Va form 21 4192 1994-2025

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2021 4.8 Satisfied (147 Votes)
2017 4.3 Satisfied (198 Votes)
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1994 4 Satisfied (47 Votes)
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An accredited attorney, claims agent, or Veterans Service Organization (VSO) representative can help you file a claim or request a decision review. Learn how to find and appoint one of these types of accredited representatives to help you.
Use VA Form 21-4192 if youre a Veteran and you need your most recent employer to send us information so you can apply for Individual Unemployability disability benefits. Your most recent employer must complete and submit this form.
If you decide to file a TDIU claim, youll need to submit a VA Form 21-8940. 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.
To receive TDIU benefits, the veteran must apply for disability compensation and fill out two additional forms: Veterans Application for Increased Compensation Based on Unemployability (Form 21-8940) Request for Employment Information in Connection with Claim for Disability Benefits (Form 21-4192)
When to use this form. Use VA Form 21-4192 if youre a Veteran and you need your most recent employer to send us information so you can apply for Individual Unemployability disability benefits. Your most recent employer must complete and submit this form.
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People also ask

The VA cant deny your unemployability claim if your former employer fails to complete VA Form 21-4192. The form is not absolutely necessary to receive a favorable decision on your TDIU claim. Many veterans have succeeded with their TDIU claim without a 21-4192. However, without the form, the process could be delayed.

employer won't fill out va form 21 4192