Privacy Act Notice: VA and the Service Provider will not disclose information collected on this form to any source other than what has been authorized under the Privacy Act of 1974 or Title 38,-2025

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Use VA Form 21-4138 to provide additional information to support your claim.
A system of records is a group of records under the control of an agency from which information is retrieved by the name of the individual or by some identifier assigned to the individual. The Privacy Act requires that agencies give the public notice of their systems of records by publication in the Federal Register.
What is VA Form 21-4138? Form 21-4138 also referred as a Statement in Support of Claim , is offered by the VA to claimants who are interested in offering a written statement that attests to the medical condition preventing them from working.
This landmark law secures new privacy rights for California consumers, including: The right to know about the personal information a business collects about them and how it is used and shared; The right to delete personal information collected from them (with some exceptions);
The Veterans Benefits Administration (VBA) uses VA Form 21-4142, Authorization to Disclose Information to the Department of Veterans Affairs (VA), to request private medical records and information regarding the source of records in support of claims for compensation and/or pension benefits.
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People also ask

VA does not collect personal information from Web users, unless the personal information is provided by you. A Limited Privacy Policy will apply in each case where you may provide personal information to VA through our Web site. We will never sell or rent your personal information to outside parties.
Privacy Act Records If you, or your authorized representative, are requesting your VA records (i.e., VA claims records, Military Medical Records, etc.), this is considered a Privacy Act request. To request records of this nature, your request must contain your original signature and your social security number.
How to File a Privacy Act Request. The Privacy Act allows individuals to seek records about themselves that are maintained in a DOI system of records. For a list of Government-wide and DOI systems of records visit the DOI System of Records Notices (SORNs) webpage.

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