The VA forms you need for a mesothelioma claim depend on who is filing and why. A veteran filing a new disability claim starts with Form 21-526EZ; a surviving spouse claiming survivor benefits uses Form 21P-534EZ. Below is the complete list, organized by situation, with a direct link to each form’s official VA.gov page.
This page assumes mesothelioma already qualifies as a service-connected condition. If you need that background first, start with VA benefits for mesothelioma. Every link in the table below goes straight to the form’s official page on va.gov, where you can view the current PDF or file online.
VA forms for a mesothelioma claim, at a glance
| Form # | Official name | What it does | Who files it | Link |
|---|---|---|---|---|
| 21-0966 | Intent to File a Claim for Compensation and/or Pension, or Survivors Pension and/or DIC | Locks in the earliest possible payment start date while you gather documents for the full claim. | Veteran or survivor | View on VA.gov |
| 21-526EZ | Application for Disability Compensation and Related Compensation Benefits | The main form for a VA disability claim, including a claim based on a service-connected mesothelioma diagnosis. | Veteran | View on VA.gov |
| 21P-534EZ | Application for DIC, Survivors Pension, and/or Accrued Benefits | Files a Dependency and Indemnity Compensation (DIC), Survivors Pension, or accrued-benefits claim. | Surviving spouse or dependent | View on VA.gov |
| 21-2680 | Examination for Housebound Status or Permanent Need for Regular Aid and Attendance | The physician exam form that documents the need behind an Aid and Attendance or Housebound claim. | Veteran or surviving spouse (completed with a doctor) | View on VA.gov |
| 21P-527EZ | Application for Veterans Pension | The needs-based pension application for wartime veterans with limited income, separate from disability compensation. | Wartime veteran | View on VA.gov |
| 21-4138 | Statement in Support of Claim | A plain-language form for adding a written statement or a detail a claim form has no room for. | Veteran, survivor, or dependent | View on VA.gov |
| 21-4142 | Authorization to Disclose Information to the Department of Veterans Affairs (VA) | Gives VA permission to request medical records directly from a private doctor or hospital. | Veteran, survivor, or dependent | View on VA.gov |
| 21-22 | Appointment of Veterans Service Organization as Claimant’s Representative | Authorizes a Veterans Service Organization, such as the DAV or VFW, to help with the claim at no cost. | Veteran, survivor, or dependent | View on VA.gov |
| 21-22a | Appointment of Individual As Claimant’s Representative | Authorizes one named accredited attorney or claims agent, rather than an organization, to help with the claim. | Veteran, survivor, or dependent | View on VA.gov |
| 20-0995 | Decision Review Request: Supplemental Claim | Challenges a VA decision you disagree with by submitting new evidence VA has not already considered. | Veteran, survivor, or dependent | View on VA.gov |
Filing a new disability claim
If your veteran has a documented mesothelioma diagnosis and asbestos exposure during military service, Form 21-526EZ is the disability compensation claim itself. Most veterans file Form 21-0966 first, which locks in an effective date while records are still being gathered, since VA generally pays from the filing date forward. For the full process, including the free Veteran Service Officer path, see how to file a VA claim for mesothelioma.
Surviving spouse / DIC & survivor benefits
A surviving spouse, dependent child, or dependent parent files Form 21P-534EZ to claim Dependency and Indemnity Compensation (DIC), Survivors Pension, or benefits the veteran was owed but had not yet received. As with a new disability claim, filing Form 21-0966 first can preserve an earlier effective date. See DIC survivor benefits for mesothelioma for current monthly amounts and the 8-year provision.
Aid & Attendance / housebound
Aid and Attendance adds a monthly amount on top of VA disability compensation or pension for a veteran or surviving spouse who needs help with daily activities. Form 21-2680 is completed with a physician and documents that need. If a pension claim has not been filed yet, Form 21P-527EZ goes with it. See VA Aid and Attendance for mesothelioma for who qualifies and current amounts.
Adding evidence & authorizing help
Five forms cover the rest of a typical claim. Form 21-4138 adds a written statement or a detail a claim form has no room for. Form 21-4142 lets VA request medical records directly from a private doctor, which is usually faster than gathering them yourself. Form 21-22 authorizes a Veterans Service Organization to help at no cost; Form 21-22a does the same for one named accredited attorney or claims agent. If VA denies the claim, Form 20-0995 is how you submit new evidence and ask for another review. See appeal a denied VA claim for mesothelioma for the full appeals process, or start a free veteran case review if you want help figuring out which forms apply to your situation.
Common questions about VA forms for a mesothelioma claim
Which VA form should a veteran file first?
Most veterans file Form 21-0966 (Intent to File) first to lock in an effective date, then follow with Form 21-526EZ, the actual disability compensation claim.
Do I need to hire an attorney to file these forms?
No. VA forms are free to file, and a VA-accredited Veterans Service Officer, authorized with Form 21-22, can help at no cost. That is separate from any attorney involved in an asbestos trust fund claim.
Can a surviving spouse file a VA claim and an asbestos trust fund claim at the same time?
Yes. The two systems are separate and do not offset each other. A spouse can pursue DIC benefits with Form 21P-534EZ and a trust fund claim in parallel.
Mesothelioma Funds Administration is not a law firm and does not complete, file, or decide these forms for you. Nothing on this page is legal or medical advice. For help with your specific situation, use a VA-accredited Veteran Service Officer (Form 21-22), a private attorney or claims agent (Form 21-22a), or call us and we will point you to the right resource.
Not sure which forms apply to you?
Call to talk through your situation, or start a free veteran case review. We do not file VA forms for you, but we can help you understand which ones apply and point you to a Veteran Service Officer at no cost.
Call (800) 763-9692
or start a free veteran case review. Phone line staffed during business hours.