VA Form 21-4138
- Form name:Statement in Support of Claim
- Form revision date: July 2024
- Related to: Careers and employment, Disability, Education and training, Health care, Housing assistance, Life insurance, Pension
When to use this form
Use VA Form 21-4138 to share more information as instructed by another VA form or process. Here are a few examples of when you may need to use this form:
- To share more details about your family situation or finances for applications or claims related to pension, Dependency and Indemnity Compensation, or accrued benefits
- To tell us about reimbursement you received after you submitted a medical expense report
- To share more details about claimed disabilities or other issues in support of your claim that can’t fit on the original claim form
Downloadable PDF
Online tool
You can submit your statement in support of claim online instead of filling out and sending us the paper form.
Related forms and instructions
VA Form 21-10210
Form name: Lay/Witness Statement
Use VA Form 21-10210 to submit a formal statement to support your VA claim—or the claim of another Veteran or eligible family member. People also sometimes call this statement a “buddy statement.”
VA Form 20-10206
Form name: Freedom of Information Act (FOIA) or Privacy Act (PA) Request (VA Form 20-10206)
VA Form 20-10207
Form name: Priority Processing Request
Use VA Form 20-10207 to request priority processing for your claim due to certain qualifying circumstances or status.