8764 VBA 21 ARE
User Manual: 8764
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DISABILITY COMPENSATION AWARD ATTACHMENT IMPORTANT INFORMATION WHEN WILL YOU RECEIVE YOUR FUNDS? Depending on whether you elect to receive your monthly compensation by check or direct deposit, you should receive your funds within 15 days. Thereafter, your payments will be made at the beginning of each month for the prior month. HOW CAN YOU RECEIVE HOSPITALIZATION AND OUTPATIENT TREATMENT? Veterans who have one or more service-connected disabilities as determined by the Veterans Benefits Administration are eligible for medical care through the VA health care system. If you are interested in obtaining VA medical care, you may contact your nearest VA health care facility or the VA Health Revenue Center at 1-877-222-8387. HOW CAN YOU RECEIVE DENTAL TREATMENT? If you are evaluated as 100% disabled for service-connected disabilities or as 100% disabled because of Individual Unemployability, you may be eligible for VA dental treatment. For additional information, contact your nearest VA medical center or outpatient Clinic. You can find the address of your closest VA medical center or facility by going to the VA internet website http://www.va.gov/directory. HOW CAN YOU RECEIVE ADDITIONAL COMPENSATION FOR DEPENDENTS? Veterans having a 30% or more service-connected evaluation may be entitled to additional compensation for a spouse, dependent parents, unmarried children under 18 (or under 23 if attending an approved school) or a child who became permanently incapable of self-support because of mental or physical defect prior to age 18. The additional benefit for a spouse is payable in a higher amount upon receipt of evidence establishing that the spouse is a patient in a nursing home or so disabled as to require the aid and attendance of another person. HOW CAN YOU RECEIVE INCREASED BENEFITS BASED ON INDIVIDUAL UNEMPLOYABILITY? If your service-connected disabilities are seriously disabling to the extent that you are unable to secure and hold steady work/employment, you may apply to receive total disability. To apply for this benefit, you should contact the nearest VA office and complete VA Form 21-8940, "Veteran's Application for Increased Compensation Based on Unemployability," available on the VA forms website at www.va.gov/vaforms. HOW CAN YOU RECEIVE A CLOTHING ALLOWANCE? You may be eligible for a clothing allowance if, because of a service-connected disability, you wear or use a prosthetic device or orthopedic appliance which tends to wear or tear clothing. You may also be eligible if a doctor has prescribed medication for a service-connected skin condition, and the medication causes irreparable damage to your outer garments. To apply for this benefit, contact the Prosthetic and Sensory Aids Service at your nearest VA medical center or outpatient clinic. The address of your closest VA medical center or facility is available on the VA internet website http://www.va.gov/directory . HOW CAN YOU RECEIVE EDUCATIONAL BENEFITS? A monthly educational assistance allowance is payable to certain veterans. Each program has unique eligibility criteria specified by law, and only one program can be used at any given time. If you need help with your VA education benefits, you can call toll-free 1-888-442- 4551 or visit the VA national education website at http://www.gibill.va.gov. HOW CAN YOU RECEIVE GOVERNMENT LIFE INSURANCE? If you receive a rating for a new service-connected disability (even 0%), you may be eligible for Government life insurance if you are in good health (except for service-connected conditions) and apply within two years of this notification of your new disability rating. Call our toll-free number 1-800-669-8477 or visit our website http://www.insurance.va.gov for further information about Service-Disabled Veterans Insurance. VA FORM MAY 2009 21-8764 SUPERSEDES VA FORM 21-8764, FEB 2004, WHICH WILL NOT BE USED. (See reverse) ARE YOUR BENEFITS EXEMPT FROM CLAIMS OR CREDITORS? Compensation payments are exempt from claims of creditors. With certain exceptions, the payments are not assignable and are not subject to attachment, levy or seizure except as to claims of the United States. HOW DO YOU REPORT A CHANGE OF ADDRESS OR DIRECT DEPOSIT? Please notify us by calling our toll-free number at 1-877-838-2778. TO SEND ANY COMPLETED, SIGNED FORMS OR TO FURNISH ANY INFORMATION TO VA You can obtain the address to mail VA any information or completed forms by calling toll-free 1-800-827-1000 (for the hearing impaired call 1-800-829-4833). You can also locate the address of the closest VA regional office on the Internet at http://www.va.gov/directory or in the Government pages of your telephone book under "United States Government, Veterans." HOW DO I FIND OUT ABOUT STATE OR LOCAL BENEFITS FOR SERVICE-CONNECTED VETERANS? You should contact your State or local office of veterans' affairs for information on any tax, license, or fee-related benefits for which you may be eligible as a veteran (or surviving dependent of a veteran). State offices of veterans' affairs are available at http://www.va.gov/statedva.htm. You should also contact your local tax assessor's office to ask if you are entitled to any personal or property tax relief. AM I ELIGIBLE FOR COMMISSARY AND EXCHANGE PRIVILEGES? Honorably discharged veterans evaluated as 100 percent disabled due to service-connected disability, Medal of Honor recipients or, military retirees and their dependents may qualify for Armed Forces Commissary and Exchange privileges. WHAT CONDITIONS AFFECT RIGHT TO PAYMENTS? 1. Your award of disability compensation is subject to future adjustment upon receipt of evidence showing any change in the degree of disability. 2. Your payments may also be affected by any of the following circumstances which you must promptly call to our attention. a. Reentrance into active military or naval service. b. Receipt of armed forces service retirement pay, unless your retirement pay has been reduced because of award of disability compensation. c. Receipt of benefits from the Office of Federal Employees Compensation. d. Receipt of active duty or drill pay as a reservist or member of the Federally recognized National Guard. 3. If you have a disability rating of 30% or more, you must promptly advise us of any change in the status of your dependents. 4. If your award includes special monthly compensation due to the need for aid and attendance, this additional allowance is generally subject to reduction from the first day of the second calendar month of admission to hospitalization, nursing home or domiciliary care at VA expense. 5. Benefits will be reduced upon incarceration in a Federal, State or local penal institution in excess of 60 days for conviction of a felony. The amount not payable may be apportioned to a spouse, dependent children or parents. 6. Monthly payments of your award may be stopped if you fail to furnish evidence as requested, fail to cooperate or submit to a VA examination when requested, or if you furnish VA, or cause to be furnished, any false or fraudulent evidence. 7. Information submitted is subject to verification through computer matching programs with other agencies. 8. The law provides severe penalties, which include fine, imprisonment, or both, for the fraudulent acceptance of any payment to which you are not entitled. IMPORTANT Please notify VA immediately if there is a change in any condition affecting your right to continued payments. Failure to notify us of these changes immediately may result in a debt that you will have to repay. VA FORM 21-8764, May 2009
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