VA Form 21-8940 Instructions: How Do You Apply for Individual Unemployability?
When applying for disability benefits through the United States Department of Veterans Affairs, veterans will need to fill out several forms. Unfortunately, these VA benefits forms can be confusing.
The VA’s application for Total Disability due to Individual Unemployability (TDIU or just IU) is one of most difficult VA forms to fill out. The form is called VA Form 21-8940, and you can find it on VA.gov.
This particular form is challenging to fill out, because the VA requires specific information but offers limited space.
Luckily, there is an easier way to approach the veteran’s application for TDIU benefits. In this post, we are going to go over the boxes on this form one by one. These VA Form 21-8940 tips will get you started with applying for individual unemployability benefits.
Section I: Veteran Identification Information
This first section on VA For 21-8940 is the most straightforward. Simply fill out your name, social security number, VA file number, date of birth, mailing address, email address, and telephone number.
Section II: Disability and Medical Treatment
This section includes boxes 8-13. When filing these out the boxes in section II, think in general terms.
Box 8: What service-connected disability prevents you from securing or following any substantially gainful occupation?
Answer: This is tricky. The VA is specifically asking what service-connected disability prevents you from working. If you are service connected for a disability that makes you unemployable, list the disability here. If, however, you are service connected for Tinnitus (for example), but stopped working due to your bad back (which has not been service connected), then it makes no sense to put Tinnitus in this box. In this case, we recommend that you put your back condition in this box (provided that you are pursuing a claim for this). That way, if/when your back condition is granted service connection, your claim for IU will already be on file.
- If you have multiple conditions that prevent you from working, limit the answer to the top two (such as back and PTSD).
Box 9: Have you been under a doctor’s care and/or hospitalized within the past 12 months?
Answer: If you have received care from doctors and from a hospital, then answer “Yes”. If you are being treated by only one, then list which one. The next boxes will provide space to give facility/doctor information.
Box 10: Date(s) of treatment by doctor(s)
Answer: The best way to answer this question is to think in terms of frequency – not exact dates. How often do you receive treatment? Weekly? Monthly? Every two weeks? Twice a year?
Note: This question refers only to treatment that you are receiving for the condition that you listed in Box 8.
Box 11: Name and address of doctor(s)
Answer: If you are being treated by a private doctor, list the doctor’s name and address in this box.
- If you are being treated by more than one private doctor, you can include a separate attachment with the names and addresses.
- If you are being treated by VA doctors, then list the doctor’s name and the VA facility you go to.
- Remember: this information only applies the condition that you listed in Box 8
Box 12: Name and address of hospital
Answer: If you have been or are being treated by a private hospital, list the facility name and address in this box.
- If you are being treated at a VA facility, simply list the facility name, city and state
- Remember: this information only applies the condition that you listed in Box 8
Box 13: Date(s) of hospitalization
Answer: Refer to Box 10
Section III: Employment Statement
This section refers to Boxes 14-22. When answering these questions, be mindful that the information you provide must be in the context of the disabling condition that you listed in Box 8.
Box 14: Date your disability affected full-time employment
Answer: Consider the question like this: When did your condition start affecting your full-time employment? Or, when did your condition start affecting your work performance?
- If you are having trouble with a date, think about this: Was there a time when you started getting written up, missing work for doctor’s visits, calling out sick, getting your shift covered?
- Generally, a month and year is sufficient for this question
Box 15: Date you last worked full-time
Answer: This can be when you transitioned from full to part time, or from full time to not working at all.
Box 16: Date you became too disabled to work
Answer: This is the date that you stopped working due to the condition listed in Box 8. If you cannot remember the exact date, a month and year will suffice.
Box 17A: What is the most you ever earned in one year?
Answer: This is a comprehensive question. The VA wants to know how much you have ever earned in one year over your lifetime. If you cannot remember the exact amount, a ball-park figure will suffice.
Box 17B: What year?
Answer: List the year during which you earned the amount that you listed in Box 17A.
Box 17C: Occupation during that year
Answer: List your occupation or job title for which you earned the amount listed in Box 17A.
Box 18: 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 five years you worked”. The VA is looking for employment history for the last five years that you were employed, not in the past five 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 18A that the company is out of business.
- If you were self-employed, indicate this in Box 18A, along with the name of your business (if applicable).
Box 18B: Type of work
Answer: Give your job title or type of work. This could be supervisor, truck driver, salesman, refrigeration repair, etc.
Box 18C: Hours per week
Answer: If the hours varied, give an average. You can also use a range (35-40).
Box 18D: Dates of Employment
Answer: Use the month and year that you started and left the employer.
Box 18E: Time lost from illness
Answer: This question references the disabling condition(s) that you listed in Box 8. 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 two weeks a year? Ten hours a week?
Box 18F: Highest gross earnings per month
Answer: The VA wants to know the most amount of money that you made per 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 calculate your monthly pay that way.
Box 18Q: 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. his 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 18R: 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 19: 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 8. 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 20: 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 21: Do you receive/expect to receive Workers Compensation benefits?
Box 22: Have you tried to obtain employment since you became too disabled to work?
Answer: This only applies if you have applied to any jobs 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. There are boxes to list three employers in this section.
Section IV: Schooling And Other Training
Box 23: Education
Answer: Check the highest level of education that you completed. The answers include grade school, high school, and college, as well as corresponding grade levels.
Box 24A: 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 24B & 24C blank.
Note: you may have used your GI Bill for this.
Box 25A: 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 25B & 25C blank. Be sure to fill out the dates of training in the corresponding boxes.
Box 26: 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 18) a form to fill out (the VA Form 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.
If you’ve applied for VA individual unemployability benefits and have been denied, the team at Hill & Ponton is here to help. Our experienced attorneys understand the ins and outs of the disability benefits claim and appeals process timeline, so we can help you obtain proper disability compensation. We can also assist with VA Form 21-8940. Contact us today for a free evaluation of your TDIU claim.
We are sorry that this post was not as useful for you!
Help us improve this post!
Tell us how we can improve this post?