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Vba 21 8764 Are

DISABILITY COMPENSATION AWARD ATTACHMENT

IMPORTANT INFORMATION

WHEN WILL YOU RECEIVE YOUR FUNDS?

Depending on whether you elect to receive your monthly compensation by check or direct deposit, you should receive

your funds within 15 days. Thereafter, your payments will be made at the beginning of each month for the prior month.

HOW CAN YOU RECEIVE HOSPITALIZATION AND OUTPATIENT TREATMENT?

Veterans who have one or more service-connected disabilities as determined by the Veterans Benefits Administration are

eligible for medical care through the VA health care system. If you are interested in obtaining VA medical care, you may

contact your nearest VA health care facility or the VA Health Revenue Center at 1-877-222-8387.

HOW CAN YOU RECEIVE DENTAL TREATMENT?

If you are evaluated as 100% disabled for service-connected disabilities or as 100% disabled because of Individual

Unemployability, you may be eligible for VA dental treatment. For additional information, contact your nearest VA

medical center or outpatient Clinic. You can find the address of your closest VA medical center or facility by going to the

VA internet website //www.va.gov/directory.

HOW CAN YOU RECEIVE EDUCATIONAL BENEFITS?

A monthly educational assistance allowance is payable to certain veterans. Each program has unique eligibility criteria

specified by law, and only one program can be used at any given time. If you need help with your VA education benefits,

you can call toll-free 1-888-442- 4551 or visit the VA national education website at //www.gibill.va.gov.

VA FORM

MAY 2009

21-8764

(See reverse)

HOW CAN YOU RECEIVE ADDITIONAL COMPENSATION FOR DEPENDENTS?

Veterans having a 30% or more service-connected evaluation may be entitled to additional compensation for a spouse,

dependent parents, unmarried children under 18 (or under 23 if attending an approved school) or a child who became

permanently incapable of self-support because of mental or physical defect prior to age 18. The additional benefit for a

spouse is payable in a higher amount upon receipt of evidence establishing that the spouse is a patient in a nursing home

or so disabled as to require the aid and attendance of another person.

HOW CAN YOU RECEIVE GOVERNMENT LIFE INSURANCE?

If you receive a rating for a new service-connected disability (even 0%), you may be eligible for Government life

insurance if you are in good health (except for service-connected conditions) and apply within two years of this

notification of your new disability rating. Call our toll-free number 1-800-669-8477 or visit our

website //www.insurance.va.gov for further information about Service-Disabled Veterans Insurance.

SUPERSEDES VA FORM 21-8764, FEB 2004,

WHICH WILL NOT BE USED.

HOW CAN YOU RECEIVE A CLOTHING ALLOWANCE?

You may be eligible for a clothing allowance if, because of a service-connected disability, you wear or use a prosthetic

device or orthopedic appliance which tends to wear or tear clothing. You may also be eligible if a doctor has prescribed

medication for a service-connected skin condition, and the medication causes irreparable damage to your outer garments.

To apply for this benefit, contact the Prosthetic and Sensory Aids Service at your nearest VA medical center or outpatient

clinic. The address of your closest VA medical center or facility is available on the VA internet website

//www.va.gov/directory .

HOW CAN YOU RECEIVE INCREASED BENEFITS BASED ON INDIVIDUAL UNEMPLOYABILITY?

If your service-connected disabilities are seriously disabling to the extent that you are unable to secure and hold steady

work/employment, you may apply to receive total disability. To apply for this benefit, you should contact the nearest VA

office and complete VA Form 21-8940, "Veteran's Application for Increased Compensation Based on Unemployability,"

available on the VA forms website at www.va.gov/vaforms.

1. Your award of disability compensation is subject to future adjustment upon receipt of evidence showing any change in

the degree of disability.

2. Your payments may also be affected by any of the following circumstances which you must promptly call to our

attention.

a. Reentrance into active military or naval service.

b. Receipt of armed forces service retirement pay, unless your retirement pay has been reduced

because of award of disability compensation.

c. Receipt of benefits from the Office of Federal Employees Compensation.

d. Receipt of active duty or drill pay as a reservist or member of the Federally recognized

National Guard.

3. If you have a disability rating of 30% or more, you must promptly advise us of any change in the status of your

dependents.

4. If your award includes special monthly compensation due to the need for aid and attendance, this additional allowance

is generally subject to reduction from the first day of the second calendar month of admission to hospitalization, nursing

home or domiciliary care at VA expense.

5. Benefits will be reduced upon incarceration in a Federal, State or local penal institution in excess of 60 days for

conviction of a felony. The amount not payable may be apportioned to a spouse, dependent children or parents.

6. Monthly payments of your award may be stopped if you fail to furnish evidence as requested, fail to cooperate or

submit to a VA examination when requested, or if you furnish VA, or cause to be furnished, any false or fraudulent

evidence.

7. Information submitted is subject to verification through computer matching programs with other agencies.

8. The law provides severe penalties, which include fine, imprisonment, or both, for the fraudulent acceptance of any

payment to which you are not entitled.

WHAT CONDITIONS AFFECT RIGHT TO PAYMENTS?

ARE YOUR BENEFITS EXEMPT FROM CLAIMS OR CREDITORS?

Compensation payments are exempt from claims of creditors. With certain exceptions, the payments are not assignable

and are not subject to attachment, levy or seizure except as to claims of the United States.

AM I ELIGIBLE FOR COMMISSARY AND EXCHANGE PRIVILEGES?

Honorably discharged veterans evaluated as 100 percent disabled due to service-connected disability, Medal of Honor

recipients or, military retirees and their dependents may qualify for Armed Forces Commissary and Exchange privileges.

Please notify VA immediately if there is a change in any condition affecting your right to continued payments. Failure to

notify us of these changes immediately may result in a debt that you will have to repay.

IMPORTANT

TO SEND ANY COMPLETED, SIGNED FORMS OR TO FURNISH ANY INFORMATION TO VA

You can obtain the address to mail VA any information or completed forms by calling toll-free 1-800-827-1000 (for the

hearing impaired call 1-800-829-4833). You can also locate the address of the closest VA regional office on the Internet

at //www.va.gov/directoryor in the Government pages of your telephone book under "United States Government,

Veterans."

HOW DO I FIND OUT ABOUT STATE OR LOCAL BENEFITS FOR SERVICE-CONNECTED VETERANS?

You should contact your State or local office of veterans' affairs for information on any tax, license, or fee-related benefits

for which you may be eligible as a veteran (or surviving dependent of a veteran). State offices of veterans' affairs are

available at //www.va.gov/statedva.htm. You should also contact your local tax assessor's office to ask if you are

entitled to any personal or property tax relief.

HOW DO YOU REPORT A CHANGE OF ADDRESS OR DIRECT DEPOSIT?

Please notify us by calling our toll-free number at 1-877-838-2778.

VA FORM 21-8764, May 2009