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Veterans and Spouses would require assistance in performing their daily activities of living (ADLs), must have their primary care physician complete this form indicating the need for either Aid and Attendance (AA) or Housebound status.
You can have your doctor fill out the examination information section. You can also include with your VA form: Other evidence, like a doctors report, that shows you need Aid and Attendance or Housebound care.
How do I request a waiver? Youll need to submit these 2 items: A Financial Status Report (VA Form 5655) A personal statement that explains why you feel you shouldnt have to repay the debt.
Veterans and Spouses would require assistance in performing their daily activities of living (ADLs), must have their primary care physician complete this form indicating the need for either Aid and Attendance (AA) or Housebound status.
GENERAL INSTRUCTIONS. FOR APPLICATION FOR DEPENDENCY AND INDEMNITY COMPENSATION, DEATH PENSION AND ACCRUED. BENEFITS BY A SURVIVING SPOUSE OR CHILD (INCLUDING DEATH COMPENSATION IF APPLICABLE) VA FORM 21-534.
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Title: Statement of Marital Relationship (VA Form 214170). OMB Control Number: 29000114. Type of Review: Revision of an approved collection. Abstract: VA Form 214170 is used to gather information that is necessary to determine whether a valid common law marriage was established.
Use this form to determine eligibility for aid and attendance or housebound benefits. For more information, you can contact us online through Ask VA: . Ask us a question online or call us toll-free at 1-800-827-1000 (TTY: 711). VA forms are available at .va.gov/vaforms.
Use VA Form 21-2680 to apply for Aid and Attendance benefits that will be added to your monthly compensation or pension benefits.

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