About VA Form 21-0966
- Form name: Intent to File a Claim for Compensation and/or Pension, or Survivors Pension and/or DIC
- Related to: Disability, Family member benefits, Pension
- Form last updated: January 2023
When to use this form
Use VA Form 21-0966 if you’re still gathering information to support your claim, and want to start the filing process. Submitting an intent to file can secure the earliest possible effective date for any retroactive payments you may be eligible to receive.
Downloadable PDFDownload VA Form 21-0966 (PDF)
Helpful links related to VA Form 21-0966
How to file a VA disability claim
Learn about the steps for filing a claim for disability compensation or increased disability compensation. Note: If you file your disability claim online, you don’t need to submit a paper Intent to File form.
How to apply for a VA pension as a Veteran
Find out how to apply for tax-free VA pension benefits as a Veteran. Note: If you apply online for pension benefits, you still need to submit VA Form 21-0996 as your intent to file.