Understanding Va Form 21-6789 For Disability Benefits

Quick Links :

As a veteran, understanding the process of applying for disability benefits can be a daunting task. One of the most crucial steps in this process is completing the VA Form 21-6789, also known as the "Dependency and Indemnity Compensation (DIC) Claim for Surviving Spouses or Dependents." In this article, we will break down the VA Form 21-6789, its purpose, and provide a step-by-step guide on how to fill it out.

The VA Form 21-6789 is used by the surviving spouse or dependents of a veteran who died as a result of their military service or a service-connected disability. The form is used to claim Dependency and Indemnity Compensation (DIC) benefits, which provide tax-free monetary benefits to eligible survivors.

Who is Eligible to File VA Form 21-6789?

To be eligible to file the VA Form 21-6789, the survivor must meet the following requirements:

• The veteran must have died as a result of their military service or a service-connected disability.
• The survivor must be the spouse, child, or parent of the veteran.
• The survivor must not be remarried or, if remarried, the remarriage must have ended in divorce or annulment.

Required Documents

Before starting the application process, it's essential to gather the required documents, which include:

• The veteran's death certificate
• The veteran's discharge or separation papers (DD Form 214)
• Marriage certificate (if applicable)
• Birth certificate (if applicable)
• Social Security number

Step-by-Step Guide to Filling Out VA Form 21-6789

The VA Form 21-6789 consists of 14 sections, which we will break down below:

Section 1: Claimant Information

• Provide the survivor's name, address, and Social Security number.
• Indicate the relationship to the veteran (spouse, child, or parent).

Section 2: Veteran Information

• Provide the veteran's name, Social Security number, and service number.
• List the veteran's branch of service and dates of service.

Section 3: Claim for DIC Benefits

• Check the box indicating the type of claim being filed (DIC, DIC for a child, or DIC for a parent).
• Provide the date of the veteran's death.

Section 4: Supporting Evidence

• List the documents being submitted in support of the claim, including the death certificate, discharge papers, and marriage certificate.

Section 5: Employment Information

• Provide information about the survivor's employment status, including income and employer.

Section 6: Medical Information

• Provide information about the veteran's medical treatment, including the name of the treating physician and the dates of treatment.

Section 7: Military Service Information

• Provide information about the veteran's military service, including the dates of service and the type of discharge.

Section 8: Dependents Information

• Provide information about the survivor's dependents, including their name, date of birth, and Social Security number.

Section 9: Claimant's Signature

• Sign and date the form.

Section 10: Power of Attorney

• If the survivor has appointed a power of attorney, provide their name, address, and Social Security number.

Section 11: Agent or Attorney Information

• If the survivor has an agent or attorney, provide their name, address, and Social Security number.

Section 12: Verification

• Sign and date the form, verifying that the information provided is true and accurate.

Section 13: Certification

• Sign and date the form, certifying that the survivor understands the claims process and has provided accurate information.

Section 14: Supplemental Claims

• Provide any additional information or supporting evidence.

Submitting the VA Form 21-6789

Once the form is complete, submit it to the Department of Veterans Affairs (VA) with the required supporting documents. The VA will review the claim and make a determination about the survivor's eligibility for DIC benefits.

Appealing a Denied Claim

If the VA denies the claim, the survivor has the right to appeal the decision. The appeal process involves filing a Notice of Disagreement (NOD) with the VA, which will review the claim and make a new determination.

Conclusion

The VA Form 21-6789 is a crucial document in the process of applying for DIC benefits. By following the step-by-step guide outlined above, survivors can ensure that their claim is complete and accurate, increasing the chances of a successful outcome.

If you have any questions or concerns about the VA Form 21-6789 or the claims process, please don't hesitate to reach out. We encourage you to share your experiences and ask questions in the comments below.