U.S. Department of Veterans Affairs (VA) · United States

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VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits

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JustFill is not affiliated with U.S. Department of Veterans Affairs (VA). This is an independent third-party tool to help you complete VA Form 21-526EZ. Always download the current blank form from the official source and verify your completed copy before signing or submitting. Official VA Form 21-526EZ from U.S. Department of Veterans Affairs (VA)

Quick answer

VA Form 21-526EZ is the Application for Disability Compensation and Related Compensation Benefits, issued by the U.S. Department of Veterans Affairs (OMB 2900-0747). Veterans complete it to file an initial, increased, or secondary disability claim and list their service-connected conditions, treatment facilities, service history, and direct deposit details. It is signed only by the veteran (Item 33A) or an authorized representative. JustFill lets you fill VA Form 21-526EZ online free by auto-detecting each field so you can type or dictate every answer in your browser.

Form
VA Form 21-526EZ
Issued by
U.S. Department of Veterans Affairs (VA)
Country
United States
Cost to fill
Free

What is VA Form 21-526EZ?

VA Form 21-526EZ is the U.S. Department of Veterans Affairs application veterans use to claim disability compensation for illnesses or injuries connected to active military service. You can fill VA Form 21-526EZ online free to file an original claim, request an increased rating, or claim a secondary condition, as well as apply for related benefits such as Special Monthly Compensation. The January 2026 revision (OMB Control No. 2900-0747) runs across thirteen sections covering veteran identification, exposure history, the disabilities being claimed, service information, service pay, and direct deposit. Because the official PDF is long and densely formatted, many veterans struggle to type into it. JustFill auto-detects the fields so you can complete the entire 21-526EZ in your browser without Adobe Acrobat.

Download the VA Form 21-526EZ form PDF — free

The official January 2026 VA Form 21-526EZ PDF is free to download from VA.gov and is in the public domain. Print it to mail to the VA Claims Intake Center, or open it in JustFill to type your answers on screen before submitting.

Get the official VA Form 21-526EZ PDF from U.S. Department of Veterans Affairs (VA)

Who fills out VA Form 21-526EZ?

  • Veterans filing their first (original) claim for service-connected disability compensation
  • Veterans requesting an increased rating because an existing service-connected condition has worsened
  • Veterans claiming a new secondary condition caused by an already service-connected disability
  • Service members filing a Benefits Delivery at Discharge (BDD) claim before separation
  • Accredited Veterans Service Officers (VSOs) or attorneys helping a veteran prepare and submit the claim

Field-by-field breakdown

What each section of VA Form 21-526EZ asks for. JustFill’s AI will detect these fields automatically when you upload the PDF — review the breakdown below so you know what to enter.

Type of Claim Program (Item 1)

Optional checkbox to elect the Fully Developed Claim (FDC) Program for expedited processing; leave blank for the standard claims process.

Section I — Veteran's Identification (Items 2-12)

Veteran's name, Social Security Number, VA file number, date of birth, service/DoD ID number, mailing address, phone, and email.

Section IV — Exposure Information (Item 15)

Whether you are claiming a condition related to toxic exposure (e.g., burn pits, Agent Orange, radiation); if Yes, complete Items 15B-15E.

Section V, Item 16 — Disabilities Claimed

List each current disability or symptom you believe is related to military service or to an existing service-connected condition.

Section V, Item 17 — Treatment Facilities

List the VA Medical Centers (VAMC) and DoD Military Treatment Facilities (MTF) where you received treatment for the claimed conditions.

Section VI — Service Information (Items 18+)

Branch of service, entry and separation dates, and whether you served in a combat zone.

Section VIII — Direct Deposit (Items 29-32)

Bank account number, account type, name of financial institution, and routing/transit number for compensation payments.

Section IX — Certification & Signature (Items 33A-33B)

The veteran's required signature and date signed certifying the claim; only Section I, V, and a signature are needed for a non-original claim.

Common mistakes to avoid

  • 1Forgetting that for an increased or secondary claim (not an original claim), only Section I, Section IV if applicable, Section V, and a signature in Item 33A are required — many veterans needlessly fill the entire form.
  • 2Listing a condition in Item 16 without naming a specific symptom or diagnosis, or leaving Item 17 blank so VA cannot locate the treatment records that prove service connection.
  • 3Leaving the signature and date in Items 33A/33B blank or unsigned — VA cannot process an unsigned 21-526EZ, which is the single most common cause of rejected claims.

How JustFill helps you complete VA Form 21-526EZ

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Frequently asked questions

Yes. VA Form 21-526EZ is a free U.S. Department of Veterans Affairs form, and filing a disability compensation claim never costs the veteran anything. You can fill VA Form 21-526EZ online free in JustFill, then download the completed PDF to mail, fax, or upload — no fees and no software purchase.
Download the official January 2026 PDF (OMB 2900-0747) from the VA at va.gov/forms/21-526ez. It is public domain, so you can also open that same PDF directly in JustFill to type your answers instead of printing and writing by hand.
Yes. The VA offers an online claim tool on VA.gov, and you can also complete the downloadable PDF digitally. JustFill auto-detects every field on the 21-526EZ so you can type or dictate each answer in your browser, even if the PDF is scanned or non-fillable, then download it ready to submit.
Not always. If your claim is not an original claim — for example an increased rating or a secondary condition — the VA only requires Section I, Section IV (if you have a toxic-exposure claim), Section V, and your signature in Item 33A. JustFill lets you fill only the sections that apply.
Mail the signed form to the Department of Veterans Affairs Claims Intake Center, PO Box 4444, Janesville, WI 53547-4444, or fax it to 844-531-7818. You can also upload it through your VA.gov account. Always confirm the current address on VA.gov before sending.
Have your Social Security Number, VA file number (if any), service dates and branch, a list of the disabilities or symptoms you are claiming (Item 16), the VA or military treatment facilities where you were treated (Item 17), and your bank routing and account numbers for direct deposit.

Official source: VA Form 21-526EZ on U.S. Department of Veterans Affairs (VA)’s website

JustFill is an independent product and is not affiliated with, endorsed by, or sponsored by U.S. Department of Veterans Affairs (VA) or any government agency. Always verify your completed form on the official version before signing or submitting.