VA Form 21-526EZ: Application for Disability Compensation and Related Compensation Benefits

What VA Form 21-526EZ is for

Use this form to claim VA disability compensation, including for a new condition or a rating increase. VA also accepts the same application online at VA.gov, where it asks the same questions and sets your intent to file as soon as you start.

Disagree with a decision VA already made? Use a decision review form instead. This form points you to VA Form 20-0995 for a Supplemental Claim. Fill in VA Form 20-0995.

Parts someone else completes

Sections X to XII are only for someone other than you: two witnesses if you sign with an "X", an alternate signer with VA Form 21-0972 on record, or a representative with VA Form 21-22 or 21-22a on record. The form says a representative cannot sign an original claim. The VA date stamp box is for VA.

What you fill in by hand

The filler never asks for your Social Security number, VA file number, date of birth or signature. You write those in by hand. Leave these boxes for yourself:

• Item 3: Social Security number (top of every page)
• Item 5: VA file number
• Item 6: date of birth
• Item 7: service number or DoD ID number
• Item 9: international phone number
• Section II, Items 13A to 13C: change of address
• Items 26 and 28: "Do NOT pay me VA compensation"
• Section VIII, Items 29 to 32: direct deposit
• Items 33A and 33B: signature and date

Where to send it

• Online: VA's instructions say you can apply at VA.gov and upload your supporting documents with the claim. Starting the online application sets your intent to file automatically.
• By mail: Department of Veterans Affairs, Evidence Intake Center, PO Box 4444, Janesville, WI 53547-4444. On paper, VA suggests submitting an intent to file first.
• VA's filing page also lists filing in person at a regional office, or with help from an accredited representative.
• If you listed more than 15 conditions, send page 15 (Section XIII) with the form. Attach any extra forms the table on page 11 lists for your claim, such as VA Form 21-0781 for a mental health condition.
• Keep a complete copy of what you sent and your confirmation or delivery proof. You have up to one year to send more evidence, but VA may decide sooner if it asks for information and you do not respond within 30 days.

Claim Raven does not submit forms to VA. You review the filled PDF, sign and date it, and send it to VA yourself. Claim Raven is independent and is not affiliated with VA.

Official form and guide

• VA's page for Form 21-526EZ on VA.gov
• VA Form 21-526EZ example and how to fill it out

This filler uses the January 2026 edition of the form.