Military Veterans PTSD Reference Manual - Chapter 10

Veterans PTSD Reference Manual

Chapter 10 (Partial)


Letters, Forms, Notices, and Statements



Section I. GENERAL


10-01. General.  As with anything you do that concerns the government there will always be a pile of forms to fill out. A quick reference list is followed by sample letters, forms, notices, and simplified instructions for all of the forms (the forms themselves can be found in appendix H) you should require when filing for initial disability, claims, records, appeals, etc.

You should ALWAYS make copies (remember CoPP) of any letters or forms you send to the VA and make copies of any letters or forms they send you. To be safe I would advise you to send any documents by registered mail.

Most of the veterans I have spoken with submit all of their letters and forms through their local benefits counselor or national Service Organization Representative. I recommend you do the same as they already know the ropes,  and their association with your material will lend it some additional credence.

Using FOIA. If there is any doubt that the information will be released on your signature alone include the statement “This information is requested under the FOIA”. USASCRUR points out that requesting documents under FOIA may cause your request to slow down because of additional administrative requirements. Your call.


Section II. QUICK REFERENCE (Revised)


10-02. A list of All documents provided in this chapter. Listed alphabetically then numerical:


Located in Section III:


·        Air Force Historical Research Agency Request for Microfilm Titles


·        Air Force Historical Research Agency Request for Microfilm


·        Claim file request under the Freedom of Information Act (FOIA)


·        Freedom Of Information Act (FOIA) Request, Personnel Records


·        Medical and Clinical Treatment Records


·        National Archives Request for Textual Material


·        Notice of Disagreement (NOD)


·        Statement of Illness


·        Stress Letter Package


·        World Wide Locator Request for Forwarding


Located in Section IV:


·        SF 180 (Request Pertaining to Military Records) (Revised)


Located in Section V:


·        HA-501-U5 (Request for Hearing By Administrative Law Judge)


·        HA-520 (Request for Review of Hearing Decision/Order)


·        HA-4486 (Claimant’s Statement When Request for Hearing is Filed and the Issue is Disability)


·        SSA-561-U2 Form (Request for Reconsideration)


·        SSA-3368-BK Form (Disability Report - Adult)


·        SSA-3369-BK Form (Work History Report)


·        SSA-7050-F4 (Request for Social Security Earnings Information)


Located in Section VI:


·        VA Form 1-646 (Statement of Accredited Representative)


·        VA Form 9 (Appeal to Board of Veteran’s Appeals) (Revised)


·        VA Form 10-10I (Insurance Information)


·        VA Form 10-10EZ (Application for Health Benefits) (Revised)


·        VA Form 10-5345 (Request for and Consent to Release of Medical Records)


·        VA Form 21-526 (Veteran’s Application for Compensation or Pension) (Revised)


·        VA Form 21-527 (Income Net Worth and Employment)  (Revised)


·        VA Form 21-2545 (Report of Medical Examination for Disability Evaluation) -


·        VA Form 21-4138 (Statement in Support of Claim) (Revised)


·        VA Form 21-8940 (Veteran’s Application for Increased Compensation Based on Unemployability)


·        VA Form 22a (Appointment of Attorney or Agent as Claimant’s Representative) (Revised)


·        VA Form 0220 (Notice of Appellate Rights Following Denial of Motion For Reconsideration)


·        VA Form 4107 (Your Rights to Appeal our Decision) (Revised)


·        VA Form 4597 (Board of Veteran’s Appeals Notice)


Page last updated 06-01

© Msg. I. S. Parrish, USA Retired