Report of Medical, Legal, and Other Expenses Incident to Recovery for Injury or Death (21P-8416b)

Report of Medical, Legal, and Other Expenses Incident to Recovery for Injury or Death (VA Form 21P-8416b)

OMB: 2900-0545

IC ID: 28721

Documents and Forms

Document Name Document Type
Form 21P-8416b Report of Medical, Legal, and Other Expenses Incident to Recovery for Injury or Death (21P-8416b) Form
21P-8416b Report of Medical, Legal, and Other Expenses Incident to Recovery for Injury or Death VA Form 21P-8416b -New Burden Statement (508 Conformant 6-20-23) 3-28-24.pdf www.va.gov/vaforms Form