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While the VA has direct access to medical records from VA facilities, it does not automatically retrieve records from private doctors, specialists, or hospitals. Thats where VA Forms 21-4142 (Authorization to Disclose Information) and 21-4142a (General Release for Medical Provider Information) come into play.
Who must the VA form 21 4192 be sent to?
Based on the information you provide in Form 21-8940, the VA will automatically generate and send a VA Form 21-4192 to your most recent employer. The VA will send you a copy as well. At that point, its a good idea to work with your former employer directly to make sure they complete and submit the form on time.
What is a VA form 21 4142 used for?
Use VA Form 21-4142 to give us permission to obtain your personal information from a non-VA source like a private doctor or hospital. Examples of personal information may include your medical treatment, hospitalizations, psychotherapy, or outpatient care.
What date does the VA form 21-4142 expire?
PENALTY: The law provides severe penalties which include fine or imprisonment, or both, for the willful submission of any statement or evidence of material fact knowing it to be false. If you do not revoke this authorization, it will automatically expire in 12 months from the date you sign and date the form.
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