VA Form 21-8951-2 Notice of Waiver of VA Compensation or Pension to Receive Military Pay and Allowances

VA Form 21-8951-2 is a U.S. Department of Veterans Affairs form also known as the "Notice Of Waiver Of Va Compensation Or Pension To Receive Military Pay And Allowances". The latest edition of the form was released in May 1, 2018 and is available for digital filing.

Download a PDF version of the VA Form 21-8951-2 down below or find it on U.S. Department of Veterans Affairs Forms website.

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OMB Approved No. 2900-0463
Respondent Burden: 10 minutes
Expiration Date: 05/31/2021
VA DATE STAMP
(DO NOT WRITE IN THIS SPACE)
NOTICE OF WAIVER OF VA COMPENSATION OR PENSION TO RECEIVE
MILITARY PAY AND ALLOWANCES
IMPORTANT: We need this information to determine whether you choose to waive your VA compensation
or pension or your military pay and allowances for the days for which you received training pay (10 U.S.C.
12316 and 38 U.S.C.5304(c)). If you have any questions about the information contained on this form or if
you need assistance in completing the form, call VA's toll-free number 1-800-827-1000.
NAME AND ADDRESS OF VETERAN
FROM
TO
SECTION I - VETERAN'S IDENTIFICATION INFORMATION
NOTE: You can either complete the form online or by hand. Please print the information required in ink, neatly, and legibly to help process the form.
1. NAME OF VETERAN (First, Middle Initial, Last)
4. DATE OF BIRTH (MM/DD/YYYY)
2. SOCIAL SECURITY NUMBER
3. VA FILE NUMBER
5. VETERAN'S SERVICE NUMBER (If applicable)
7. EMAIL ADDRESS (Optional)
6. TELEPHONE NUMBER (Include Area Code)
SECTION II - TRAINING PAY INFORMATION
Based on your Social Security Number (SSN), the Defense Manpower Data Center (DMDC) has identified you as having been a reservist or guardsman
during the fiscal year indicated below. Please verify that the Social Security number shown above is your correct Social Security number. If it is not,
please enter the correct number. Also, please enter your telephone number above.
By law, active or inactive duty training pay can't be paid at the same time you're receiving VA disability compensation or pension benefits. You may decide
to keep the training pay you received from your military branch. However, to keep your training pay, you must waive your VA benefits for the same number
of days as the number of days you received training pay. Usually, it's to your advantage to waive benefits and keep your training pay.
Please enter the number of days for which you received training pay below.
FISCAL YEAR
TRAINING DAYS
NOTE: A fiscal year runs from October 1 through September 30. For example, fiscal year 2017 runs from October 1, 2016 through September 30, 2017.
Please note that the National Guard and Reserves report one full day's duty pay for each 4-hour session of training you attend. That means they may
credit you with 4 days' worth of training for a 2-day drill weekend. The National Guard and Reserves pay most of their members for about 63 training
days during a fiscal year. That included 48 armory drills or training sessions, and 15 days of active training.
Please fill out this form, sign it, have your unit commander or commander's designee sign it, and return it to one of the addresses listed on page 3.
VA FORM
21-8951-2
EXISTING STOCK OF VA FORM 21-8951, DEC 2016,
Page 1
MAY 2018
WILL BE USED.
OMB Approved No. 2900-0463
Respondent Burden: 10 minutes
Expiration Date: 05/31/2021
VA DATE STAMP
(DO NOT WRITE IN THIS SPACE)
NOTICE OF WAIVER OF VA COMPENSATION OR PENSION TO RECEIVE
MILITARY PAY AND ALLOWANCES
IMPORTANT: We need this information to determine whether you choose to waive your VA compensation
or pension or your military pay and allowances for the days for which you received training pay (10 U.S.C.
12316 and 38 U.S.C.5304(c)). If you have any questions about the information contained on this form or if
you need assistance in completing the form, call VA's toll-free number 1-800-827-1000.
NAME AND ADDRESS OF VETERAN
FROM
TO
SECTION I - VETERAN'S IDENTIFICATION INFORMATION
NOTE: You can either complete the form online or by hand. Please print the information required in ink, neatly, and legibly to help process the form.
1. NAME OF VETERAN (First, Middle Initial, Last)
4. DATE OF BIRTH (MM/DD/YYYY)
2. SOCIAL SECURITY NUMBER
3. VA FILE NUMBER
5. VETERAN'S SERVICE NUMBER (If applicable)
7. EMAIL ADDRESS (Optional)
6. TELEPHONE NUMBER (Include Area Code)
SECTION II - TRAINING PAY INFORMATION
Based on your Social Security Number (SSN), the Defense Manpower Data Center (DMDC) has identified you as having been a reservist or guardsman
during the fiscal year indicated below. Please verify that the Social Security number shown above is your correct Social Security number. If it is not,
please enter the correct number. Also, please enter your telephone number above.
By law, active or inactive duty training pay can't be paid at the same time you're receiving VA disability compensation or pension benefits. You may decide
to keep the training pay you received from your military branch. However, to keep your training pay, you must waive your VA benefits for the same number
of days as the number of days you received training pay. Usually, it's to your advantage to waive benefits and keep your training pay.
Please enter the number of days for which you received training pay below.
FISCAL YEAR
TRAINING DAYS
NOTE: A fiscal year runs from October 1 through September 30. For example, fiscal year 2017 runs from October 1, 2016 through September 30, 2017.
Please note that the National Guard and Reserves report one full day's duty pay for each 4-hour session of training you attend. That means they may
credit you with 4 days' worth of training for a 2-day drill weekend. The National Guard and Reserves pay most of their members for about 63 training
days during a fiscal year. That included 48 armory drills or training sessions, and 15 days of active training.
Please fill out this form, sign it, have your unit commander or commander's designee sign it, and return it to one of the addresses listed on page 3.
VA FORM
21-8951-2
EXISTING STOCK OF VA FORM 21-8951, DEC 2016,
Page 1
MAY 2018
WILL BE USED.
VETERAN'S SOCIAL SECURITY NO.
SECTION III - ELECTION NOTICE
8.
Complete the appropriate box below, sign this form, secure the signature of your unit commander or designee, and return the completed form to VA
within 60 days. Check one of the following boxes. If you check neither, we will assume that you agree with the number of training pay days shown
on the front of this form.
I agree that the number of training days shown on the front of this form is correct.
The number of training days shown on the front of this form is not correct. The following is the actual number of days for
which I received training pay. (Enter correct information in the boxes below).
FISCAL YEAR
TRAINING DAYS
9.
Check only one of the following boxes:
I elect to waive VA benefits for the days indicated in order to retain my training pay.
I elect to waive military pay and allowances for the days indicated in order to retain my VA compensation or pension.
NOTE: Checking this option will give most veterans LESS money.
I received no military pay and allowances during the fiscal year indicated on page 1 of this form.
SECTION IV - CERTIFICATION AND SIGNATURE
If we do not receive a waiver from you, we will assume that you wish to waive VA compensation or pension for the number of days printed on the front of
the form. However, we will not adjust your award until we have advised you of the specific changes we propose to make.
NOTE: In the past you may have filed a one-time waiver of disability benefits which was to remain in effect until your reserve/guard status changed or you
withdrew the waiver. That waiver is no longer valid. Annual waivers are again required.
10. SIGNATURE OF RESERVIST/GUARDSMAN (REQUIRED)
11. DATE SIGNED (MM/DD/YYYY)
I CERTIFY THAT to the best of my knowledge, the information shown above concerning the member's training days is correct.
13. DATE SIGNED (MM/DD/YYYY)
12. SIGNATURE OF UNIT COMMANDER OR DESIGNEE (REQUIRED)
14. NAME AND MAILING ADDRESS OF RESERVE/GUARD UNIT
15. UNIT TELEPHONE NO. (Include Area Code)
PRIVACY ACT NOTICE: VA will not disclose information collected on this form to any source other than what has been authorized under the Privacy Act of 1974 or
Title 38, Code of Federal Regulations 1.576 for routine uses (i.e., civil or criminal law enforcement, congressional communications, epidemiological or research studies,
the collection of money owed to the United States, litigation in which the United States is a party or has an interest, the administration of VA programs and delivery of VA
benefits, verification of identity and status, and personnel administration) as identified in the VA system of records, 58VA21/22/28, Compensation, Pension, Education,
and Vocational Rehabilitation and Employment Records - VA, published in the Federal Register. Your obligation to respond is required to obtain or retain benefits. The
requested information is considered relevant and necessary to determine maximum benefits under the law. The responses you submit are considered confidential (38 U.S.
C. 5701). Information submitted is subject to verification through computer matching programs with other agencies.
RESPONDENT BURDEN: We need this information to determine whether you choose to waive your VA compensation or pension or your military pay and
allowances for the days for which you received training pay (10 U.S.C. 12316 and 38 U.S.C. 5304(c). Title 38, United States Code, allows us to ask for this information.
We estimate that you will need an average of 10 minutes to review the instructions, find the information, and complete the form. VA cannot conduct or sponsor a
collection of information unless a valid OMB control number is displayed. You are not required to respond to a collection of information if this number is not displayed.
Valid OMB control numbers can be located on the OMB Internet Page at www.reginfo.gov/public/do/PRAMain. If desired, you can call 1-800-827-1000 to get
information on where to send comments or suggestions about this form.
PENALTY: The law provides severe penalties which include fine or imprisonment, or both, for the willful submission of any statement or evidence of a material fact,
knowing it to be false, or for fraudulent acceptance of any payment to which you are not entitled.
VA FORM
21-8951-2
Page 2
MAY 2018
D
V
A
EPARTMENT OF
ETERANS
FFAIRS
Where to Send Your Written Correspondence
In order to properly determine where to send your written correspondence, please first
identify your benefit type (Compensation, Veterans Pension, or Survivors Benefits); then,
locate the corresponding address based on your location of residence.
For correspondence relating to all Compensation claims:
Location of Residence
Address
All United States and Foreign Locations
Department Of Veterans
Affairs Evidence Intake Center
P.O. Box 4444
Janesville WI 53547-4444
Or fax your information to:
Toll Free: 844-531-7818
* Note: For foreign Veterans Pension and Survivors
Local: 248-524-4260
Benefits please refer to the below addresses.
For correspondence relating to all Veterans Pension and Survivors Benefits claims:
Location of Residence
Address
Alabama
Kentucky
Missouri
Department Of Veterans
Arkansas
Louisiana
Ohio
Affairs Claims Intake Center
Illinois
Michigan
Tennessee
Attention: Milwaukee Pension
Indiana
Mississippi
Wisconsin
Center
P.O. Box 5192
Janesville WI 53547-5192
Or Fax your information to:
Toll Free: (844) 655-1604
Alaska
Montana
Texas
Arizona
Nebraska
Utah
Department Of Veterans
California
Nevada
Washington
Affairs Claims Intake Center
Colorado
New Mexico
Wyoming
Attention: St. Paul Pension
Hawaii
North Dakota Mexico
Center
Idaho
Oklahoma
Central America
P.O. Box 5365
Iowa
Oregon
South America
Janesville WI 53547-5365
Kansas
South Dakota Caribbean
Or fax your information to:
Minnesota
Toll Free: (844) 655-1604
Connecticut
New Hampshire
South Carolina
Department Of Veterans
Delaware
New Jersey
Vermont
Affairs
Claims Intake Center
Florida
New York
Virginia
Attention: Philadelphia Pension
Georgia
North Carolina
West Virginia
Center
Maine
Pennsylvania
District of Columbia
P.O. Box 5206
Maryland
Rhode Island
Puerto Rico
Massachusetts
Canada
Janesville WI 53547-5206
Or fax your information to:
Toll Free: (844) 655-1604
Countries outside of North, Central or South America
VA Form 21-8951, MAY 2018
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