VA Form 21-526EZ: Disability Compensation — Fill

What is VA Form 21-526EZ?

VA Form 21-526EZ is the application veterans and service members use to claim VA disability compensation and related compensation benefits. It covers new claims and claims for increase, the Fully Developed Claim (FDC) program, Benefits Delivery at Discharge (BDD) and the Integrated Disability Evaluation System (IDES).

The form asks for your identification and contact details, a change of address, homelessness, toxic exposures (including the PACT Act locations), the conditions you claim and how they relate to service, where you were treated, your service history, military retired, separation and training pay, and direct deposit. Pages 1 to 8 are VA's instructions; the form itself is pages 9 to 15, with an addendum for more than 15 conditions.

FileIt fills VA's own PDF (JAN 2026 edition), printing names, numbers and dates in its one-character boxes, and files the result in your vault folder. FileIt never submits anything to VA.

Who fills it: The veteran or service member claiming compensation.
Given to: VA, online at va.gov or by mail to the Evidence Intake Center, PO Box 4444, Janesville, WI 53547-4444.
Claim processes: Standard, FDC (optional expedited), IDES (only on referral) or BDD (before release from active duty).
Signatures: You sign item 33A. Witnesses, an alternate signer or a POA sign only when their sections apply.
Edition: VA Form 21-526EZ, JAN 2026 (supersedes NOV 2022), OMB 2900-0747
Room for: 15 claimed conditions on page 11, and 20 more on the page 15 addendum.

Who needs to fill out VA Form 21-526EZ?

Veterans claiming service connection for a condition for the first time.
Veterans asking for an increased rating for a service-connected condition.
Service members filing a Benefits Delivery at Discharge claim before separation.
Veterans claiming conditions related to toxic exposures such as burn pits, Agent Orange or Camp Lejeune water.
Veterans who prefer to file on paper instead of online.

When to use VA Form 21-526EZ

When you are ready to file your disability claim, ideally within a year of an intent to file (VA Form 21-0966).
Within the BDD window before your release from active duty, if you qualify.
When a service-connected condition has worsened and you want a higher rating.

What you need before you start

Your Social Security number, VA file number if you have one, service number, date of birth and contact details.
Each condition you claim, any exposure or event it relates to, how it relates to service, and when it began or worsened.
The VA medical centers and military treatment facilities where you were treated, with approximate dates.
Your service history: branch, component, entry and exit dates, place of separation, Reserve or Guard details and any POW confinement.
Details of retired, separation or severance pay, and your bank's routing and account numbers for direct deposit.

What’s on VA Form 21-526EZ

The 2026 edition has 15 pages. FileIt asks for it in 15 parts, and it is signed by Veteran or service member and Alternate signer and Poa / authorized representative:

Item 1: Type of claim program/processVeteran or service member
Section I: Veteran's identification informationVeteran or service member
Section II: Change of addressVeteran or service member
Section III: Homeless informationVeteran or service member
Section IV: Exposure informationVeteran or service member
Section V: Claim informationVeteran or service member
Item 17: VA medical centers and military treatment facilitiesVeteran or service member
Section VI: Service informationVeteran or service member
Section VII: Service payVeteran or service member
Section VIII: Direct deposit informationVeteran or service member
Section IX: Claim certification and signatureVeteran or service member
Section X: Witnesses to signatureVeteran or service member
Section XI: Alternate signerAlternate signer
Section XII: Power of attorney (POA) signaturePoa / authorized representative
Section XIII: Claim information (addendum)Veteran or service member

How to fill out VA Form 21-526EZ, step by step

1 Item 1 and Sections I to III

Choose the claim process, then identify yourself (items 2 to 12). Section II is for a change of address, and Section III (items 14A to 14F) only if you are homeless or at risk of becoming homeless.

2 Sections IV and V: Exposures and claimed conditions

Item 15 covers toxic exposures: Gulf War hazard and herbicide locations and other exposures, with approximate dates. Item 16 lists each condition with its exposure, how it relates to service and when it began. Item 17 lists treatment facilities.

3 Sections VI and VII: Service and pay

Items 18 to 23 give your service history, Reserve or Guard service, activation and POW status. Items 24 to 28 cover retired pay, separation or severance pay, and training pay, including the boxes to waive VA compensation.

4 Sections VIII to XIII: Deposit, signatures and addendum

Items 29 to 32 are direct deposit. You certify and sign item 33. Witnesses (items 34 and 35), an alternate signer (item 36) and a POA (item 37) sign only when needed, and the addendum lists 20 more conditions.

Common mistakes to avoid

Choosing the FDC program and then sending more evidence later, instead of the standard process.
Listing a condition without saying how it relates to service.
Leaving out treatment facilities, which VA uses to request records.
Ticking item 26 or 28 without meaning to waive VA compensation.
Selecting BDD or IDES when you don't meet those programs' criteria.

After you fill it out

Sign item 33A and send the form and your evidence online at va.gov or to the Evidence Intake Center, PO Box 4444, Janesville, WI 53547-4444.

Add any forms the claim needs, such as VA Form 21-8940 and 21-4192 for individual unemployability or 21-686c for dependents (listed on page 11).

Keep the filed PDF in your FileIt vault, together with your intent to file if you sent one.

Fill out VA Form 21-526EZ online with FileIt

Pick the person. Choose someone from People and FileIt fills in their name, date of birth, address and other details it already knows.
Answer plain-language questions. One part of the form at a time, with the official help text beside each question — 257 fields in all. Your answers save as you go.
Check the live preview. Watch your answers land on the real U.S. Department of Veterans Affairs, Veterans Benefits Administration (VBA) form, and let FileIt do any worksheet arithmetic.
Generate the official PDF. FileIt prints your answers into the agency’s own PDF and files it in that person’s folder in your vault. Sign it, or send it for e-signature.

FileIt fills the form — it never files or submits anything for you. Deliver the finished form to whoever asked for it, the way the form’s instructions say.

Start VA Form 21-526EZ now — it’s free

VA Form 21-526EZ: frequently asked questions

What is VA Form 21-526EZ used for?

It is the application for VA disability compensation and related compensation benefits, for both new and increased claims.

What is the difference between the FDC and standard claim process?

Under the FDC program you send all your evidence with the claim, which VA's instructions describe as the faster option. Under the standard process VA helps gather evidence and you can send more later.

Can I claim toxic exposures on this form?

Yes. Section IV asks about Gulf War hazard and herbicide locations and other exposures such as burn pits, asbestos, radiation and Camp Lejeune water.

What if I have more than 15 conditions?

Use Section XIII, the addendum on page 15, which has room for 20 more. FileIt adds it when you switch on that part.

Where do I send VA Form 21-526EZ?

Online at va.gov, or by mail to the Department of Veterans Affairs, Evidence Intake Center, PO Box 4444, Janesville, WI 53547-4444.

Does FileIt file my claim?

No. FileIt fills VA's own PDF and keeps it in your vault. You sign it and send it to VA.

Official sources

Blank form (PDF), published by U.S. Department of Veterans Affairs, Veterans Benefits Administration (VBA): https://www.vba.va.gov/pubs/forms/VBA-21-526EZ-ARE.pdf
Official instructions and guidance: https://www.va.gov/find-forms/about-form-21-526ez/
Edition shown on this page: VA Form 21-526EZ, JAN 2026 (OMB No. 2900-0747, expires 01/31/2029) (checked 2026-10-19).

FileIt is not affiliated with or endorsed by U.S. Department of Veterans Affairs, Veterans Benefits Administration (VBA) or any government. This page explains the form in general terms and is not legal, tax or immigration advice. Always read the official instructions, and check that you are using the edition the recipient accepts. Page last reviewed 2026-10-19.