The VA’s application for Total Disability due to Individual Unemployability (TDIU or just IU) is one of the hardest VA forms to fill out. In a previous blog post, we went over Boxes 6-15C on the VA 21-8940 Form. This post is going to cover the rest of the form.
Box 16: List all your employment for the last five years you worked
Answer: While this seems fairly self-explanatory, many people miss the key phrase in the question: “for the last 5 years you worked”. The VA is looking for employment history for the last 5 years that you were employed, not in the past 5 years. For example, if you stopped working in 2010, the VA wants your employment history from 2005 – 2010.
- The VA wants names and addresses of the places/companies that you worked for. If this information is missing, the VA will send you a notice requesting the names and addresses.
- If the company you worked for is no longer in business, fill in the information as best you can, and indicate in Box 16A that the company is out of business
- If you were self-employed, indicate this in Box 16A, along with the name of your business (if applicable)
Box 16B: Type of work
Answer: Give your job title or type of work. This could be supervisor, truck driver, salesman, refrigeration repair, etc.
Box 16C: Hours per week
Answer: If the hours varied, give an average. You can also use a range (35-40).
Box 16D: Dates of Employment
Answer: Use the month and year that you started and left the employer.
Box 16E: Time lost from illness
Answer: This question references the disabling condition(s) that you listed in Box 6. As with the first part of the form, think in terms of frequency. Did you call out monthly or weekly? Did you use all your vacation time? Were you out 2 weeks a year? Ten hours a week?
Box 16F: Highest gross earnings per month
Answer: The VA wants to know the most you made a month at that particular company. If you cannot remember the exact amount, but do remember what you were being paid hourly, multiply that number by the hours you worked in a week, and figure out your monthly pay that way.
Box 16G: Indicate your total earned income for the last 12 months
Answer: The key word here is “earned” income. This is money earned from physically working and receiving payment. This does NOT include: pensions, retirement, IRA’s, 401k’s, SSD or SSI. Generally, this amount should be $0. However, if you stopped working within the past 12 months or are working part time, you will need to indicate how much you earned/are earning.
Box 16H: If presently employed, indicate your current monthly earned income
Answer: If you are not physically working, this amount should be $0. However, if you are working, give the amount that you earn per month.
Box 17: Did you leave your last job/self-employment because of your disability?
Answer: This question is reflective of the disabling condition(s) that you listed in Box 6. Check “Yes” if you were fired, laid off, or resigned from your last job because of the disabling condition(s). Check “No” if you left your last job due to outside circumstances, such as being laid off due to the economy.
Box 18: Do you receive/expect to receive Disability Retirement benefits?
Answer: In addition to Disability Retirement benefits, this also includes any Social Security benefits, such as SSD and SSI.
Box 19: Do you receive/expect to receive Workers Compensation benefits?
Box 20: Have you tried to obtain employment since you became too disabled to work?
Answer: This only applies if you have applied anywhere since you stopped working.
- If you cannot remember, answer “No”
- If you have applied for work, list the name and address of the business/employer, the type of work and the date applied.
Box 21: Education
Box 22A: Did you have any other education and training before you were too disabled to work?
Answer: This applies to any education or training before you stopped working. This could include trade schools or specialized training, such as truck driving school, welding school, mechanics, etc. If not, answer “No”, and leave Boxes 22B & 22C blank.
Note: you may have used your GI Bill for this.
Box 23A: Have you had any education and training since you became too disabled to work?
Answer: This applies to any education or training that you had in an attempt to get a job after you became too disabled to work. This could include vocational rehab. If not, answer “No”, and leave Boxes 23B & 23C blank.
Box 24: Remarks –This section is usually left blank. However, you can use this to make additional notes on any of the previous sections.
Once the VA receives this application, they will send you a notice indicating that they have received your application and will verify your employment history. They do this by sending your past employer(s) (which you listed in Box 16A) a form to fill out – the VA 21-4192. This form will ask the employer to verify the dates of employment and indicate why you stopped working for that employer.
If the VA is unsuccessful with obtaining completed copies of this form from your past employer(s), they will send you a second notice, requesting that you attempt to contact the past employer(s) to have them fill out the necessary form.