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A Financial Status Report is a document also referred to as VA Form 5655 by the Department of Veterans Affairs. This document supplies the VA with details regarding a veteran's financial status. A Financial Status Report is most often used to determine the eligibility of a veteran for benefits through the VA.
You can request a waiver if you can't afford to repay your full debt balance\u2014even with smaller monthly payments over time. We may grant a waiver for part or all of a VA debt. If we grant your waiver request, you won't have to repay the amount we agree to waive.
If you're struggling because of life situations like losing your job, having a sudden decrease in income, or having an increase in out-of-pocket family health care expenses, we can help. You can request financial hardship assistance to manage your current VA copay debt or request an exemption from future copays.
VA form 5655 may be submitted via mail, fax, or email. If you will submit via fax, send the form to the number 1-612-970-5798. If you will submit via email, send the form to dmc.ops@va.gov with the purpose of the form (either Payment Plan, Waiver, Repay, or Repay and Waiver) specified in the subject line.
If you believe you have received an overpayment notice in error, then you may request a waiver to terminate collection action on a debt. If a waiver is granted in full or part, you will not be required to pay the amount that was waived.
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You can request a waiver if you can't afford to repay your full debt balance\u2014even with smaller monthly payments over time. We may grant a waiver for part or all of a VA debt. If we grant your waiver request, you won't have to repay the amount we agree to waive.
If the Veterans Administration (VA) claims that they overpaid your VA disability benefits, they will send you a letter advising you of this and that they will deduct a portion of the overpayments from your monthly benefit check.
VA Form 5655, Financial Status Report, is used to determine eligibility for waiver of collection, for the acceptance of a compromise offer or for a payment plan.
If you have questions about debt collection, call our Debt Management Center at 800-827-0648 (1-612-713-6415 from overseas) (TTY: 711), Monday through Friday, 7:30 a.m. to 7:00 p.m. ET.
Fill out and sign VA Form 5655. Write your personal statement in a separate document. Send your form and statement by mail, or bring them in person, to the business office or health administration office at your nearest VA medical center.

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