
VA Form 21-0779: How to Fill Out the Nursing Home Form, With an Example
VA Form 21-0779 is how a nursing home verifies care for an Aid and Attendance claim. Below is every item on the September 2023 form, in order, with a fictional example.
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VA Form 21-0779 is how a nursing home verifies care for an Aid and Attendance claim. Below is every item on the September 2023 form, in order, with a fictional example.

VA Form 21-0966 tells VA you intend to file while you finish your application. Below is every item on the May 2026 form, in order, with a fictional example and the one-year rule.

VA Form 21-686c adds or removes a dependent from your VA benefits. Below is every item on the August 2025 form, in order, with a fictional example of adding a spouse and a child.

VA Form 21-2680 records the medical findings behind an aid and attendance or housebound request. Below is every item on the June 2026 form, in order, with a fictional example.

VA Form 21-674 keeps a child aged 18 to under 23 on your benefits while in school. Below is every item on the November 2024 form, in order, with a fictional example.

VA Form 21P-534EZ is one application for DIC, Survivors Pension and accrued benefits. Below is every section of the August 2025 form, in order, with a fictional surviving spouse example.

VA Form 21-0845 lets VA share your claim or benefit information with one person or organization you choose. Below is every item on the May 2026 form, in order, with a fictional example.

VA Form 21-4142 lets VA request your private medical records, and 21-4142a lists the providers. Below is every item on both August 2024 forms, in order, with a fictional example.

VA Form 20-0998 explains your options after a VA decision. You do not fill it out. Here is what each row of the April 2024 notice means, with fictional examples, and which form to file instead.

VA Form 21-0788 asks VA to pay part of a beneficiary's award to another eligible person. Below is every item on the February 2026 form, in order, with a fictional example.
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