فرم 21-0966: Intent to File a Claim for Compensation and/or Pension, or Survivors Pension and/or D.I.C. (VA Form 21-0966)

Use VA Form 21-0966 if you’re still gathering information to support your claim and want to start the filing process. This form is for disability, Veterans pension, survivors pension, or Dependency and Indemnity Compensation (D.I.C.) claims. Submitting an intent to file can secure the earliest possible effective date for any retroactive payments you may be eligible to receive.