 1-800-827-1000 or call the VA Hotline at 1-855-948-2311. Cases the OIG Does Not Act On. Individual claims for disability or other benefits. VA billing issues. Discrimination, EEO, unfair labor practices., Veterans Affairs Evidence Intake Center P.O. Box 5154 Janesville, WI 53547. You can also seek review through the VHA Clinical Review Process. Please contact the Patient Advocate at your local VA medical facility for more information on the Clinical Review Process. Review options for decisions issued on or after February 19, 2019 , number on each page. Send your application and any evidence in support of your claim to the following address: Department of Veterans Affairs Evidence Intake Center P. O. Box 4444 Janesville, WI 53547-4444 . If you are unable to mail your application or evidence, please use the following Fax Lines: • (844) 531-7818 (Toll Free) •, Department of Veterans Affairs Evidence Intake Center PO Box 4444 Janesville, WI 53547-4444: VA gov: www.va.gov ... cannot be resolved through contact with you or a review of other information of record ... • number of prior marriages for each spouse, if not shown on the official record. ..., Apply for VA health care, find out how to access services, and manage your health and benefits online. File a claim for disability compensation for conditions related to your military service, and manage your benefits over time. Apply for and manage your GI Bill and other education benefits to help pay for college and training programs., To file your claim through a VSO, you must sign a United States Department of Veterans Affairs (USDVA) Appointment of Representation form, which authorizes the VSO to act on your behalf in preparing, presenting, and pursuing your claim for any and all benefits from the federal VA. ... or ask the VA to get evidence from a VA Medical Center ..., Departments; Veterans Affairs; Veterans Affairs Welcome. ... Please contact our office at 610-213-4022 (phone or text) to schedule an appointment. Leadership. ... Human Services Center P.O. Box 311 Norristown, PA 19404. Get Directions. Ph: 610-213-4022. Hours. Monday - Friday 8:30 a.m. - 4:15 p.m., Department of Veterans Affairs. Evidence Intake Center. PO Box 4444. Janesville, WI 53547-4444 ... In addition, you will need to include your basic information like date of birth, social security number, email address, phone number, and current mailing address. ... Department of Veterans Affairs. Evidence Intake Center. PO Box 4444. Janesville ..., The Department of Veterans Affairs (VA) offers a variety of services and benefits to veterans, including access to VA forms. These forms are used to apply for benefits, file claims..., Janesville, WI 53547-4444. When submitting documentation, veterans should be sure that the envelope, if mailed, is clearly marked and the veteran’s name is …, CA WRIISC VA Palo Alto Health Care System 3801 Miranda Ave. Mail Code 151Y Palo Alto, CA 94304 1-888-482-4376. DC WRIISC VA Medical Center Suite 1028, Building 14, Visitors seeking assistance from our Public Contact Team are encouraged to schedule a ... You may mail or fax Veteran compensation claims and evidence to: Department of Veterans Affairs Claims Intake Center ... Department of Veterans Affairs Pension Intake Center P.O. Box 5365 Janesville, WI 53547-5365 Fax Toll Free 844-655-1604 . Office Status., As a leading healthcare provider for our nation’s veterans, Hines VA Medical Center offers a wide range of innovative technologies and treatments to ensure the best possible care. ..., Benefits Questions, such as GI Bill, Claim Status or Disability Benefits. 1-800-827-1000. Monday-Friday, 8:00 am-9:00 pm ET., After completing the form, mail to: Department of Veterans Affairs, Evidence Intake Center, P.O. Box 4444, Janesville, WI 53547-4444. 1. VETERAN'S NAME (First, Middle Initial, Last) 2. VA FILE NUMBER (If known) 3A. PERSON COMPLETING THIS FORM (First, Middle Initial, Last) (If other than veteran) 3B., For assistance or to ask questions about your claim status please call the Veterans Benefits Administration National Call Center at 1-800-827-1000 . Report the passing of a Veteran or beneficiary. Check on the status of your claim. Obtain financial documentation. Request information on burial and mortuary benefits., ATTACHMENT I - VA Evidence Intake Centers All correspondence regarding disability compensation claims should be sent to the following address: EVIDENCE INTAKE CENTER DEPARTMENT OF VETERANS AFFAIRS CLAIMS INTAKE CENTER P.O. BOX 4444 JANESVILLE, WI 53547-4444, U.S. Department of Veterans Affairs | 810 Vermont Avenue, NW Washington DC 20420. Last updated May 02, 2024., If you’re looking for affordable rental housing, the U.S. Department of Housing and Urban Development (HUD) has a program called Veterans Affairs Supportive Housing (VASH) that can..., Submitting claims and evidence via regular mail For all claims, supplemental claims and higher level reviews related material; Department of Veterans Affairs. Compensation Intake Center. P.O. Box 4444. Janesville, WI 53547-4444 For Notice of Disagreements and related material. Board of Veterans Appeals. P.O. Box 27063. Washington, D.C. 20038, Department of Veterans Affairs Evidence Intake Center P.O. Box 4444 Janesville, WI 53547-4444. 38 U.S.C. 1805: Vietnam 38 U.S.C. 1821: Korea. Monetary benefits may be paid to, or on behalf of, children of veterans who served in or near the demilitarized zone (DMZ) in Korea. 38 U.S.C. 1822: Thailand, The Department of Veterans Affairs (VA) runs programs benefiting veterans and members of their families. It offers education opportunities and rehabilitation services and provides compensation payments for disabilities or death related to military service, home loan guaranties, pensions, burials, and health care that includes the services of nursing …, Here's what you'll need to do for us to consider your claim fully developed: Submit your completed Application for Disability Compensation and Related Compensation Benefits (VA Form 21-526EZ), and. Submit all the evidence (supporting documents) you have along with your claim, and. Certify that there's no more evidence we might need to ..., Download VA Form 10-5345a (PDF) Mail your signed form to. 3900 Woodland Avenue. Philadelphia, PA 19104. Fax your signed form to. 215-823-5839. We process mailed or faxed requests within 10-14 days. For privacy reasons, we can't accept requests for medical records by email., If you prefer to mail your correspondence, please use the related mailing address below. Compensation Benefits. Pension & Survivors Benefits. Department of Veterans Affairs Compensation Intake Center PO Box 4444 Janesville, WI 53547 Toll Free Phone: 1-800-827-1000 Toll Free Fax: (844) 531-7818., The final of the seven most common VA forms is VA Form 21-686C, Declaration Application Request to Add or Remove Dependents. You use the form when you want to submit a claim for additional benefits for a dependent, add a new dependent, or request to remove a dependent from your benefits., Notice to Veterans and service members of evidence needed: We’re required by law to tell you what evidence you’ll need to provide to support your disability claim. The information on this page is a summary of evidence requirements (called “section 5103 notice”). You can review the official evidence requirements in VA Form 21-526EZ., Department of Veterans Affairs, Evidence Intake Center, P.O. Box 4444, Janesville, WI 53547-4444. INSTRUCTIONS: NOTE: 10A. PROVIDER OR FACILITY NAME . 10D. PROVIDER/FACILITY STREET ADDRESS (Number and street or rural route, P.O. Box, City, State, ZIP Code and Country) From: 10C. DATE(S) OF TREATMENT: (Include the time period (MM/DD/YYYY), Review VA pension rates for Veterans, including Aid and Attendance and Housebound rates. Review pension rates for surviving spouses and children. Review protected pension rates for section 306 and old law VA disability and death pension benefits. Find out how to schedule your VA claim exam and what to expect during and after the appointment., Get answers to your questions about VA benefits and services. Explore our FAQs and other resources, send us a question online, or contact us by phone.