June 2014 N/A 21-4142a General Release for Medical Provider Information to the Department of Veterans Affairs (VA) c. Acceptable See the table below for a listing of outdated versions of some commonly used Outdated pension forms that VA accept. will Versions of Common Pension Forms VA Form Form Name Current Older Version Dates Number Version Accepted by VA Available February June 2004 All Eligibility Verification Reports (EVRs) 2012 (ALL EVRS ending in June 2014 August 2011 Fully Developed Claim (Express Pension Claim) July 2014 July 2012 21P-527 Income net worth and employment statement June 2014 May 2012 21P-530 Application for burial benefits June 2014 March 2009 21P-534 Application for DIC, death pension and accrued benefits by a surviving spouse or child June 2014 December 2012 Fully Developed Claim (Express Survivors Benefits) June 2014 October 2011 21P-534a Application for Dependency and Indemnity Compensation By a Surviving Spouse or Child-In Service Death Only June 2014 February 2012 21P-535 Application for DIC by parents (including accrued benefits and death compensation) June 2014 December 2010 21P-601 Application for reimbursement from accrued amounts due a deceased beneficiary February December 2011 21P-8416 Medical Expense Report 2012 June 2009 N/A 21P-0847 Request of Substitution of Claimant Upon Death of Claimant d. Rejecting an If a VA form needs to be rejected Outdated Version of a VA return the form to the Veteran and POA, if necessary, Form provide the Veteran and POA, if necessary, a copy of the current form, and
21-4142a General Release for Medical Provider Information to the Department of Veterans Affairs (VA) June 2014 N/A c. Acceptable Outdated Versions of Common Pension Forms See the table below for a listing of outdated versions of some commonly used pension forms that VA will accept. VA Form Number Form Name Current Version Available Older Version Dates Accepted by VA (ALL EVRS ending in All Eligibility Verification Reports (EVRs) February 2012 June 2004 Fully Developed Claim (Express Pension Claim) June 2014 August 2011 21P-527 Income net worth and employment statement July 2014 July 2012 21P-530 Application for burial benefits June 2014 May 2012 21P-534 Application for DIC, death pension and accrued benefits by a surviving spouse or child June 2014 March 2009 Fully Developed Claim (Express Survivors Benefits) June 2014 December 2012 21P-534a Application for Dependency and Indemnity Compensation By a Surviving Spouse or Child-In Service Death Only June 2014 October 2011 21P-535 Application for DIC by parents (including accrued benefits and death compensation) June 2014 February 2012 21P-601 Application for reimbursement from accrued amounts due a deceased beneficiary June 2014 December 2010 21P-8416 Medical Expense Report February 2012 December 2011 21P-0847 Request of Substitution of Claimant Upon Death of Claimant June 2009 N/A d. Rejecting an Outdated Version of a VA Form If a VA form needs to be rejected return the form to the Veteran and POA, if necessary, provide the Veteran and POA, if necessary, a copy of the current form, and
12-11-15_Key%20Changes_M21-1III_ii_1_SecC.docx