Request for Aid and Attendance Allowance for Dependency and Indemnity Compensation (DIC) Recipients

According to your answers, we believe you may be entitled to the DIC Aid and Attendance allowance of $387 per month.

If you are not already receiving DIC from the VA, please contact the VA at 800-827-1000 and ask them what you are receiving and if you are eligible for the Aid and Attendance benefit.

To request this increase please submit the following forms to the Department of Veterans Affairs by fax or certified mail:

1.) VA Form 21-4138 Complete the top portion of the form, have the Surviving Spouse sign and date.

2.) VA Form 21-2680 Medical Statement: Have your primary care physician fill out the Medical Statement. The more detail provided by the doctor the better. You may also include copies of your recent medical records.

Mail or Fax the above documents to the following:

Department of Veterans Affairs Pension Intake Center
P.O. Box 5635
Janesville, WI 53547

Always send the original application via Certified Mail “Registered Return Receipt” or Fax. Keep a copy of everything you send for your own records.

If you have any further questions, please call the VA at 800-827-1000.