Information Collection

Veteran's Application for Increased Compensation Based on Unemployability (VA Form 21-8940)

IC 28617 under ICR 202009-2900-013 · OMB 2900-0404.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0404 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VA Form 21-8940 Veteran's Application for Increased Compensation Based on Unemployability (VA Form 21-8940)	Form
VA Form 21-8940 Veterans Application for Increased Compensation Based on 21-8940(2-03-21).pdf www.va.gov/vaforms	Form

IC Title:

Veteran's Application for Increased Compensation Based on Unemployability (VA Form 21-8940)

Agency IC Tracking Number:

2900-0404

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 3.341 38 CFR 4.16 38 CFR 3.340

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	VA Form 21-8940	Veterans Application for Increased Compensation Based on Unemployability	21-8940(2-03-21).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records

Title: 58VA21/22/28 Compensation, Pension, Education and Vocational Rehabilitation & Employment Records

FR Citation: 86 FR 10114

Number of Respondents: 19,609

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	19,609	-4,391	24,000
Annual IC Time Burden (Hours)	14,707	-3,293	18,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.