VA form 21-526EZ is the form Veterans use to apply for VA disability compensation.
Filling it out means providing information about the disabilities you’re claiming, your military service and how the two are connected. You’ll also provide information about your medical treatment and any relevant toxic exposures.
The form can look overwhelming at first. Breaking it into sections makes it much easier to complete.
1. Complete your personal and service information
Start with your basic information, including your:
- Full name
- Social Security number
- VA file number, if applicable
- Date of birth
- Mailing address
- Phone number and email address
You’ll also provide information about your military service, including your branch and dates of service.
Before submitting the form, check your contact information. The VA may contact you during the claims process, and you don’t want to miss an important notice.
2. List the disabilities you’re claiming
This is one of the most important parts of VA form 21-526EZ.
List each disability you want VA to consider. For each condition, provide:
- The condition you’re claiming
- When it began or worsened
- The injury, illness, event or exposure you believe caused it
- Whether you’re claiming it as secondary to an existing service-connected condition
Be specific. For example, avoid simply writing “knee problems.” Identify the condition as clearly as you can. Then explain what happened and when your symptoms began.
Keep your explanation focused. You don’t need to write your entire medical history.
Explain three things:
- What is the condition?
- When did it begin or worsen?
- Why do you believe it is connected to your active service?
If you’re filing a secondary claim, explain that relationship, too. For example, if you believe a service-connected right knee condition caused or aggravated a left knee condition, make that clear on your claim form.
3. Report relevant toxic exposures
VA form 21-526EZ asks about potential toxic exposures during military service.
Depending on your service history, these may include:
- Burn pits and other airborne hazards
- Agent Orange and other herbicides
- Asbestos
- Radiation
- Contaminated water
If an exposure is relevant to your claim, provide the information requested on the form. Include where and when the exposure occurred if you know.
You don’t have to determine whether your condition qualifies for presumptive service connection before you file. Simply provide accurate information about your service and potential exposures. VA will evaluate the evidence and determine what rules apply.
4. Provide your medical treatment information
Next, identify VA and military medical facilities where you received treatment for the conditions you’re claiming.
If you’ve seen a private doctor, visited a hospital or received other treatment outside VA, gather those records if you have them.
The VA can obtain federal records. You need to submit your private medical records yourself – or authorize VA to request them with its 21-4142 or 21-4142a forms.
Don’t focus only on recent treatment. Older medical records can help show when a condition began or how it has changed over time.
5. Submit supporting evidence
Your application tells VA what you’re claiming. Your evidence helps support it.
Depending on your claim, evidence may include:
- Service treatment records
- Military personnel records
- VA medical records
- Private medical records
- Medical opinions
- Diagnostic test results
- Statements from people who know about your condition or what happened during service
The evidence you need depends on the type of claim you’re filing. A direct service-connection claim may require different evidence than a secondary claim, presumptive claim or increased-rating claim.
For each condition, ask yourself:
- What shows that I have this condition?
- What shows what happened during my service?
- What connects the two?
If you’re unsure what evidence you need, getting help before you file can help you identify gaps in your claim.
6. Review and submit your application
Before signing VA Form 21-526EZ, review your application one more time.
Make sure:
- Every condition you want to claim is listed
- Your service dates are accurate
- Your explanations are clear
- Relevant toxic exposures are included
- Your VA and DOD medical treatment information is complete
- Your supporting evidence is included or identified
- Your contact information is current
Then sign and date the application.
You can file online through VA.gov or submit a paper application according to VA’s instructions.
Common mistakes to avoid
Being too vague. Give VA enough information to understand the condition you’re claiming and why you believe it is related to your service.
Leaving out secondary conditions. If you believe a service-connected disability caused or aggravated another condition, make sure you address that relationship.
Forgetting about toxic exposures. Review your service history and consider whether burn pits, Agent Orange, contaminated water or any exposures that are relevant to your claim.
Assuming VA has every medical record. The VA can obtain certain federal records, but you may want to provide copies of your private medical evidence instead of signing a release of information form.
Filing without reviewing your claim. Take one final look before submitting. Make sure your conditions, dates, explanations and evidence are complete.
Need help with VA form 21-526EZ?
Completing the form is only one part of filing a VA disability claim. VBG helps Veterans understand the VA disability claims process, identify potential gaps in evidence and determine what documentation may support the claim.
If you’re preparing to file, the right guidance can help you move forward with confidence.