Fill out VA 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance) online
VA Form 21-2680 is a medical examination form used to establish a veteran eligibility for Aid and Attendance (A&A) or Housebound benefits. These are additional monthly payments added on top of existing VA disability or pension benefits for veterans who require the regular assistance of another person for daily activities or who are substantially confined to their home due to a disability.
How to fill out VA 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance)
Enter veteran identification information
Provide the veteran full name, Social Security number, VA file number, date of birth, and contact information. Indicate whether the claim is for Aid and Attendance, Housebound status, or both.
Complete the medical examination with a physician
Schedule an appointment with a licensed physician to complete the medical examination section. The physician must document the veteran diagnoses, the specific functional limitations, and the type and frequency of assistance required for daily activities.
Document daily living limitations
The physician should detail whether the veteran can dress, bathe, eat, attend to needs of nature, and manage medications independently. Include any mobility limitations, vision or cognitive impairments, and whether the veteran requires a protected environment.
Sign and submit with supporting evidence
The veteran signs the claim section and the physician signs the examination section. Submit the completed form along with any supporting medical records, treatment notes, or other documentation that demonstrates the need for aid and attendance or housebound status.
About VA 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance)
Who needs this form
Veterans receiving VA disability compensation or pension benefits who need the regular aid of another person to perform daily activities such as bathing, dressing, eating, or attending to the needs of nature. Also used by veterans who are substantially confined to their home or immediate premises due to permanent disability.
Where to submit
Submit to the VA by mail to the Evidence Intake Center or the Pension Management Center handling your claim, by fax, or through your Veterans Service Organization (VSO). The examination portion must be completed by a licensed physician.
Source and content freshness
- Reviewed: 2026-02-24
- Filing deadlines may shift for weekends and holidays. Verify due dates with official instructions.
Common mistakes to avoid
- Not having the medical examination section completed by a licensed physician (self-reported information is insufficient)
- Failing to describe specific daily activities the veteran cannot perform without assistance
- Not documenting the frequency and type of assistance needed in sufficient detail
- Submitting without attaching additional medical evidence that supports the need for aid and attendance
Frequently asked questions
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What is the difference between Aid and Attendance and Housebound benefits?
Aid and Attendance benefits are for veterans who require the regular assistance of another person to perform everyday activities such as bathing, dressing, eating, or managing medications. Housebound benefits are for veterans who are substantially confined to their home or immediate premises due to a permanent disability. You cannot receive both simultaneously. Aid and Attendance generally provides a higher additional payment. The VA determines which benefit applies based on the medical evidence submitted with this form.
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