What is VA Form 21-4138?
VA Form 21-4138, also known as the Statement in Support of Claim, is an official Department of Veterans Affairs document associated with an existing VA benefits claim.
It provides a formal way for a veteran, beneficiary, or claimant to submit written statements, explanations, or other relevant information for inclusion in the VA claim record. The form does not request disability benefits or initiate a new claim.
What is VA Form 21-4138 used for?
Use VA Form 21-4138 to:
- Submit written statements related to an existing VA benefits claim -Provide additional details connected to a claim
- Clarify facts or information already in the claim file
- Explain the circumstances relevant to the claim
- Add personal or witness statements for VA review, often referred to as a VA Form 21-4138 lay statement
How to fill out VA Form 21-4138
- 1
Veteran or Beneficiary Identification Information (Section I)
- Name: Full legal name of the veteran or beneficiary
- Social Security Number: Used to match the statement to the correct VA claim file
- VA File Number: Enter only if already assigned
- Date of Birth: MM/DD/YYYY format
- Service Number: If applicable
- Mailing Address: Current address, including unit or apartment number
- Telephone Number: Required contact number
- Email Address: Optional
This section identifies whose claim the statement relates to.
- 1
Remarks (Section II)
- Written Statement: Enter the statement connected to the VA claim
- Content: Facts, explanations, or other relevant information
- Additional Pages: If more space is needed, attach continuation pages and include personal information on each page
This section contains the actual statement being added to the claim record.
- 1
Declaration of Intent and Signature (Section III)
- Certification: Confirms the statement is true and correct
- Signature: Required from the veteran or beneficiary
- Date Signed: MM/DD/YYYY format
Who is required to fill out VA Form 21-4138?
VA Form 21-4138 is filled out by the person submitting a written statement for a VA benefits claim. This is usually:
- The veteran, when the statement relates to their own claim
- A beneficiary, such as a surviving spouse or dependent
- A claimant, if they are authorized to provide information for the claim
Whoever completes the form must sign it to confirm that the information is accurate and truthful.
When is VA Form 21-4138 not required?
VA Form 21-4138 is not required if you do not need to submit a written statement for your VA claim. If all necessary information is already provided in the required application forms or supporting documents, submitting this form may not be necessary. It is also not required when the VA specifically requests information using a different VA form.
When is VA Form 21-4138 due?
VA Form 21-4138 doesn't have a set deadline. It can be submitted at any time while a VA benefits claim is under review. If the VA requests additional information, it may specify a timeframe for responding.
How to get a blank VA Form 21-4138
To get a blank VA Form 21-4138, simply visit our platform. The form is pre-loaded in our editor, ready for you to start filling out right away. Remember, our website helps you fill and download the form, but it doesn't assist with submitting it.
How to sign VA Form 21-4138
VA Form 21-4138 can be signed either by hand or with a valid electronic signature, as long as it clearly shows who is submitting the statement. The signature must include the date. If the form is not signed, it is considered incomplete and may not be approved/processed.
Where to file VA Form 21-4138?
VA Form 21-4138 can be submitted online through the VA’s official website, which allows you to upload the completed form directly to your claim.
You may also mail the form to the VA Evidence Intake Center at the address listed on the form. Mailing is an option if you prefer to submit paper documents or are unable to file online.
Other forms used with 21-4138 for a claim
- VA Form 21-526EZ – Application for Disability Compensation and Related Compensation Benefits This is the main form used to file a VA disability claim. VA Form 21-4138 is often submitted at the same time to provide written explanations, background details, or personal statements that support the claim.
- VA Form 21-10210 – Lay/Witness Statement This form is used when someone other than the veteran provides a statement, such as a spouse, family member, friend, or fellow service member. While VA Form 21-4138 captures the veteran’s own statement, this form serves a similar role for third-party accounts.
- VA Form 21-4142 – Authorization to Disclose Information to the VA This form allows the VA to request medical records from private healthcare providers. Information described in a statement submitted on VA Form 21-4138 often corresponds to medical evidence obtained through this authorization.
- VA Form 21-4142a – General Release for Medical Provider Information Typically submitted alongside VA Form 21-4142, this form identifies the medical providers whose records are relevant to the claim. Those records may support the details explained in a written statement.
- VA Form 20-0995 – Supplemental Claim This form is used to continue or reopen a claim by submitting new and relevant evidence. VA Form 21-4138 may be included to explain that evidence or clarify how it supports the claim.
