Fill out VA 21-0966 (Intent to File a Claim for Compensation and/or Pension) online
VA Form 21-0966 allows veterans and their survivors to submit an intent to file a claim for disability compensation, pension, or survivors benefits. Filing an intent to file establishes a potential effective date for benefits up to one year before the formal claim is submitted.
How to fill out VA 21-0966 (Intent to File a Claim for Compensation and/or Pension)
Enter claimant information
Provide the veteran name, Social Security number, VA file number (if known), date of birth, and contact information. If filing as a survivor, provide both the veteran and survivor information.
Select the type of benefit
Check the box for the type of benefit you intend to claim: compensation (disability), pension, or survivors benefits (DIC or survivors pension).
Provide any additional information
If applicable, include the name and contact information of your representative (VSO, attorney, or claims agent) and any other relevant details.
Sign and submit
Sign and date the form. Submit it to the VA as soon as possible to establish your potential effective date. Then work on gathering evidence and completing your formal claim within 1 year.
About VA 21-0966 (Intent to File a Claim for Compensation and/or Pension)
Who needs this form
Veterans planning to file a disability compensation or pension claim, and surviving spouses or dependents planning to file for Dependency and Indemnity Compensation (DIC) or survivors pension. Filing this form first protects your effective date while you gather evidence.
Where to submit
Submit to the VA by mail to the Evidence Intake Center, by fax, or through a Veterans Service Organization (VSO). You can also submit an intent to file online at va.gov or by calling the VA at 1-800-827-1000.
Source and content freshness
- Reviewed: 2026-02-16
- Filing deadlines may shift for weekends and holidays. Verify due dates with official instructions.
Common mistakes to avoid
- Not submitting the formal claim within 1 year of the intent to file (the intent expires)
- Not specifying the correct type of benefit (compensation, pension, or survivors)
- Assuming the intent to file is the same as filing the actual claim
- Not following up with the complete claim application within the 1-year window
Frequently asked questions
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Why should I file an intent to file before my full claim?
Filing an intent to file establishes a potential effective date for your benefits up to one year before you submit the formal claim. This means if your claim is approved, your benefits may be backdated to the date you filed the intent to file, potentially resulting in a larger retroactive payment. Follow up with VA Form 21-526EZ to complete your disability compensation claim.
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