Fv13 2026

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The CARE PROVIDER CERTIFICATION OF SERVICES (FORM FV13) is designed for care providers to report the types of care support services they offer to veterans or their spouses applying for VA benefits. It clarifies the distinction between 'medical services' and 'nursing services' as defined by the VA, emphasizing the importance of Activities of Daily Living (ADLs) and Incidental Activities of Daily Living (IADLs) in determining eligibility for aid and attendance pension benefits. The form also outlines requirements for documenting services, including the need for a 'protected environment' for individuals requiring supervision and support.

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Click ‘Get Form’ to open the FV13 in the editor.
Begin by entering the 'Name of Person Receiving Care Services' in Line 1. This should be the veteran or their spouse.
In Line 2, provide the 'Name of Veteran' for VA purposes, ensuring it matches official records.
Fill in Line 3 with the 'Veteran Social Security Number or VA Case Number.' If there is no case number, leave it blank.
Complete Lines 4 through 10 with the necessary address and contact information for both the care recipient and provider.
Check the appropriate box for the type of service offered by your care facility, such as Assisted Living or Nursing Home.
Document any monthly charges and service details as required, ensuring you have supporting invoices marked 'paid.'
Finally, ensure that a responsible person signs and dates the form at the bottom to certify its accuracy.

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