Fillable Form VBA 21-686c (2014-2017)

What is VA Form 21-686c?

VA Form 21-686c is issued by the United States Department of Veterans Affairs. VA Form 21-686c is used to submit a claim for additional benefits for a dependent, or to request to remove a dependent from your benefits. It is also known as Application Request to Add and/or Remove Dependents or Declaration of Status of Dependents.

The Veterans Affairs VA Form 21-686c this form to ensure that a dependent is still eligible for veterans ‘benefits. This information will be verified by the Department of Veterans Affairs in order to determine the eligibility of benefits for these dependents.

Who needs Form VA 21 686c?

To add dependents using paper forms, you will first need to determine the correct form:

• To add a spouse or child, fill out: VA Form 21-686c - Declaration of Status of Dependents
• To add a child over 18 who is attending school full time, you must fill out: VA Form 21-674 - Request for Approval of School Attendance in addition to VA Form 21-686c
• To add a parent as a dependent, fill out: VA Form 21P-509 - Statement of Dependency of Parent(s)

Veterans of the US Armed Forces with service-connected disabilities may qualify for financial assistance from the state. The amount of financial assistance to these veterans may vary depending on whether they have dependents or not.

Who is a dependent?

For the purposes of VA disability compensation, a dependent is defined as: a spouse, children, parents in your direct care whose income and net worth are below the limit set by law.

When to add a dependent?

A dependent should be added if you did not add dependents as part of your initial disability claim. Adding dependents is important if you receive a 30% or higher rating decision from the VA. In some cases, the VA will only pay back benefits to the date of the dependency claim.

The table below identifies the types of dependents for whom VA beneficiaries may be entitled to additional benefits.

If you are a …	Then you may be entitled to additional benefits for …
veteran entitled to disability compensation who has a combined disability rating of at least 30 percent	a spouse, children under age 18, children that are between the ages of 18 and 23 who are attending school, children over age 18 that are permanently incapable of self-support, and/or dependent parents.
veteran entitled to Veterans Pension	a spouse, children under age 18, children that are between the ages of 18 and 23 who are attending school, and/or children over age 18 that are permanently incapable of self-support.
surviving spouse entitled to survivors’ benefits	children under age 18, children that are between the ages of 18 and 23 who are attending school, and/or children over age 18 that are permanently incapable of self-support. Exception: A surviving spouse entitled to Dependency and Indemnity Compensation (DIC) is not entitled to additional benefits for children over age 18 that receive DIC in their own right.

How to fill out VA Form 21-686c?

You can fill out the VA form 21-686c online. A two-page form can be completed in 15 minutes.

Provide the following information:

1. Identification Information

a. Name of veteran

b. Veteran’s social security number

2.

a. Name of claimant

b. Claimant’s social security number

3. File number

4.

a. Addresss claimant

• No. and street or rural route, city or P.O., State and ZIP Code

b. E-mail address of claimant

• If applicable

5.

a. Check the appropriate marital status.

b. If married, put the spouse’s date of birth.

Section I – Veteran’s Marriages

6. How many times have you been married? (Including current marriage)

7.

a. Date and place of marriage

• City/State or Country

b. To whom married

• First, middle, last name

c. Social security number

d. How marriage terminated

• Death/Divorce

e. Date and place terminated

• City/County/State or Country

Section II – Spouse’s Previous Marriages

8. How many times has the veteran’s current or surviving spouse been married? (Including current marriage)

9.

a. Date and place of marriage

• City/State or Country

b. To whom married

• First, middle, last name

c. How marriage terminated

• Death/Divorce

d. Date and place terminated

10.

a.Is your spouse also a veteran?

• Check which box applies.

b. What is your spouse’s VA file number?

11. Do you live with your spouse?

• Check which box applies

12. What is your spouse’s address?

13. How much do you contribute monthly to your spouse’s support?

Section III – Veteran’s Unmarried Children

14.

a. Name of child

• First, middle initial, last

b. Date of birth

• City/State or Country

c. Social security number

For items 14d to 14i check all boxes that apply.

j. If you checked “stepchild,” is the stepchild the biological child of your spouse?

1. 1. • Check which applies.

If any of the children listed above don’t live with you, Items 15a through 15c must be answered.

15.

a. Name of child

• First, middle initial, last

b. Child's complete address

c. Name of person the child lives with

• If applicable

16. Remarks

17. Signature of claimant

a. Should be signed in ink

18. Date

19. Telephone numbers

• Include area code

a. Daytime

b. Nighttime

If you have other questions on how to fill out this form, you can contact an accredited veteran service officer (VSO) to help you with your application. A list of veterans’ service organizations is available at the official veteran’s website.

Where to file VA Form 21-686c?

The filled-in copy of the form should be sent to the regional Veterans Affairs intake center that will process the documents and inform the claimant of any changes to their status. Is the Form VA 21 686c accompanied by other forms? Submission of this form is most often preceded by filing other documents. For spouses, a marriage certificate must be included, while dependent children must have their birth certificates included. Once all information is included in this form and submitted to the Department, a decision can be made on whether or not a dependent is eligible for benefits from the VA.