VA Form 21-4138, the Statement in Support of Claim, gives Veterans a way to provide additional information to the VA about a benefits claim.
You may use the form to explain a claimed disability, provide details about an event during service, describe symptoms or add information that does not fit on another VA form. The VA also accepts Form 21-4138 as a means of submitting lay evidence.
The form is two pages – and knowing what to include in each section can make it easier to complete.
How to fill out VA Form 21-4138
Enter your information
The first section identifies you and connects your statement to your VA claim.
Enter your:
- Full name
- Social Security number
- VA file number, if applicable
- Date of birth
- Service number, if applicable
- Telephone number
- Email address, if applicable
- Mailing address
If you complete the form by hand, the VA instructs you to print clearly in ink. You can also complete the form online.
Review your information before moving on. Make sure your name and contact information are correct and your VA file number is included if you have one.
Write your statement
This is the most important part of VA Form 21-4138.
The remarks section gives you space to explain information related to your claim. The VA specifically lists claimed disabilities and other issues that cannot fit on the original claim form as reasons to use this statement.
Keep your statement focused on the issue you are supporting.
Include the facts that help explain:
- What happened
- When it happened
- Where it happened, when relevant
- When your symptoms began
- How your symptoms have changed
- What treatment you received
- How your condition affects you now
If your statement supports a direct service-connection claim, explain the in-service injury, illness, event or exposure and the symptoms or condition that followed.
If you are providing information about an existing service-connected condition, describe the symptoms you currently experience and how they affect your daily life.
If you are seeking an increased rating, explain how your condition has changed and how those changes affect your ability to function.
Keep your statement specific
Avoid vague statements that do not give the VA enough information to understand your situation.
At the same time, you do not need to write your entire medical history.
Focus on information that relates directly to the claim.
Describe your own experiences in your own words. Include details that may not appear in your medical records, such as the frequency of your symptoms, their severity and how they affect your daily activities.
Your statement is considered lay evidence and can be reviewed along with your medical records and other evidence in your claim.
Keep your information accurate
Only include information that is true and based on your experience.
Review dates, locations and other details before submitting the form. If you are unsure about an exact date, do not guess. Provide the most accurate information you can.
Your statement should also be consistent with the rest of your claim. If there is a difference between your statement and an earlier record, explain the difference rather than changing information to make the records match.
Sign and certify the form
After completing your statement, review the entire form.
Make sure:
- Your identifying information is correct.
- Your statement addresses the issue you are claiming.
- Important dates and details are accurate.
- Your statement is clear and focused.
- You have included relevant supporting information.
- You have completed the required signature and date fields.
What to know when you fill out VA Form 21-4138
What evidence should you include?
A Statement in Support of Claim can provide important information, but it is only one part of your claim.
The VA may consider your statement along with medical records, service records, medical opinions and other evidence. Depending on your claim, you may need additional evidence to establish your diagnosis, an event during service or the connection between your service and your current condition.
If you have supporting documents, review your claim to make sure the evidence you need has been submitted or identified.
VA Form 21-4138 vs. VA Form 21-10210
Do not confuse VA Form 21-4138 with VA Form 21-10210.
VA Form 21-4138 is a Statement in Support of Claim that you can use to provide additional information about your claim.
VA Form 21-10210 is a Lay/Witness Statement. The VA provides this form for a formal statement from you or another person supporting a VA claim. It is also commonly called a “buddy statement.”
If another person has firsthand knowledge about your condition or an event related to your claim, Form 21-10210 may be the appropriate form for their statement.
Common mistakes to avoid
Being too vague: Provide enough detail for the VA to understand what happened and how it relates to your claim.
Writing too much: Keep your statement focused on information that supports the issue you are claiming.
Leaving out current symptoms: Explain how your condition affects you now, not only what happened during service.
Guessing about dates: Give accurate information. If you do not know an exact date, do not make one up.
Making medical conclusions: Describe what you experienced. Medical professionals may need to address medical questions about diagnosis, causation or aggravation.
Forgetting to sign: Review the certification section and make sure you have signed and dated the form before submitting it.
How to submit VA Form 21-4138
The VA allows you to submit Form 21-4138 online or by mail.
Use the current submission instructions from the VA when you are ready to file. If you are mailing the form, use the mailing information provided on the current form.
Need help with VA Form 21-4138?
VA Form 21-4138 gives you an opportunity to explain information that may not fit elsewhere in your VA disability claim.
A clear, specific statement can help the VA understand your experience and consider information that may not be fully reflected in your medical or service records.
VBG helps Veterans understand the VA disability claims process, identify potential evidence gaps and determine what documentation may help support a claim. Learn more about the process and your eligibility today.