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Learn what the PACT Act means for your VA benefits

About VA Form 21P-534EZ

Form name: Application for DIC, Survivors Pension, and/or Accrued Benefits
Related to: Disability, Family member benefits, Pension
Form last updated: November 2022

When to use this form

Use VA Form 21P-534EZ if you want to submit evidence along with your claim, using the Fully Developed Claim (FDC) program to get a decision on your claim faster. You can use this form if you’re:

  • A surviving spouse or child of a Veteran who has died
  • Applying for VA benefits and/or the money that we owe the Veteran but didn’t pay prior to their death (accrued benefits)
  • Using the Fully Developed Claim (FDC) program to get a decision on your claim faster by submitting evidence along with your claim

Downloadable PDF

Download VA Form 21P-534EZ (PDF)

DIC eligibility for survivors of Blue Water Navy Vietnam Veterans

If we denied your Blue Water Navy Veteran’s service-connected disability claim in the past, you may be eligible for DIC benefits based on the Blue Water Navy Vietnam Veterans Act of 2019.

Learn more about DIC eligibility information 

Find out how to apply for benefits

Veterans who served on a Blue Water Navy vessel offshore of the Republic of Vietnam, or on another U.S. Navy or Coast Guard ship operating in the coastal waterways of Vietnam between November 1, 1955, and May 7, 1975, are now entitled to a presumption of service connection for illnesses related to Agent Orange exposure. This is a result of Public Law 116-23, also known as the Blue Water Navy Vietnam Veterans Act of 2019.

Learn  more about service connection for illnesses related to Agent Orange exposure

  • VA Form 21P-534

    Form name: Application for Dependency and Indemnity Compensation, Survivors Pension and Accrued Benefits by a Surviving Spouse or Child (Including Death Compensation if Applicable)

    Use VA Form 21P-534 if you prefer to provide evidence at a later time to support your claim. You can use this form if you’re a surviving spouse or child of a Veteran who has died and want to begin the process of applying for VA benefits or money that we owe the Veteran but did not pay prior to his or her death.

    Download VA Form 21P-534 (PDF)
  • VA Form 21P-0969

    Form name: Income and Asset Statement in Support of Claim for Pension or Parents' Dependency and Indemnity Compensation (DIC)

    VA Form 21P-0969 is an attachment to other forms, and is used to provide supporting financial evidence. Use VA Form 21P-0969 only if you’re instructed to, when you’re completing VA form 21P-527, 21P-527EZ, 21P-534, or 21P-534EZ.

    Download VA Form 21P-0969 (PDF)