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  • 14 Questions about VA Disability Compensation Benefits Claims

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    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
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  • Can a 100 percent Disabled Veteran Work and Earn an Income?

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    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

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Question

I'm having some trouble understanding the 21-4192 document,

in section 1 it says in parenthesis (to be completed by VA) 

and below that it has address blocks 1 and 2 (and the word "complete" in parentheses) 

Pretty sure my former employer's information goes into block one (filled out by me?) 

but i'm not sure what goes in block 2 - It says "return to" between the blocks

Thanks for any assistance you can give. :smile:

Edited by stovokore

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Good question. 

When I looked up this form online, it was strangely absent.  My guess:  This form is no longer used, but that is a guess.  Can you call your VSO and ask him?  Try an IRIS inquiry.  Or maybe someone else can chime in.  

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6 hours ago, broncovet said:

Good question. 

When I looked up this form online, it was strangely absent.  My guess:  This form is no longer used, but that is a guess.  Can you call your VSO and ask him?  Try an IRIS inquiry.  Or maybe someone else can chime in.  

Thanks for responding. I'v re read my comment and I see now that I made a typo regarding the form number. Its actually 21-4192 (not 21-4129)  

http://www.nd.gov/veterans/files/resource/21-4192.pdf is where you can find an example of the document. 

Iv thought about seeking a VSO and asking him but they are difficult to track down in the small town I live in. 

Thanks for any advice you can give me, iv got about 25 days left to complete the form and upload it to ebenefits 

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I agree its confusing.   This is the form sent to your employer for him to fill, sign and return.  This was not done THIS way, when I applied.  

I have 2 suggestions:

1.  Put the name of the employer, and the employer address in the applicable box, even if it says to be filled out by VA, after all, why would the VA know who you worked for, unless you told them.  

2.  If you dont like that idea, you can ask a VSO, who is supposed to do this stuff everyday.

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The form is sent to your employer for verification, then its supposed to be returned by your employer to VA.  Hope this helps.  

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