VA Form 21-0779, Request for Nursing Home Information in Connection with Claim for Aid and Attendance is a form used to put the level of care required by a claimant or a claimant's dependent on record. This form is used only for certain non-service-connected pension claims.
The latest version of the form was released by the Department of Veterans Affairs (VA) in February 2017 with all previous editions obsolete. An up-to-date VA Form 21-0779 fillable version is available for digital filing and download below or can be found through the VA Forms website.
The VA "Aid and Attendance Form 21-0779" is designed specifically for individuals who are residents of nursing homes. Documenting the level of required care is necessary to support a claim for additional pension above and beyond the base level and to support the need for certain medical expenses.
Accessing medical records is vital in advocating for quality care for residents. Residents and their legal representatives have the right to put in a request for nursing home records pertaining to their care, including current clinical records. Residents also have the right to purchase additional photocopies of their medical records. A claim cannot be filed with a general or durable power of attorney.